• Title/Summary/Keyword: external skeletal fixation

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Assessment of neovascularization during bone healing using contrast-enhanced ultrasonography in a canine tibial osteotomy model: a preliminary study

  • Jeon, Sunghoon;Jang, Jaeyoung;Lee, Gahyun;Park, Seungjo;Lee, Sang-kwon;Kim, Hyunwook;Choi, Jihye
    • Journal of Veterinary Science
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    • v.21 no.1
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    • pp.10.1-10.12
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    • 2020
  • Blood perfusion of skeletal muscle and callus was evaluated using contrast-enhanced ultrasonography (CEUS) in a canine osteotomy model to determine the applicability of CEUS in the assessment of neovascularization during fracture healing and to compare the vascular signals on CEUS between external skeletal fixation and cast-applied dogs. In 6 Beagle dogs, a simple transverse osteotomy was performed at the left tibial shaft and external skeletal fixation (n = 3) or a cast (n = 3) was applied. Radiography, power Doppler ultrasonography (power Doppler), and CEUS were performed until complete union was achieved. On CEUS, vascular changes were quantitatively evaluated by measuring peak intensity (PI) and time to PI in the soft tissue and callus and by counting the vascular signals. Vascular signals from the soft tissue were detected on power Doppler and CEUS on day 2. Significantly more vascular signals were detected by CEUS than by power Doppler. On CEUS, PI in the surrounding soft tissue was markedly increased after the fracture line appeared indistinctively changed on radiography in all dogs. In the cast-applied dogs, vascular signals from the periosteal and endosteal callus were detected on CEUS before mineralized callus was observed on radiography. CEUS was useful in assessing the vascularity of soft tissue and callus, particularly in indirect fracture healing, and provided indications of a normally healing fracture.

Stabilization of Short Juxta-articular Fractures Using a Circular External Skeletal Fixator System in Dogs (개에서 원형외고정장치를 이용한 관절주위 골절의 안정화)

  • Cheong, Hye-Yeon;Kim, Joo-Ho;Cha, Jae-Gwan;Seol, Jae-Won;Kim, Min-Su;Lee, Hae-Beom
    • Journal of Veterinary Clinics
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    • v.31 no.6
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    • pp.523-526
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    • 2014
  • Three dogs were admitted for repair of bone fracture. Case 1 (Maltese, 1.8 kg, intact female, 5-month-old) and case 2 (poodle, 3.0 kg, intact female, 6-month-old) had non-weight bearing lameness in the left pelvic limb, and case 3 (mixed, 3.3 kg, intact female, age unknown) had non-weight-bearing lameness in the left thoracic limb. On orthopedic examination, there was pain, crepitus, palpable instability and substantial soft tissue swelling on the affected side. No neurological deficits were identified. Radiographs revealed left proximal metaphyseal tibial and fibular fractures in cases 1 and 2, and left proximal metaphyseal radial and ulnar fractures in case 3. All cases had closed long-bone fractures with short juxta-articular fracture segments. Under fluoroscopic guidance, proper placement of the ring fixation elements was confirmed during surgery. Two or three rings were used to stabilize fractures with traditional circular external skeletal fixators (CESF). Postoperative radiographs showed acceptable alignment and apposition of the previously identified fracture. Time to radiographic union ranged from 5 to 14 weeks and there were no signs of implant failure or pin tract infection. Functional outcomes were excellent in all cases. CESF can be successfully used to reduce short juxta-articular fractures in which bone plates or external skeletal fixation cannot be applied.

