Omentalisation as adjunctive treatment of an infected femoral nonunion fracture: a case report

Abstract

A three-year-old male working border collie with an infected femoral nonunion fracture was managed in a two-stage procedure involving debridement and omentalisation, followed by stabilisation with a bone plate and an autogenous cancellous bone graft. Osseous union was documented radiographically 16 weeks after surgery. Telephone follow-up one year later revealed the dog had returned to full working function without evidence of lameness. To the authors' knowledge, this is the first clinical case described in the veterinary literature using omentalisation as an adjunct to the management of an infected, biologically inactive nonunion fracture.

Treatment of a femoral septic nonunion in a dog with interlocking nail stabilization associated to corticospongious bone autograft and greater omentum flap: case report

“…As reported by other authors who used the omentum as an adjuvant in the treatment of fractures (McAlinden et al, 2009), in this case, the bone healing occurred, surprisingly, within 12 weeks. The omentum probably contributed to the reduction of the recovery time, mainly due to the support it provided to the control of osteomyelitis.…”

“…Omentum can preserve its immunogenic and angiogenic capacity as well as its potential of drainage even in distant places when used as flap through the subcutaneous, being able to potentiate several surgical procedures (Ito et al, 2010). The use of the omentum properties for treatment on biologically inactive nonunion associated with chronic osteomyelitis as reported by McAlinden et al (2009), are not common in the consulted literature, so the present report aimed to describe step by step the success of its use in the treatment of a young dog femoral septic nonunion case.…”

The Omental Pedicle Flap in Dogs Revised and Refined: A Cadaver Study

“…In all cases, the superficial and the deep leaves of the omentum were each supplied by a left and right marginal omental artery that anastomosed near the caudal omental border into a superficial and a deep omental arch, respectively ( Fig 1). The right gastroepiploic artery gave off a variable number (6)(7)(8)(9)(10)(11)(12) of omental arteries to the superficial leaf. The third or fourth of these omental branches was the superficial right marginal artery, which supplied the superficial arch from the right.…”

“…7,8 In people, new clinical applications such as omental transposition to improve bone healing or to enhance survival of transplanted pluripotent stem cell-derived cardiomyocytes, are being explored. 9,10 Surprisingly, veterinary surgeons have still not widely employed the omentum in surgeries, although most of them do acknowledge its exceptional wound healing capacities and make good use of it at the end of abdominal procedures. Indeed, wrapping omentum around an intestinal anastomosis site is reported to promote healing.…”

Enxerto pediculado de omento maior como adjuvante no tratamento de osteomielite de tíbia em cão ˗ relato de caso

“…Inúmeros relatos clínicos e experimentais investigam as capacidades do omento quanto à neovascularização, à drenagem linfática, à função imune e de adesão (Ito et al, 2010). Resultados significativos foram descritos nas diferentes funções e também como adjuvante na cicatrização óssea em cães (Ferrigno et al, 2010;Ree et al, 2018) e no tratamento da osteomielite (McAlinden et al, 2009).…”