Postoperative TPA

Both triceps tendons and the medial collateral ligaments of both stifles of 10 freshly euthanized dogs were sharply transected. One tendon and one ligament of each dog were sutured with a three loop pulley pattern, and the opposite tendons and ligaments were sutured with a locking loop pattern. The tendons and ligaments were harvested with their muscular and bony attachments. The anastomoses were slowly tested in tension until failure occurred. The amount of tensile load required to produce failure of the anastomosis, the amount of distraction of the sutured ends prior to failure, and the modes of failure were recorded. In both tendons and ligaments, the three loop pulley pattern provided significantly greater tensile strength (p < 0.01) and allowed significantly less distraction between the sutured ends (p < 0.01) than the locking loop pattern. In tendons, disruption of the suture material was the most common mode of failure with both patterns. In ligaments, both patterns failed most commonly by pulling free from the tissue.

Achilles' ruptures repaired with suture can be augmented with mesh to increase the ultimate load to failure, but as currently tested, there was a decrease in resistance to gap formation At this time we cannot recommend Mesh or the Suture+Mesh techniques without further testing.

Results suggested that early neutering was a significant risk factor for development of excessive TPA in large-breed dogs with CCLD. Further research into the effects of early neutering on TPA and the pathophysiology of CCLD is warranted.

The purpose of this study was to determine the respective contribution of each of the following parameters to the compressive, bending, and torsional rigidity of the Kirschner-Ehmer (KE) external fixation splint as applied to canine tibiae with an osteotomy gap: bilateral versus unilateral splints; increasing the number of fixation pins; altering the diameter of fixation pins and side bars; decreasing side bar distances from the bone; increasing pin separation distances in each pin group; decreasing distances between pin groups; altering pin clamp orientation; and altering side bar conformation. Bilateral splints were 100% (mean) stiffer than unilateral splints, with stiffness enhanced to the greatest extent in mediolateral bending and torsion. Increasing pin numbers stiffened both bilateral (mean, 41%; 8 versus 4) and unilateral splints (mean, 14%; 8 versus 4). Medium KE splints were 85% (mean) stiffer than small KE splints. Decreasing side bar distances to the bone from 1.5 cm to 1.0 cm to 0.5 cm increased stiffness of both bilateral and unilateral splints by a mean of 13% to 35%. Widening pin spacing from 1.67 cm to 2.5 cm increased stiffness in craniocaudal bending only (56% increase, bilateral splints; 73% increase, unilateral splints). Decreasing the distance between pin groups from 5.84 cm to 2.5 cm increased stiffness in torsion between 23% (unilateral splints) and 45% (bilateral splints) and decreased stiffness of unilateral splints by 29% in craniocaudal bending. Altering pin clamp configuration so that the bolts of the clamp were inside the side bar rather than outside the side bar increased stiffness in axial compression only (73% increase, bilateral splints; 54% increase, unilateral splints). Conforming the lateral side bar to the tibiae increased only axial compressive stiffness by 77% but was no different than placing the clamps inside the side bars of an unconformed bilateral splint. These results quantify the relative importance of specific parameters affecting KE splint rigidity as applied to unstable fractures in the dog.