LATE RECONSTRUCTION OF PARTIALLY-RESECTED MANDIBLE AFTER REMOVAL OF AMELOBLASTOMA OF THE MANDIBLE (하악골 부분절제술후 이물성형재료에 의한 즉시재건술이 실패된 예에서 양측 장골뼈와 Miniplate Osteosynthesis 를 이용하여 재건시킨 법랑아세포종 치험 1예)

  • Park, Hyung-Sik;Kim, Sun-Yong;Kwon, Joon-Ho;Lee, Sang-Hye
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.12 no.1
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    • pp.171-179
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    • 1990
  • This is a report on a case of delayed reconstruction after partial mandibularectomy for Ameloblastoma involving symphysis and bodies of the mandible by using of two large pieces of corticocancellous bone blocks obtained from both iliac crests. The authors failed immediate reconstruction with two kinds of Alloplasts(metal, methylmethacrylate) at two times of trial due to known infection and suggestive poor histocompatibility of materials aginst the host who has been suffered from long-term and active pulmonary tuberculosis. However we could get success late reconstruction of this problem-occured and curved area with two pieces of large corticocancellous blocks by using of miniplate osteosynthesis and biphasic external pin fixation. From our experience we are obtained some results as follows : 1. Alloplastic graft materials seemed to be dangerous to maintain successfuly in patient who has a long-term debilitating disease as a active pulmonary tuberculosis. 2. Biphasic external skeletal pin fixation appliance gave many advantages such as maintain functional position of the remained bodies and condyles of the mandible after removal of failed alloplasts and during control of inflammation of this area, assist supportive roles to fix and maintain bone grafts during healing, allow mandibular movement during healing and so offer to conduct normal functional stimuli to bone grafts during osteogenesis etc. 3. Bony union was successful between not only normal bones and grafted bones but also grafted bone pieces even though we used two pieces of large blocks of corticocancellous bone for graft. 4. Miniplate osteosynthesis was not affect any adverse effects to bone grafts but offered good role of fixation and maintenance for bone grafts.

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Tibiotarsal and Ulnar Fracture Repair in a Great Horned Owl (Bubo virginianus)

  • Yoon, Hun-Young;Fox, Derek B.;Jeong, Soon-Wuk
    • Journal of Veterinary Clinics
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    • v.25 no.3
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    • pp.218-220
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    • 2008
  • A 1.4 kg adult great homed owl was presented to the University of Missouri-Columbia Veterinary Teaching Hospital after being found by the side of the highway. Physical examination revealed soft tissue injuries to the left wing and leg, and good body condition (body score 4/5). The radiographs revealed comminuted fracture of the diaphysis of the left tibiotarsus (severe) and ulna (mild). Closed reduction of the fracture was performed to the left tibiotarsus and ulna. System combining an intramedually (IM) Kirschner pin, IM Kirschner pin for external skeletal fixation, and polymethylmethacrylate was used for fracture repair. At 13 weeks, radiographs revealed that bridging callus was well formed over cortices of the fracture area. No physical, behavioral, or other assessable impairment was found during the rehabilitation period.

Single oblique osteotomy for correction of congenital radial head luxation with concurrent complex angular limb deformity in a dog: a case report

  • Kim, Junhyung;Song, Jaeyong;Kim, Sun-Young;Kang, Byung-Jae
    • Journal of Veterinary Science
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    • v.21 no.4
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    • pp.62.1-62.7
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    • 2020
  • A 5-month old Shih Tzu was diagnosed with congenital elbow luxation and uniapical complex angular deformity of the radius. Single radial oblique and dynamic ulnar osteotomies were performed, using patient-specific 3D-printed osteotomy guide. External skeletal fixation was maintained for three weeks to prevent re-luxation of elbow joint. Three months after the surgery, objective gait analysis indicated markedly improved limb function. In addition, radiograph showed improved congruity of elbow joint and appropriate bone healing. In dogs with congenital radial head luxation and concurrent complex angular deformity, a single oblique osteotomy might be a viable option to preserve bone length and correct the luxation of elbow joint.

