AHMET ÖZAK, CENK YARDIMCI, HATİCE ÖZLEM NİSBET, Yusuf Sinan ŞİRİN

Treatment of long bone fractures with acrylic external fixation in dogs and cats: retrospective study in 30 cases (2006-2008)

Bu çalışmanın amacı; kedi ve köpeklerin uzun kemik kırıklarının sağaltımında akrilik eksternal fiksasyonun kullanımın değerlendirilmesidir. Bu retrospektif çalışmanın materyalini 22 köpek ve 8 kedi oluşturdu. Uzun kemiklerde lokalize olan otuz değişik kırığın farklı çerçeve konfigürasyonları ile stabilizasyonu yapıldı. Köpeklerdeki fiksatör konfigürasyonu 2 olguda (%9) unilateral (tip I), 14 olguda (%63.6) bilateral (tip II), 3 olguda (%13.7) serbest form iken kedilerde 2 olguda (%25) unilateral (tip I), 6 olguda (%75) ise bilateral (tip II) olarak belirlendi. Ortalama fiksatör uzaklaştırma zamanı köpeklerde 37, kedilerde ise 29,5 gündü. Sekiz olguda (%26,6) pin yolu enfeksiyonu, periosteal reaksiyon, uzun dönem pin gevşemesi, sinostoz ve hafif dereceli interfragmental angulasyon gibi rutin komplikasyonlar; üç olguda (%10) ise osteomyelitis, kaynama gecikmesi ve nonunion gibi ciddi komplikasyonlar gözlendi. Olgulardan birine, eşlik eden vertebra kırığından dolayı ötenazi uygulandı. Fiksatörün uzaklaştırılmasından sonra yapılan değerlendirmede 19 olguda (%65,5) mükemmel, 7 olguda (%24,2) iyi, 1 olguda (%3,4) vasat, 2 olguda (%6,8) ise zayıf sonuçlar elde edildi. Kemik iyileşmesi ve fiksatör toleransı, kedi ve yavru köpeklerde, ergin köpeklerdekine oranla daha iyi olarak belirlendi.Sonuç olarak, uygun bir fiksatör konfigürasyonu oluşturulduğunda, akrilik eksternal fiksasyonun kedi ve köpeklerin uzun kemik kırıklarının stabilizasyonunda etkili bir yöntem olduğu kanısına varıldı. Ucuz olması, tekniğin bir diğer önemli avantajı olarak değerlendirildi.

Anahtar Kelimeler:

kemik kırıkları, olgu çalışmaları, köpek, kedi

Kedi ve köpeklerin uzun kemik kırıklarının akrilik eksternal fiksasyonla sağaltımı: 30 olguda retrospektif çalışma (2006-2008)

The aim of the present study is to assess the use of acrylic external fixation in long bone fractures of dogs and cats. The material of this retrospective study was composed of 22 dogs and 8 cats. Thirty fractures localized in long bones were stabilized using acrylic external fixation with different frame configurations. Configuration of the ESF was unilateral (type I) in 2 (9%), bilateral (type II) in 14 (63.6%), bilateral biplanar (type III) in 3 (13.7%), and free-form in 3 (13.7%) dogs and unilateral (type I) in 2 (25%), and bilateral (type II) in 6 (75%) cats. Mean frame removal duration was 37 days in dogs and 29.5 days in cats. Minor complications like pin tract infection, periosteal reaction, late pin loosening, synostose, and mild interfragmental angulation were observed in 8 cases (26.6%) and major complications like osteomyelitis, nonunion and delayed union in three (10%). One case was euthanasised because of a concomitant vertebral fracture. The final outcome at frame removal was judged as excellent in 19 cases (65.6%), good in 7 (24.2%), fair in 1 (3.4%), and poor in 2 (6.8%). Fixator tolerance and bone healing were better in cats and puppies when compared with adult dogs. It was concluded that with a proper frame configuration, acrylic external fixation can maintain effective stabilization in long bone fractures of dogs and cats. Costeffectiveness is one of the other advantages of this technique.

