O entrópio é uma afecção oftálmica que acontece quando a margem palpebral se inverte parcial ou totalmente, possibilitando o contato dos pelos da porção externa da pálpebra com a córnea e/ou com a conjuntiva, sendo acentuado pelas pregas nasais exuberantes em cães braquicefálicos, os quais apresentam frequentemente alterações oculares relacionadas a predisposição racial por sua conformação anatômica. Os sinais clínicos encontrados incluem epífora, secreção mucopurulenta, blefaroespasmo e, além disso, devido a irritação crônica na córnea, observa-se sinais de edema, vascularização, granulação, pigmentação e até mesmo úlceras, sendo elas superficiais ou profundas. O diagnóstico é realizado pelo médico veterinário durante o exame clínico através da observação cuidadosa da inversão da margem palpebral em direção a córnea e/ou conjuntiva, sendo o procedimento cirúrgico o tratamento indicado. O objetivo desse trabalho consiste na descrição do procedimento de ressecção da prega cutânea nasal para correção de entrópio em um cão da raça Pug.
Background: Shearing wounds on the limbs of dogs usually affect the regions distally from the radiocarpal joint at the thoracic limb and from the tibiotarsal joint at the pelvic limb. The tissue coverage and re-epithelialization of the injured region are important factors that should be considered in the definitive surgical treatment. The hydrocolloid membrane promotes selective autolytic debridement and accelerates the formation of granulation tissue and epithelialization. The present study aims to describe the treatment with hydrocolloid membrane dressing of three cases of shearing wounds with concomitant orthopedic injuries in the pelvic limbs of dogs. Case: Three dogs with pelvic limb injuries after vehicular trauma were selected for treatment. Two patients had shearing lesions on the medial aspect of the pelvic limb with exposure of the tibia and fibula, the talus and the tibiotarsal joint, associated with bone loss on the medial surface of the limb and rupture of the medial collateral ligament of the tarsus. Another patient had a shearing wound on the dorsal surface of the distal region of the pelvic limb, with injury of the digital extensor tendons and bone exposure of the second and third metatarsals. Initially, the surgical debridement of the lesion was performed and during the first five days after trauma the wound was cleansed with chlorhexidine solution and topical application of crystallized sugar daily. In this initial period a dry adherent dressing was used on the lesions, without bandages for immobilization of the pelvic limb. In all dogs, the hydrocolloid membrane was applied from the sixth day after initial wound management. Immediately after the application of the hydrocolloid membrane, temporary immobilization of the affected pelvic limb with a padded Robert Jones bandage was performed. The first changes of the hydrocolloid membranes were performed after five days of their use. Subsequently, the membranes changes became more spaced and were performed within a period between 7 to 10 days. After wound repair, in one of the dogs with a shearing injury in the medial surface of the pelvic limb, the rupture of the medial collateral ligament was surgically treated with the use of anchor screws and nylon thread for the ligament reconstruction. The other dog presented with lesion in the medial surface of the pelvic limb and collateral ligament rupture was not submitted to late orthopedic surgical treatment. The latter was clinically managed and developed valgus deviation of the affected pelvic limb, but with functional use of the limb. The dog with a shearing lesion on the dorsal surface of the pelvic limb and injury to the extensor tendons was managed conservatively with use of orthosis and, after 45 days of initial trauma, the dog showed a functional lameness and absence of pain in the affected limb. Discussion: In all animals, the hydrocolloid membrane was applied on the wound from the sixth day after the initial lesion treatment. As the wound was healing the hydrocolloid dressing was changed in a m...
Background: Radius curvus is a clinical manifestation of the premature closure of the distal ulnar physis and the most common physeal disease in dogs, representing 63% of all physeal injuries. There are few reports indicating the technique of stapling for treatment of radius curvus in squeletically immature dogs. The aim of this study is to report a case of radius curvus in a young dog successfully treated with a combination of 3 surgical tecniques: 1- Stapling the medial and cranial portions of the distal radial physis; 2- Oblique osteotomy of the proximal ulna and ostectomy of the distal ulna, and 3- Dynamic external skeletal fixation in the elbow joint.Case: A 5-month-old female dog was referred to the University Veterinary Hospital with a history of left thoracic limb deformity for 2 weeks. There was a history of possible traumatic event on the front limb, in addition to providing nutritional supplements daily. In the radiographic evaluation the changes were identified in the left thoracic limb: shortening of the ulna, procurvatum and medial angulation of the distal radius, increased joint space and articular incongruity of the elbow joint. The dog was subjected to surgical treatment by the combination of three main surgical techniques. For the stapling of the distal radial physis the surgical approach on the cranial-medial surface of the distal radius was made. Two surgical staples were positioned in the distal radial physis. Thereafter a caudal approach was made to the distal region of the ulnar diaphysis for the distal ostectomy of the ulna. A bone segment of 1 cm in length of the distal ulnar diaphysis was removed. Another caudal approach was made to the proximal region of the ulnar diaphysis and a proximal oblique osteotomy of the ulna was performed. For the dynamic external skeletal fixation in the elbow joint two Steinmann pins were inserted. The first pin was proximal to the supracondilar foramen of the humerus and the second pin was caudal to the trochlear notch of the ulna, both parallel to the joint surface. To create a dynamic system, the pin tips were connected with elastic rubber bands on the medial and lateral sides of the elbow joint. Clinical and radiographic revaluation were made at 15, 30 and 60 days after surgery. Total correction of the limb deviation was achieved at 60 days postoperative. Two years after the surgical procedure, the owner was contacted and reported that the dog was very well and with no change in the operated limb.Discussion: The most common cause of premature closure of the distal ulnar physis is trauma. Due to the proper conical shape of the distal ulnar physis, there is more predisposition to the compression of the germinative cells in traumatic events, leading to radius curvus disease. Another cause of the radius curvus is the nutritional disbalances. In the reported case the patient had both predisponent factors, although unilateral limb involvement suggested trauma with primary causative agent. The treatment included the interruption of the supplementation of the diet associated with surgical techniques. The stapling of the distal radial physis is usually indicated for mild angular valgus deviation. In the current case the technique was applied with success regardless of the higher grade of radial deviation. Generally, the ulnar ostectomy is preferred to the osteotomy, since it reduces the rate of ulnar osteosynthesis, ensuring that the restrictive effect of the ulna upon the radial growth does not restart. In the reported case the ulnar ostectomy was associated with ulnar osteotomy to achieve a more effective result. Furthermore, the proximal ulnar osteotomy is usually indicated when elbow subluxation is present. In the current case the joint congruence was improved with the use of the dynamic external skeletal fixator.