Fracture analysis of wild mammals in South Korea

  • Jang, Hyunkyu;Park, Jong-Moon;Ahmed, Sohail;Seok, Seong-Hoon;Kim, Ho-Su;Yeon, Seong-Chan
    • Korean Journal of Veterinary Research
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    • v.59 no.4
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    • pp.175-180
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    • 2019
  • This study was conducted to evaluate and analyze fractures types in wild mammals in Korea. Wild mammals treated at 3 wildlife centers in Korea were included. Of the 63 cases included in this study, water deer was the most common species encountered with fractures. We determined 85 different fracture sites, with maximum lumber vertebral fractures followed by femoral, tibial and pelvic fractures. External skeletal fixator (ESF)-intramedullary (IM) pin (IM+ESF tie-in fixation) was the most common method applied for the surgical treatment of mammals. Lumbar vertebrae and femur were the most common bones involved. The findings of this study are expected to provide information for veterinarians regarding the frequency and characteristics of fractures in wild mammals and serve as a basic database for the types and outcomes of fractures in wild mammals.

DISTRACTION OSTEOGENESIS OF THE MIDFACE WITH A RIGID EXTERNAL DISTRACTOR (RED) (강성 외장형 신장기(Rigid External Distractor)를 이용한 중안면부의 골신장술)

  • Oh , Jung-Hwan;Alexander, Kuebler.;Zoeller, Joachim E.
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.28 no.2
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    • pp.161-164
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    • 2002
  • In recent, distraction osteogenesis has been used to correct skeletal malformations and discrepancies in the craniofacial area. It also seems to be considered as an alternative in the treatment of severe midfacial hypoplasia. There are some types of distractors for midfacial distraction such as subcutaneous distractors and rigid external distractors. We used a rigid external distractor for correction (RED) of craniofacial hypoplasia. Seven patients underwent a midfacial distraction osteogenesis with a rigid external distractor between April 2000 and July 2001. Three patients suffered from Apert's syndrome, three patients from Crouzon's syndrome, and one patient suffered from midfacial hypoplasia due to midfacial radiotheraphy during childhood. On average, the mean distance of distraction was 19.8mm ($10{\sim}25mm$) and the distraction lasted for 24 days. The patients showed no severe complications like infections, optic disturbance, or wrong distraction vectors. One patient complained pain on the site of the occipital fixation of the distractor. In one patient who underwent subtotal craniectomy 3 months before Le Fort III distraction, the distractor was dislocated as the cranial bone was too weak to support the distractor. This report reveals that the application of rigid external distractor and transfacial pull results in an exact control of the distraction vectors and an excellent correction of midfacial hypoplasia without any severe complications.

Effects of Intramedullary K-wire Insertion on Femoral Lengthening in Canine with Monolateral External Fixator (단측성 외고정 기구를 이용한 개의 대퇴골 신연에 있어서 골수강내 K-강선 삽입의 효과)

  • Hwang, Jae-Min;Kim, Young-Ki;Chin, Hee-Tec;Seok, Seong-Hoon;Lee, Hee-Chun;Koh, Phil-Ok;Chang, Hong-Hee;Lee, Hyo-Jong;Yeon, Seong-Chan
    • Journal of Veterinary Clinics
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    • v.23 no.3
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    • pp.291-299
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    • 2006
  • During long bone lengthening, there are many disadvantages including axial deviation, malalignment and re-fracture which are commonly encountered inspite of its proven abilities. To study the effects of intramedullary K-wire application on the lengthening of long bone, ten skeletally mature mongrel dogs were separated into two groups(Group I, II). Right femurs of group I(5 dogs) were fixed with only monolateral external fixator after subperiosteal osteotomy. Right femurs of group II(5 dogs) were fixed with mono lateral external fixator and intramedullary K-wire after subperiosteal osteotomy. Lengthening was started at 7 days after the surgery with the rate of 0.5 mm per day for 5 weeks and the dogs were sacrificed after 15 weeks postoperatively to examine histologic differences and evaluate bone mineral density. Radiographic examination at an interval of two weeks was done to evaluate the type of callus formed and to analyze complications including instability of external skeletal fixation and axial deviation. Bone mineral density at the lengthened area and contralateral nonlengthened area were measured using quantitative computerized tomography. Histological examination of regenerated bone was performed using Masson's trichrome stain method. The radiographs demonstrated poor callus formation, higher incidence of axial deviation and screw loosening in the group I compared to the group II. The bone mineral density at the lengthened area in the group II was higher than that of the group I(P<0.05). Histological examination showed that the new bone trabeculae in the group II were greater than that of the group I. In conclusion, the combination of monolateral external fixator and intramedullary K-wire can prevent pin loosening, axial deviation and reduce healing period in dogs.