Keywords:

bone fractures, case studies, dogs, cats,

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1. Egger EL: Instrumentation for external fixation. Vet Clin North Am: Small Anim Pract, 22, 19-43, 1992.
2. Kraus KH, Toombs JP, Ness MG: The acrylic pin external fixation system. In, Kraus KH, Toombs JP, Ness MG (Eds): External Fixation in Small Animal Practice. 1st ed, 60-67, Blackwell Science, Iowa, 2003.
3. McCartney WT: Use of an acrylic external fixator with an intramedullary tie-in pin for the treatment of tibial fractures in 85 dogs. Vet Rec, 161, 596-597, 2007.
4. Martinez SA, Arnoczky SP, Flo GL, Brinker WO: Dissipation of heat during polymerization of acrylics used for external skeletal fixator connecting bars. Vet Surg, 26, 290-294, 1997.
5. Okrasinski EB, Pardo AD, Graehler RA: Biomechanical evaluation of acrylic external skeletal fixation in dogs and cats. J Am Vet Med Assoc, 199, 1590-1593, 1991.
6. Fox SM, Bray JC, Guerin SR, Burbridge HM: Antebrachial deformities in the dog: treatment with external fixation. J Small Anim Pract, 36, 315-320, 1998.
7. McCartney WT: Use of modified acrylic external fixator in 54 dogs and 28 cats. Vet Rec, 143, 330-334, 1998.
8. Boothe HW, Tangner CH: Clinical application of Kirschner apparatus in long bone fractures. J Am Anim Hosp Assoc, 19, 679-686, 1983.
9. Egger EL: Introduction to external fixation. In, Proceedings of the 55th Annual Meeting of the American Animal Hospital Association, 186,Washington DC, USA, 1988.
10. Green SA: Complications of external skeletal fixation. Clin Orthop Relat Res, 180, 109-116, 1983.
11. Aron DN, Toombs JP: Updated principles of external external skeletal fixation. Comp Cont Educ Pract, 6, 845-858, 1984.
12. Behrens F: General theory and principles of external fixation. Clin Orthop Relat Res, 24, 15-23, 1989.
13. Harari J: Complications of external skeletal fixation. Vet Clin North Am: Small Anim Pract, 22, 99-107, 1992.
14. Hass B, Reichler IM, Montavon PM: Use of the tubular external fixator in the treatment of distal radial and ulnar fracture in small dogs and cats. A retrospective clinical study. Vet Comp Orthop Traumatol, 3, 132-140, 2003.
15. Aron DN, Toombs JP, Hollingsworth SC: Primary treatment of severe fractures by external skeletal fixation: threaded pins compared with smooth pins. J Am Vet Med Assoc, 22, 659670, 1986.
16. Mathews LS, Green CA, Goldstein SA: The thermal effects of skeletal fixation-pin insertion in bone. J Bone Joint Surg, 66, 1077-1083, 1984.
17. Canpolat İ, Bulut S, Kılıç S, Cengiz HM, Hayat A: Comparative treatment of tibia and fibula fractures with half pin (unilateral) and acrylic bar external fixation method using pin and screw. Turkish J Vet Surg, 3 (2): 32-36, 1997.
18. Canpolat İ, Bulut S, Kılıç S, Han MC: Treatment of tibia and fibula fractures with full pin (bilateral) experimental external fixation method using acrylic, hard dental plaster and normal plaster in dogs. Turkish J Vet Surg, 3 (2): 14-18, 1997.
19. Egger EL, Histand MB, Blass CE, Powers BE: Effect of fixation pin insertion on the bone-pin interface. Vet Surg, 15: 246-252, 1986.
20. Ross JT, Matthiesen DT: The use of multiple pin and methylmethacrylate external skeletal fixation for the treatment of orthopaedic injuries in the dog and cat. Vet Comp Orthop Traumatol, 6, 115-121, 1993.
21. DeBastiano G, Aldegheri R, Renzo Brivio L: The treatment of fractures with a dynamic external fixator. J Bone Joint Surg, 66B, 538-545, 1984.
22. Feith R: Side-effects of acrylic cement implanted into bone. Acta Orthop Scan, 161, 1-135, 1975.
23. Bonfield W, Li CH: The temperature dependence of the deformation of bone. J Biomech, 1, 323-329, 1968.
24. De Wijn JR: Reduction of maximum temperature in polymerization of cold and heat-curing acrylic resins. J Biomed Mater Res, 8, 421-434, 1974.