Use of a Custom-made Synthetic Internal Brace for the Repair of a Proximal Gastrocnemius Muscle Tear in a Dog

Abstract

Objectives

To describe the surgical procedure and long-term outcome of a complete traumatic tear of the gastrocnemius muscle mass without avulsion in a dog treated by sutures and using a custom-made prothesis as internal brace to support healing.

Case Description

A mix-breed dog had acute right hindlimb lameness caused by a complete proximal tear of both heads of the gastrocnemius muscle with hematoma. The tear was resolved with sutures. The gastrocnemius was augmented using an ultra-high molecular weight polyethylene (UHMWPE) implant sutured to the muscle mass and lengthened with two sutured nylon strands fastened through a bone tunnel drilled in the distal part of the femur to reduce the mechanical constraints on the sutured tear. Clinical, orthopedic, and imaging examinations were performed at 45 days and 8 months postoperatively. A phone call to the owner completed the follow-up at 18 months postoperatively.

Results

The dog bore weight one day after surgery. Normal stance and gait were resumed 45 days after surgery, despite moderate muscle atrophy. At 8 months, the dog had normal gait and moderate muscle atrophy. Muscle mass on the proximal right gastrocnemius muscle was continuous with few signs suggesting muscle fibrosis without any impact on clinical evolution. The owner indicated that the dog had normal gait and recovered muscle mass at 18 months.

Conclusion

This case resulted in a satisfactory functional clinical outcome. This technique could be considered to treat proximal lesions of the gastrocnemius muscle.

Keywords

dog - gastrocnemius - muscle tear - synthetic reconstruction - traumatic - proximal lesion

Author Contributions

R.G. and B.J.-F. examined the dog, diagnosed the pathology, performed surgery, performed follow-up visits, analyzed data, wrote and revised the manuscript. C.A. and G.B. analyzed data, wrote and revised the manuscript.

Publication History

Received: 25 July 2024

Accepted: 27 January 2025

Article published online:
08 April 2025

• References

• 1 Ridge PA, Owen MR. Unusual presentation of avulsion of the lateral head of the gastrocnemius muscle in a dog. J Small Anim Pract 2005; 46 (04) 196-198
• 2 Robinson A. Atraumatic bilateral avulsion of the origins of the gastrocnemius muscle. J Small Anim Pract 1999; 40 (10) 498-500
• 3 Lideo L, Milan R. Ultrasound monitoring of shortwave diathermic treatment of gastrocnemius strain in a dog. J Ultrasound 2013; 16 (04) 231-234
• 4 Stahl C, Wacker C, Weber U. et al. MRI features of gastrocnemius musculotendinopathy in herding dogs. Vet Radiol Ultrasound 2010; 51 (04) 380-385
• 5 Muir P, Dueland RT. Avulsion of the origin of the medial head of the gastrocnemius muscle in a dog. Vet Rec 1994; 135 (15) 359-360
• 6 Ting D, Petersen SW, Mazzaferro EM, Worth LT, Petersen SW. American College of Veterinary Radiology. What is your diagnosis? Avulsion of the origin of the gastrocnemius muscle. J Am Vet Med Assoc 2006; 228 (10) 1497-1498
• 7 Kramer M, Gerwing M, Michele U, Schimke E, Kindler S. Ultrasonographic examination of injuries to the Achilles tendon in dogs and cats. J Small Anim Pract 2001; 42 (11) 531-535
• 8 Meutstege FJ. The classification of canine Achilles' tendon lesions. Vet Comp Orthop Traumatol 1993; 06 (01) 53-55
• 9 Nielsen C, Pluhar GE. Outcome following surgical repair of Achilles tendon rupture and comparison between postoperative tibiotarsal immobilization methods in dogs: 28 cases (1997-2004). Vet Comp Orthop Traumatol 2006; 19 (04) 246-249
• 10 Duffy DJ, Chang Y-J, Gaffney LS, Fisher MB, Moore GE. Effect of bite depth of an epitendinous suture on the biomechanical strength of repaired canine flexor tendons. Am J Vet Res 2019; 80 (11) 1043-1049
• 11 Frame K, Ben-Amotz O, Simpler R, Zuckerman J, Ben-Amotz R. The use of bidirectional barbed suture in the treatment of a complete common calcanean tendon rupture in a dog: long-term clinical and ultrasonographic evaluation. Clin Case Rep 2019; 7 (08) 1565-1572
• 12 Moores AP, Owen MR, Tarlton JF. The three-loop pulley suture versus two locking-loop sutures for the repair of canine Achilles tendons. Vet Surg 2004; 33 (02) 131-137
• 13 Katayama M. Augmented repair of an Achilles tendon rupture using the flexor digitorum lateralis tendon in a Toy Poodle. Vet Surg 2016; 45 (08) 1083-1086
• 14 Tidwell SJ, Greenwood K, Franklin SP. Novel Achilles tendon repair technique utilizing an allograft and hybrid external fixator in dogs. Open Vet J 2022; 12 (03) 335-340
• 15 Zellner EM, Hale MJ, Kraus KH. Application of tendon plating to manage failed calcaneal tendon repairs in a dog. Vet Surg 2018; 47 (03) 439-444
• 16 Buttin P, Goin B, Cachon T, Viguier E. Repair of tendon disruption using a novel synthetic fiber implant in dogs and cats: the surgical procedure and three case reports. Vet Med Int 2020; 2020: 4146790
• 17 Mueller MC, Gradner G, Hittmair KM, Dupré G, Bockstahler BA. Conservative treatment of partial gastrocnemius muscle avulsions in dogs using therapeutic ultrasound—a force plate study. Vet Comp Orthop Traumatol 2009; 22 (03) 243-248
• 18 Prior JE. Avulsion of the lateral head of the gastrocnemius muscle in a working dog. Vet Rec 1994; 134 (15) 382-383
• 19 Chaffee VW, Knecht CD. Avulsion of the medical head of the gastrocnemius in the dog. Vet Med Small Anim Clin 1975; 70 (08) 929-931
• 20 Buttin P, Goin B, Crumière AJJ. et al. Ex-vivo biomechanical analysis of an original repair of canine calcaneal tendon rupture using a synthetic implant as mechanical support fixed by sutures in the proximal tendinous part and by an interference screw in the bone distal part. Open Vet J 2023; 13 (05) 645-653
• 21 Millis DL, Mankin J. Orthopedic and neurologic evaluation. In: Millis DL, Levine D. , editors. Canine Rehabilitation and Physical Therapy. 2nd ed. Philadelphia, PA, USA: Elsevier; 2014: 180-200
• 22 Hermanson JW. The muscular system. In: Evans HE, de Lahunta A. eds. Miller's Anatomy of the Dod. 4th ed. St. Louis, Missouri, US: Elsevier Saunders; 2013: 185-280
• 23 Smith PA, Bozynski CC, Kuroki K, Henrich SM, Wijdicks CA, Cook JL. Intra-articular biocompatibility of multistranded, long-chain polyethylene suture tape in a canine ACL model. J Knee Surg 2019; 32 (06) 525-531
• 24 Dhom J, Bloes DA, Peschel A, Hofmann UK. Bacterial adhesion to suture material in a contaminated wound model: comparison of monofilament, braided, and barbed sutures. J Orthop Res 2017; 35 (04) 925-933