The Importance of the Trauma Surgeon: A Reflection on the Management of Hemodynamically Unstable Pelvic Trauma Patients (혈역학적으로 불안정한 골반외상 환자의 치료를 통해 본 외상전문의의 필요성)

  • Shin, Sung;Kyung, Kyu Hyuk;Kim, Ji Wan;Kim, Jung Jae;Hong, Suk-Kyung
    • Journal of Trauma and Injury
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    • v.22 no.2
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    • pp.254-259
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    • 2009
  • Purpose: Pelvic trauma is a serious skeletal injury with high mortality. Especially in cases of severe injury trauma, treatment outcomes depend on early diagnosis and intervention. We expect trauma surgeon to play an important role in the management of severe multiple trauma patients. Methods: A retrospective study was performed on pelvic trauma patients with hemodynamic instability between March 2005 and September 2009. We divided the time period into period I (March 2005~Feburary 2009) and period II (March 2009~September 2009). The trauma surgeon and team started to work from period II. Data were collected regarding demographic characteristics, mechanism of injury, type of pelvic fracture, ISS(injury severity score), treatment modality, transfusion requirement, time to definitive treatment, and mortality. Results: During period I, among 7 hemodynamically unstable patients, 4(57.1%) patients died. However during Period II, only one of 6(16.6%) patients died. The demographic data and injury scores showed no differences between the two time periods, but the time to definitive treatment was very short with trauma team intervention(14.4 hrs vs. 3.9 hrs). Also, the amount of transfusion was less(41.1 U vs. 13.9 U). With arterial embolization, early pelvic external fixation led to less transfusion and made patients more stable. Conclusion: This study demonstrated the importance of the trauma surgeon and the trauma team in cases of hemodynamically unstable pelvic trauma. Even with the same facility and resources, an active trauma team approach can increase the survival of severely injured multiple trauma patients.

Fracture Analysis of Wild Birds in South Korea

  • Jang, Hyun-Kyu;Park, Jong-Moon;Ahmed, Sohail;Seok, Seong-Hoon;Kim, Ho-Su;Yeon, Seong-Chan
    • Journal of Veterinary Clinics
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    • v.36 no.4
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    • pp.196-199
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    • 2019
  • This study was conducted to evaluate and analyze fractures types, sites and surgical approach of wild birds in Korea. The study was conducted on data collected for fracture lesion sites, species, outcomes, surgical methods, treatments and medical records from wildlife centers in South Korea. All birds were subjected to clinical examination, followed by surgical invasion and post-operative care. Fractures were more common in adult non-raptor species (51.57%) as compared to raptors (48.43%). Of the 254 cases evaluated, maximum cases comprised ulnar fractures (29.70%), followed by radial (21.76%) and humeral fractures (17.35%). Treatment procedures at 340 fracture sites were maximally treated with figure-8 bandage (33.07%), external skeletal fixator-intramedullary pin (ESF+IM tie-in fixation) (20.86%), and other varied procedures. All birds were kept indoors till recovery. Treatment outcomes were dependent on the type of bone fractured and surgical method applied. Based on the surgical treatments and outcomes, birds were kept hospitalized, and released or euthanized. The findings of this study provide information for veterinarians regarding the fractures sites, basic database for the species and outcomes of fracture repair in wild birds.