Suture type, number of throws per knot (knot size), suture pattern, and surgeon experience play an important role in knot security and should be considered when performing surgery.
ObjectiveTo compare the torsional behavior of two small angle‐stable interlocking nails (I‐Loc and Targon) with that of locking compression plates (LCP). To evaluate the effect of implant removal on the torsional strength of feline bone surrogates.Study designExperimental.Sample populationFracture gap constructs and intact explanted bone surrogates.MethodsFracture gap constructs were stabilized with one of six implants (I‐Loc 3 and 4, Targon 2.5 and 3.0, LCP 2.0 and 2.4) and then cyclically tested in torsion (n = 4/group). To simulate implant removal, intact surrogates with implant‐specific pilot holes were then twisted to failure (n = 4/group). Torsional compliance (TC; °/Nm), angular deformation (AD; °), and failure torque (FT; Nm) were statistically compared (P < .05).ResultsThe I‐Loc 4 had the smallest TC and AD of all constructs (P < .05). The largest TC (P < .05) was seen with the LCP 2.0. The Targon 2.5 had the largest AD (P < .05) secondary to locking interface slippage. Targon surrogates FT were the lowest of all groups (P < .05). Conversely, there was no difference between the FT of the I‐Loc, LCP, and intact surrogates (P > .05).ConclusionWe showed that I‐Loc nails provided greater torsional stability than size‐matched Targon nails and LCPs. Conversely, Targon 2.5 locking interface slippage may jeopardize that construct's stability. Furthermore, the significantly reduced bone surrogate torsional strength provided evidence that the large Targon bolt holes increased the risk of postexplantation iatrogenic fracture.Clinical significanceOur results provide evidence to conclude that the small I‐Loc nails may be valid alternatives to other osteosynthesis options for feline fracture repair.
Objective: To characterize the torsional structural properties of the feline femur and design a bone model surrogate for mechanical testing of feline orthopedic implants. Study design: Experimental. Sample population: Paired feline femurs (n = 30) and bone models (8 materials, n = 4/group).Methods: Femurs were cyclically tested nondestructively in torsion and then loaded to failure. A generic femoral model was then designed from native femur dimensions and tested similarly by using 1 of 8 materials that were 3-dimensionally printed or machined. Outcome measures consisting of torsional compliance, angular deformation (AD), and torque to failure were compared by using Student's t test (P < .05). Failure modes are reported as descriptive statistics. Results: Torsional compliance (1.6 AE 0.3 /Nm, 2.0 AE 0.1 /Nm), AD (3.1 AE 0.6 , 3.8 AE 0.2 ) and torque to failure (7.8 AE1.2 Nm, 8.1 AE 1.3 Nm) did not differ between feline femurs and short-fiber epoxy (SFE) models. Conversely, most printed materials displayed excessive TC and failed by plastic deformation (AD > 15-fold that of native femurs) rather than by fracture. Feline bone and SFE both failed by spiral fractures. Conclusion: None of the outcome measures differed between the 4th generation SFE model and cadaveric femurs, but differences were identified between feline bone and printed materials. Clinical impact: Machined SFE can be used to create a surrogate bone model with torsional structural properties similar to those of feline femurs. In contrast, common printable materials appear unsuitable to produce a realistic feline bone surrogate.
Objective: To describe medium-term functional outcome after nail osteosynthesis in feline traumatology and report clinically relevant recommendations for I-Loc angle-stable interlocking nail use in cats. Study design: Prospective clinical study. Sample population: Client-owned cats (n = 29). Methods: Consecutive cases with femoral, tibial, or humeral fractures were included. Outcome measures included fracture and surgical procedure description, limb alignment, nail size vs body weight (BW), percentage of nail medullary canal (MC) fill, time to limb function at clinical union (CU), and complications. Descriptive statistics were reported and compared with historical data. Results: Bone distribution was 53.3% femora, 30% tibiae, and 16.7% humeri. There were six epimetaphyseal and 24 diaphyseal fractures. Overall, 67% of fractures were comminuted. Open reduction and minimally invasive techniques were used in 73% and 27% of cases, respectively. Seventeen I-Loc 3 (cat mean BW 4.4 ± 2.2 kg) and 13 I-Loc 4 (cat mean BW 5.2 ± 1.2 kg) nails were placed with mean MC fill of ≤50%. Average time to CU was 7.2 weeks. At CU, lameness had resolved or was mild in every cat, and all cats ultimately regained full limb function. No major complications were encountered. Conclusion: Because of improved CU times, excellent functional outcomes, and low complication rate, our results provide evidence that I-Loc nails are safe and effective for feline traumatology. Clinical significance: The I-Loc may be advantageous for fixation of epimetaphyseal fractures. Because of feline bone specific dimensional constraints, I-Loc 3 is likely appropriate for all feline humeri and most tibiae, while I-Loc 4 is well sized for feline femora.
This study demonstrates that MIO fixation of canine sacroiliac luxations provides more accurate and consistent sacral screw placement than ORIF. With proper techniques, iatrogenic neurological damage can be avoided with both techniques. The PL /SW-R, which relates to safe screw fixation, also demonstrates that screw penetration of at least 60% of the sacral width is achievable regardless of surgical approach. These findings, along with the limited dissection needed for accurate sacral screw placement, suggest that MIO of sacroiliac luxations is a valid alternative to ORIF.
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