Background: Angular deformity is characterized by the deviation of part of the bone that can occur in three different planes, frontal, sagittal and transverse. Trauma on physeal plates is the most common cause of angular deviations of the limbs in dogs. Currently the CORA (Center of Rotation of Angulation) methodology is the best way to evaluate and surgically correct these deformities. The objective of this study is to describe the surgical procedures performed to treat the uniapical valgus deviation affecting both tibial bones in a dog, comparing the outcomes of hybrid external skeletal fixator used in the right pelvic limb in relation to the locking plate used in the left pelvic limb.Case: A 10-month old Border Collie dog was attended at the University Veterinary Hospital with history of lameness and deviation of both pelvic limbs. In the orthopedic examination, it was possible to identify bilateral valgus deviation in the region of the tibio-tarsal joints and moderate lameness, with absence of pain or joint crepitation. Radiographic examination showed that the deformity was only uniapical in the frontal plane, affecting both tibial bones of the dog. Signs of osteoarthrosis were not observed and the preoperative examinations were within the normal limits for the species. The deformities were corrected in two surgical times starting with the procedure in the right tibia, which appeared to be clinically worse. Due to the fact that it was a bilateral affection and there was not a healthy pelvic limb to obtain the normal angles values of this dog, for planning according to the CORA methodology, the values of the tibial mechanical angles for dogs of similar size were taken from the literature. For surgical correction of the right tibia, a closed wedge osteotomy was performed following the second rule of Paley, with bone stabilization using type IB hybrid external skeletal fixator (ESF). The radiographic follow-up was done every 30 days postoperatively, however at 60 days the dog presented with severe lameness and the ESF had to be removed due to the breaking of one of the wires that composed the ring of the hybrid system. The limb continued to be treated by external bandages and total bone healing occurred at 210 days after surgery. Only after the complete recovery of the right limb, the left pelvic limb was operated and was also corrected by closed wedge osteotomy from the second Paley's rule. However, the bone stabilization was achieved with the use of a T-shaped locking plate. Radiographic follow-up was performed every 30 days postoperatively and at 60 days the osteotomy gap was already consolidated and the dog showed good weight bearing in the pelvic limbs without signs of lameness or pain.Discussion: Currently, it is indicated that bone deformities in small animals should be corrected using the CORA methodology. The hybrid ESF is one of the most commonly used fixation systems for bone stabilization after corrective osteotomies due to great versatility, however, the reported complication rates are relatively high. The locking plates with special shapes, such as the "T" plate used in this study, provide the stable fixation of osteotomies with limited bone stock, as they allow the introduction of larger number of screws per area. Thus, this latter type of implant becomes advantageous for the correction of bone deformities close to the joints. It is concluded that CORA methodology is really effective in the planning of corrective surgeries of angular deviations in dogs. In this case report, the resulting tibial angles after the surgical corrections were within the normal range for healthy dogs of similar size. However, the use of locking plate provided better results with early bone healing and fewer complications than the type IB hybrid ESF.
Lesões traumáticas em coluna vertebral e medula espinhal ocorrem frequentemente na Medicina Veterinária, e o atropelamento por veículos automotivos é uma das causas mais prevalentes entre os cães. A fisioterapia veterinária, quando relacionada aos distúrbios locomotores e usada em conjunto com os tratamentos clínico e cirúrgico, tem o objetivo de restaurar, manter e promover a melhora da função e aptidão física, o bem-estar e a qualidade de vida do animal, facilitando sua rápida, e até completa, recuperação. Este trabalho relata os resultados do tratamento fisioterápico efetuado em um cão que apresentou diversas complicações em membros pélvicos, decorrentes de traumas na coluna vertebral e na medula espinhal, e destaca os benefícios da associação entre reabilitação e os tratamentos clínico e cirúrgico.
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