Evolution of the treatment of canine radial and tibial fractures with external fixators

A. L. Johnson; D. J. Schaeffer

doi:10.1055/s-0037-1617370

Veterinary and Comparative Orthopaedics and Traumatology, Inhaltsverzeichnis

Vet Comp Orthop Traumatol 2008; 21(03): 256-261
DOI: 10.1055/s-0037-1617370

Clinical Communication

Schattauer GmbH

Evolution of the treatment of canine radial and tibial fractures with external fixators

A. L. Johnson

¹Departments of Veterinary Clinical Medicine, University of Illinois, Urbana, Illinois, USA

,

D. J. Schaeffer

²Departments of Veterinary Biosciences, College of Veterinary Medicine, University of Illinois, Urbana, Illinois, USA

› Institutsangaben

Abstract

Summary

Objectives: To determine if indications for external fixator treatment of radial and tibial fractures, management of the fractures, or outcomes have changed over three decades. Methods: Three groups of dogs were identified from discrete time spans within three decades and the medical records and radiographs were evaluated. The groups were compared in order to determine whether indications (signalment, etiology, fracture type and configuration), reduction method, equipment and implants, frame types and pin numbers, numbers of radiographic reevaluations, use of destabilization, frequency of pin track osteolysis, frame removal times and percentage of complications remained the same over the decades. Results: The indications for external fixator treatment of radial and tibial fractures remained consistent over three decades. The equipment and implants changed over the decades. Frame construction changed from the predominately Type II frames constructed in the 1980’s and 1990’s to a variety of modified Type II, Type Ia, Type Ib and hybrid frames constructed in the 2000’s. The frequency of pin track osteolysis decreased significantly over the decades. Frame removal times have not changed significantly over the past three decades. Complications (nonunion, delayed union, osteomyelitis, implant failure and premature frame loss) have decreased over this time. Clinical significance: Improvements in techniques and equipment have led to decreased complications with external fixators.

