Unique Differences of Minimally Invasive Fracture Repair in the Feline

Maritato, Karl C.; Schmierer, Philipp A; Pozzi, Antonio

doi:10.1016/j.cvsm.2019.08.016

Cited by 4 publications

(5 citation statements)

References 12 publications

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“…On the lateral side, there are branches of the radial nerve, while on the medial side are the brachial artery, brachial vein and the ulnar and median nerves. The supracondylar foramen is an important structure in the distal feline humerus as the brachial artery, brachial vein and median nerve pass through it [19]. These structures can be released from the supracondylar foramen if necessary for implant positioning.…”

Section: Discussionmentioning

confidence: 99%

“…In all procedures, a medial approach to the humerus was first performed to treat the medial condylar fracture in order to transform the bicondylar fracture into a lateral monocondylar fracture. To ensure good implant positioning and to avoid impingement of the neurovascular structures by the plate, cranial retraction of the brachial artery, vein and median nerve was performed after freeing these structures from the supracondylar foramen by removing its medial border with a rongeur as described by Maritato et al [19]. In addition, the origin of the medial head of the triceps brachii muscle was transected and retracted caudally.…”

Section: Surgical Techniquementioning

confidence: 99%

See 1 more Smart Citation

A 3D Printed Anatomically Pre-Contoured Plate for the Treatment of Y-T Humeral Condylar Fractures: A Feline Cadaveric Study

Trębacz,

Frymus,

Barteczko

et al. 2024

Animals

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(1) Background: Anatomically pre-contoured plates usually require only minimal or even no intraoperative contouring. For complex cases, such plates also assist the surgeon as an anatomical template during fracture reduction. In this study, we present our experience of using a 3D printing technology for the treatment of bicondylar humeral fractures in feline cadavers. (2) Methods: Surgeries were performed on 15 pairs of front limbs amputated at the scapula. The limbs were obtained from 15 adult cats without obvious pathology of the skeleton. After flexion of the elbow and subperiosteal elevation of the anconeus muscle, the humeral Y-T fractures were created using a bone chisel and mallet. A custom-made anatomically pre-contoured interlocking plate was used to reduce and stabilise the medial aspect of the humeral condyle to the humeral diaphysis. After reduction of the humeral condyle, a positional locking screw was then inserted from the medial to the lateral side and a straight 2.4/2.7 interlocking bone plate was used to stabilise the lateral part of the condyle to the humeral diaphysis. (3) Results: The length of the humerus ranged from 98.2 to 107.0 mm and did not differ significantly between the left and right bone. The diameter of the isthmus of the humeral condyle ranged from 5.2 to 5.5 mm and did not differ significantly between the left and right bone. In all 30 limbs, bicondylar fracture was accompanied by epicondylar comminution. In 7/30 limbs (4 left, 3 right) the fracture of the humeral shaft was also present. In the left limbs, the postoperative articular surface defect of the humeral condyle was small (<1 mm) in 11/15 cases, moderate (1–2 mm) in 2/15 cases and large (>2 mm) in 2/15 cases in which the condylar screw was incorrectly inserted. In the right limbs, the postoperative articular surface defect of the humeral condyle was small (<1 mm) in 14/15 cases and moderate (1–2 mm) in 1 case. (4) Conclusions: 3D printing and the technology of metal powder sintering offers a wide range of possibilities for the development of new surgical implants. The anatomically pre-contoured bone plate appears to be a valuable tool in the reduction and stabilisation of Y-T humeral fractures in adult domestic cats weighing 3.0 to 4.5 kg.

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Section: Discussionmentioning

confidence: 99%

Section: Surgical Techniquementioning

confidence: 99%

A 3D Printed Anatomically Pre-Contoured Plate for the Treatment of Y-T Humeral Condylar Fractures: A Feline Cadaveric Study

Trębacz,

Frymus,

Barteczko

et al. 2024

Animals

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“…Radioulnar synostosis can be congenital or develops after radioulnar fractures. [1][2][3][4][5][6][7] Post-traumatic radioulnar synostosis occurs in human medicine with a prevalence of 2%-18% after fractures. [3][4][5] The reasons can be a callus formation between the radius and ulna or an implant placed between the respective bones.…”

Section: Introductionmentioning

confidence: 99%

“…Radioulnar synostosis can be congenital or develops after radioulnar fractures 1–7 . Post‐traumatic radioulnar synostosis occurs in human medicine with a prevalence of 2%–18% after fractures 3–5 .…”

