Subscribe to RSS
Download PDF
DOI: 10.1055/s-0038-1633087
Evaluation of Experimental Proximal Femoral Physeal Fractures Repaired with Two Cortical Screws Placed from the Articular Surface
Publication History
Received for publication
20 April 1994
Publication Date:
08 February 2018 (online)
Summary
Proximal femoral physeal fractures were surgically created unilaterally in twelve immature dogs and repaired using two cortical screws placed in lag fashion from the articular surface into the femoral neck. Four dogs were euthanatized at two, four and eight weeks after surgery and evaluated by gross examination, fine detail radiography, fine detail angiography and histology. Mild to severe injury to the articular cartilage of the acetabulum was observed in all operated joints. Narrowing of the femoral neck was evident on fine detail radiographs and was most severe at week four. Metaphyseal vessels crossed the physis and revascularized the epiphysis with greater than 90% of the epiphysis being revascularized by eight weeks. Operated femora showed histological evidence of physeal disruption and premature physeal closure. Osteocyte death in the epiphysis was evident histologically with viable osteocytes following revascularization and proceeding from distal to proximal through the epiphysis over eight weeks.
The healing of proximal fe-moral physeal fractures repaired with two, 2.0 mm cortical screws placed from the articular surface was evaluated by gross evaluation, fine detail radio-graphs and angiographs, and histological examination. Fracture healing and restoration of blood supply was adequate for weight bearing. This technique is acceptable for use in clinical patients.
-
References
- 1 Berzon JL. The classification and manage-ment of epiphyseal plate fractures. JAAHA 1980; 16: 651-8.
- 2 Salter RB, Harris WR. Injuries involving the epiphyseal plate. J Bone Joint Surg 1963; 45-A: 587-622.
- 3 DeCamp CE, Probst CW, Thomas MW. Internal fixation of femoral capital physeal injuries in dogs: 40 cases (1979-1987). J Am Vet Med Assoc 1989; 194: 1750-4.
- 4 Lee R. Proximal femoral epiphyseal separation in the dog. J Small Anim Pract 1976; 11: 669-79.
- 5 Marretta SM, Schrader SC. Physeal injuries in the dog: a review of 135 cases. J Am Vet Med Assoc 1983; 182: 708-10.
- 6 Nelson CA. Operative treatment of fractures of the neck of the femur and epiphyseal separation of the head of the femur in the dog. North Amer Vet 1941; 22: 557-9.
- 7 Aron DN, Kaddatz LA, Dueland R. A review of reduction and internal fixation of proximal femoral fractures in the dog and man. JAAHA 1979; 15: 455-62.
- 8 Kuzma A, Sumner-Smith G, Miller C, McLaughlin R. A technique of repair of femoral capital epiphyseal fractures in the dog. J Small Anim Pract 1989; 30: 444-8.
- 9 Gibson KL, van Ee RT, Pechman RD. Femoral capital physeal fractures in dogs: 34 cases (1979-1989). J Am Vet Med Assoc 1991; 198: 886-90.
- 10 Hulse DH, Wilson JW, Abdelbaki YZ. Revascularization of femoral capital physeal fractures following surgical fixation. J Vet Orthop 1981; 2: 50-7.
- 11 Schroeder EF. Recent progress in canine orthopedic surgery. North Amer Vet 1939; 20: 54-61.
- 12 Newton GT. Sciatic impairment following proximal femoral physeal fracture: Two case reports. JAAHA 1989; 25: 239-42.
- 13 Milton JL. Fractures of the femur. In: Textbook of Small Animal Surgery, 2nd edn. Slatter D. ed. Philadelphia: WB Saunders; 1993: 1805-16.
- 14 Brinker WO, Piermattei DL, Flo GL. Hand-book of Small Animal Orthopedics and Fracture Treatment. 2nd edn. Philadelphia: WB Saunders H; 1990
- 15 Nunamaker DM. Repair of femoral head and neck fractures by interfragmentary compression. J Am Vet Med Assoc 1973; 162: 569-72.
- 16 Anderson WD, Schlotthauer CF, Janes JM. Method for treatment of fractures of the head of the femoral neck in the dog. I. An experimental study. J Am Vet Med Assoc 1953; 122: 158-60.
- 17 Denny HR. Simultaneous epiphyseal sepa-ration and fractures of the neck and greater trochanter of the femur in the dog. J Small Anim Pract 1971; 12: 613-21.
- 18 Schroeder EF. The treatment of fractures in dogs. North Amer Vet 1933; 14: 27-31.
- 19 Cawley AJ, Archibald J, Ditchfield WJB. Fractures of the neck of the femur in the dog: a technique for repair of fractures of the femoral neck. J Am Vet Med Assoc 1956; 129: 354-8.
- 20 Miller A, Anderson TJ. Complications of articular lag screw fixation of femoral capital epiphyseal separations. J Small Anim Pract 1993; 34: 9-12.
- 21 Piermattei DL, Greeley RG. An Atlas of Surgical Approaches to the Bones of the Dog and Cat. 2nd edn. Philadelphia: WB Saunders; 1979
- 22 Roush JK, Wilson JW. Effects of plate luting on cortical vascularity and the development of cortical porosity in canine femurs. Vet Surg 1990; 19: 208-14.
- 23 Brain IB. The Preparation of Decalcified Sections. Chicago, IL: Charles C. Thomas Publishing; 1966: 69-133.
- 24 Mankin HJ, Dorfman H, Lippiello L, Zarins A. Biochemical and metabolic abnormalities in articular cartilage from osteo-arthritic human hips. J Bone Joint Surg 1971; 53-A: 523-37.
- 25 Usui Y, Kawai K, Hirohata K. An electron microscopic study of the changes observed in osteocytes under ischemic conditions. J Orthop Res 1989; 7: 12-21.
- 26 Daly WR. Femoral head and neck fractures in the dog and cat: a review of 115 cases. Vet Surg 1978; 2: 29-38.
- 27 Bjorling DE. Fracture of the proximal femoral physis and femoral neck in two dogs. Can Pract 1986; 13: 5-11.
- 28 Manley PA. The hip joint. In: Textbook of Small Animal Surgery, 2nd edn. Slatter D. ed. Philadelphia: WB Saunders; 1993: 1786-804.
- 29 Kaderly RE, Anderson BG, Anderson WD. Intracapsular and intraosseous vascular supply to the mature dog’s coxofemoral joint. Am J Vet Res 1982; 44: 1805-12.
- 30 Riser WH. Growth and development of the normal canine pelvis, hip joints and femur from birth to maturity: a radiographic study. J Vet Radiol Soc 1973; 14: 24-34.
- 31 Smith RN. Radiological observations on the limbs of young greyhounds. J Small Anim Pract 1993; 1: 84-90.
- 32 Sumner-Smith G. Observations on epiphyseal fusion of the canine appendicular skeleton. J Small Anim Pract 1966; 7: 303-11.
- 33 Chung SMK. The arterial supply of the developing proximal end of the human femur. J Bone Joint Surg 1976; 58-A: 961-70.
- 34 Brighton CT. Structure and function of the growth plate. Clin Orthop 1978; 136: 22-32.
- 35 Rivera LA, Abdelbaki YZ, Titkemeyer CW. Arterial supply to the canine hip joint. J Vet Orthop 1979; 1: 20-32.
- 36 Tovee EB, Gendron E. The use of radio-active phosphorus in the determination of the viability of the femoral head in dogs after subcapital fracture. J Bone Joint Surg 1954; 36 A: 185 (Abstract).