Keywords

External fixator - radius - tibia - fracture - dog

Volltext

Referenzen

References
1 Pettit GD. History of external skeletal fixation.. Vet Clin North Am Small Anim Pract 1992; 22: 1-9.
2 Bradley RL, Rouse GP. External skeletal fixation using the through and through Kirschner Ehmer splint.. J Am Anim Hosp Assoc 1980; 16: 523-530.
3 Boothe HW, Tangner CH. Clinical application of the Kirschner apparatus in long bone fractures.. J Am Anim Hosp Assoc 1983; 19: 679-686.
4 Egger EL. Static strength evaluation of six external fixation configurations.. Vet Surg 1983; 12: 130-136.
5 Aron DN, Toombs JP. Updated principles of external skeletal fixation.. Comp Cont Ed 1984; 6: 845-858.
6 Aron DN, Toombs JP, Hollingsworth SC. Primary treatment of severe fractures by external skeletal fixation: Threaded pins compared with smooth pins.. J Am Anim Hosp Assoc 1985; 22: 659-670.
7 Brinker WO, Verstraete MC, Soutal-Little RM. Stiffness studies on various configuration and types of external fixators.. J Am Anim Hosp Assoc 1985; 21: 801-808.
8 Egger EL, Rigg DL, Blass CE. et al. Type I biplanar configuration of external fixation: Application technique in nine dogs and one cat.. J Am Vet Med Assoc 1985; 187: 262-267.
9 Roe SC, Johnson AJ, Harari J. Placement of multiple full pins for external fixation: technique and results in four dogs.. Vet Surg 1985; 14: 247-251.
10 Egger EL, Histand MB, Blass CE. et al. Effect of fixation pin insertion on the bone-pin interface.. Vet Surg 1986; 15: 246-252.
11 Egger EL, Runyon CL, Rigg DL. Use of Type I double-connecting bar configuration of external skeletal fixation on long bone fractures in dogs: a review of 10 cases.. J Am Anim Hosp Assoc 1986; 22: 57-64.
12 Bennet RA, Egger EL, Histand MB. et al. Comparison of the strength and holding power of 4 pin designs for use with half pin (type I) external skeletal fixation.. Vet Surg 1987; 16: 207-211.
13 Gumbs JM, Brinker WO, DeCamp CE. et al. Comparison of acute and chronic pull-out resistance of pins used with the external fixator (Kirschner splint).. J Am Anim Hosp Assoc 1988; 24: 231-234.
14 Foland MA, Egger EL. Application of type III external fixators: a review of 23 clinical fractures in 20 dogs and two cats.. J Am Anim Hosp Assoc 1991; 27: 193-202.
15 Bouvey BM, Markel MD, Chelikani S. et al. Ex vivo biomechanics of Kirschner-Ehmer external skeletal fixation applied to the canine tibiae.. Vet Surg 1993; 22: 194-207.
16 McDonald DE, Palmer RH, Hulse DA. et al. Holding power of threaded external skeletal fixation pins in the near and far cortices of cadaveric canine tibiae.. Vet Surg 1994; 23: 488-493.
17 Clary EM, Roe SC. Enhancing external skeletal fixation pin performance: Consideration of the bone-pin interface.. Vet Comp Orthop Traumatol 1995; 7: 1-8.
18 Clary EM, Roe SC. In vitro biomechanical and histological assessment of pilot hole diameter for positive-profile external skeletal fixation pins in canine tibiae.. Vet Surg 1996; 25: 453-462.
19 Anderson MA, Mann FA, Kinden DA. et al. Evaluation of cortical bone damage and axial holding power of nonthreaded and enhanced threaded pins placed with and without drilling of a pilot hole in femurs from canine cadavers.. J Am Vet Med Assoc 1996; 208: 883-887.
20 Anderson MA, Aron DN, Palmer RH. Improving pin selection and insertion techniques for external skeletal fixation.. Comp Cont Educ Pract Vet 1997; 19: 485-494.
21 Kraus KH, Wotton HM, Schwartz LA. et al. Type-II external fixation using new clamps and positive-profile threaded pins, for treatment of fractures of the radius and tibia in dogs.. J Am Vet Med Assoc 1998; 212: 1267-1270.
22 White DT, Bronson DG, Welch RD. A mechanical comparison of veterinary linear external fixation systems.. Vet Surg 2003; 32: 507-514.
23 Bronson DG, Ross D, Toombs JP. et al. Influence of the connecting rod on the biomechanical properties of five external skeletal fixation configurations.. Vet Comp Orthop Traumatol 2003; 16: 82-87.
24 Kraus KH, Wotton HM. Effect of clamp type on four-pin type II external fixator stiffness.. Vet Comp Orthop Traumatol 1999; 12: 178-182.
25 Johnson AL, Kneller SK, Weigel RM. Radial and tibial fracture repair with external skeletal fixation.. Vet Surg 1989; 18: 367-372.
26 Johnson AL, Seitz SE, Smith CW. et al. Closed reduction and type II external fixation for the treatment of twenty-three severely comminuted fractures of the radius and tibia (1990-1994).. J Am Vet Med Assoc 1996; 209: 1445-1448.
27 Gorse MJ. Using external skeletal fixation for fractures of the radius and ulna and tibia.. J Vet Med 1998; 463-467.
28 Aron DN, Palmer RH, Johnson AL. Biologic strategies and a balanced concept for repair of highly comminuted long bone fractures.. Comp Cont Educ 1995; 17: 35-49.
29 Johnson AL, Egger EL, Eurell JC. et al. Biomechanics and biology of fracture healing with external skeletal fixation.. Comp Cont Educ 1998; 20: 487-500.
30 Farese JP, Lewis DD, Cross AR. et al. Use of IMEX SK-circular external fixator hybrid constructs for fracture stabilization in dogs and cats.. J Am Anim Hosp Assoc 2002; 38: 279-289.
31 Johnson KA, Roe SC. Use of an aiming device for application of a type II (bilateral) external fixator to a fractured tibia of a dog.. J Am Vet Med Assoc 1988; 192: 1573-1576.
32 Egger EL, Histand MB, Norrdin RW. et al. Canine osteotomy healing when stabilized with decreasingly rigid fixation compared to constantly rigid fixation.. Vet Comp Orthop Traumatol 1993; 6: 182-187.
33 Green SA. Complications of external skeletal fixation.. Clin Ortho Rel Res 1983; 180: 109-116.
34 Harari J. Complications of external skeletal fixation.. Vet Clin North Am 1992; 22: 99-107.