Section: Introductionmentioning

confidence: 99%

Effects of simulated radioulnar synostosis on supination and pronation in cats. A cadaveric study

Senn,

Paulick,

Brunnberg

et al. 2024

Veterinary Surgery

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ObjectiveTo evaluate the effect of an induced synostosis with a screw on pronation and supination in cats.Study designEx vivo biomechanical study.Sample populationA total of 58 feline forelimbs.MethodsA total of 58 cadaveric feline thoracic limbs were mounted on a custom‐built jig with the elbow and carpus flexed at a 90° angle. To exclude any orthopedic disease, radiographs of the forelimbs were performed prior to the mechanical tests. Radioulnar synostosis was imitated with a 2 mm cortical screw through the radius into the ulna in the proximal (Group P; n = 54), middle (Group M; n = 52), and distal (Group D; n = 53) radial diaphysis. The angles of pronation and supination were recorded after manually applying a two‐finger tight rotational force to the metacarpus. Rotational tests were performed without a screw (Group N) and with a screw in each of the aforementioned positions. Pairwise comparisons between the groups were performed based on their angles of rotation with a paired t‐test with the Benjamini‐Hochberg procedure and a mixed model ANOVA.ResultsMean angles of rotation decreased between Group N (129.5 ± 15.9°) and all groups with imitated radioulnar synostosis to a mean angle of 37.5 ± 14.5° (p < .0001). Mean angles of rotation did not differ between the groups with imitated radioulnar synostosis.ConclusionInduced radioulnar synostosis decreases antebrachial rotation by more than two‐thirds, regardless of location.Clinical significanceImplants fixating the radius to the ulna should be avoided in cats, regardless where they are located along the radial diaphysis.

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“…A supinator muscle may be elevated for a wider approach. The distal approach to the radius is made between the extensor carpi radialis tendon and the common digital extensor tendon [16,17].…”

Section: Introductionmentioning

confidence: 99%

Minimally Invasive Plate Osteosynthesis (MIPO) of Comminuted Radial Fractures Using a Locking Plate Contoured on a 3D-Printed Model of the Feline Antebrachium: A Cadaveric Study

Trębacz,

Frymus,

Pawlik

et al. 2024

Animals

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(1) Background: Due to the unique structural and functional characteristics of the forelimb in cats, fractures of the radius and ulna are best repaired using internal fixation and stabilization in accordance with AO principles. This study presents the results of reduction of 42 cadaveric comminuted feline radial fractures reduced by minimally invasive plate osteosynthesis (MIPO). (2) Methods: Radius fractures were created on 21 pairs of forelimbs with intact bones. MIPO was then performed using two locking bone plates pre-contoured on 3D-printed bone models of the antebrachium of a male and a female cat. Pre- and postoperative radiographs were taken, and radius length and anatomical lateral distal radial angle (aLDRA) were measured. (3) Results: All fractures were classified as complex diaphyseal fractures of the radius. The radial bone length did not change significantly after surgery (F1,18 = 0.01, p = 0.933). However, the aLDRA was modified after surgery (F1,18 = 7.51, p = 0.013), but this change was only observed in females, in whom the aLDRA was significantly reduced (p = 0.035) compared to the value determined by the shape of the plate. In males, the pre- and postoperative aLDRA values were similar (p = 0.824). In 40 cases, alignment, adjacency of bone fragments, and apparatus were judged to be satisfactory. In two cases, the plate was fixed to the proximal radius and distal ulna due to misidentification of the distal radius. In both cases, revision surgery and correct fixation of the radius gave proper alignment, adjacency, and apparatus. (4) Conclusion: A pre-contoured plate on a 3D-printed model of the male and female domestic cat antebrachium was suitable for the reduction and stabilization of comminuted radial fractures in a cohort of domestic cat cadavers without the need to print individual antebrachial bone models for each patient.

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Unique Differences of Minimally Invasive Fracture Repair in the Feline

Cited by 4 publications

References 12 publications

A 3D Printed Anatomically Pre-Contoured Plate for the Treatment of Y-T Humeral Condylar Fractures: A Feline Cadaveric Study

A 3D Printed Anatomically Pre-Contoured Plate for the Treatment of Y-T Humeral Condylar Fractures: A Feline Cadaveric Study

Effects of simulated radioulnar synostosis on supination and pronation in cats. A cadaveric study

Minimally Invasive Plate Osteosynthesis (MIPO) of Comminuted Radial Fractures Using a Locking Plate Contoured on a 3D-Printed Model of the Feline Antebrachium: A Cadaveric Study

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