Transarticular elastic external skeletal fixator correction of a stifle rotational deformity and patellar luxation in a dog

Abstract

Objective To report the preoperative evaluation, treatment with transarticular elastic external skeletal fixation (ESF), and outcome of a dog with bilateral medial patellar luxation (MPL) and stifle rotational deformity. Animal One nonambulatory, 2.5‐month‐old, 7.5‐kg mixed‐breed intact female dog. Study design Case report Methods Complex pelvic limb deformities were assessed with physical examination and computed tomography (CT) and characterized as bilateral grade 4 MPL and 90° internal rotation of the tibia in relation to the femur. Three‐dimensional imaging and bone models were used to quantify the deformity and rehearse surgical correction. Transarticular elastic chains between ESF pins in the femur and tibia were used to gradually correct stifle rotational malalignment on each pelvic limb. Soft tissue releases, imbrication, and a transphyseal staple were used to correct the patellar luxation (PL) and femoral varus. The dog was reevaluated for 1 year postoperatively. Results Short‐ and long‐term management included intensive physical rehabilitation to increase pelvic limb strength and function. Surgical treatment resulted in resolution of the PL and neutral stifle alignment. The dog was able to ambulate with persistent decreased range of motion of the stifle. Conclusion Transarticular elastic chains and femoral physeal stapling improved the function of a dog with severe bone deformities and PL in a growing dog.

Correction of rotational deformities in long bones using guided growth: a scoping review

“…A total of 14 studies (10 preclinical ( 3 , 4 , 9 , 10 , 11 , 12 , 17 , 18 , 19 , 20 ), 3 clinical ( 5 , 13 , 14 ), and 1 review ( 16 )) were included that examined guided growth for rotational deformities.…”

“…Two ( 12 , 19 ) of the eight in vivo preclinical studies used an external device, with pins on either side of the growth plate, that relied on manually applied, external torque to achieve rotation of the bones. One ( 17 ) was a case report in which the device spanned the stifle joints of a dog and therefore the achieved rotation, presumably, also did occur at the level of the joint. In these three studies, rotation was achieved, but it might not be by physeal guided growth alone.…”

“…Furthermore, reference lists of all included studies were screened. Together this resulted in the inclusion of additional seven studies ( 12 , 13 , 14 , 17 , 18 , 19 , 20 ) ( Fig. 1 ).…”

“…Study details of preclinical, in vivo studies excluding one case report(17). All values are mean (range).Both studies used the same rabbits in two studies; ‡…”