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Vet Comp Orthop Traumatol 2019; 32(03): 241-249
DOI: 10.1055/s-0039-1678701
Clinical Communication
Georg Thieme Verlag KG Stuttgart · New York

Computer-Assisted Surgery Using 3D Printed Saw Guides for Acute Correction of Antebrachial Angular Limb Deformities in Dogs

Andrew J. Worth
1   School of Veterinary Science, Massey University, Palmerston North, New Zealand
,
Katherine R. Crosse
1   School of Veterinary Science, Massey University, Palmerston North, New Zealand
,
Andrew Kersley
2   Axia Design Group Ltd, Napier, New Zealand
› Author Affiliations Funding There is no grant or other financial support to disclose. Axia Design Group discounted their professional time to aid this research.
Further Information

Publication History

02 May 2018

23 December 2018

Publication Date:
09 April 2019 (online)

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Abstract

Objective The aim of this study was to report the use of custom saw guides produced using computed tomographic imaging (CT), computer simulation and three-dimensional (3D) printing to aid surgical correction of antebrachial deformities in six dogs.

Materials and Methods Antebrachial limb deformities in four small, and two large, breed dogs (seven limbs) were surgically corrected by a radial closing wedge ostectomy and ulnar osteotomy. The location and orientation of the wedge ostectomy were determined using CT data, computer-assisted planning and production of a saw guide in plastic using a 3D printer. At surgery, the guide was clamped to the surface of the radius and used to direct the oscillating saw blade. The resultant ostectomy was closed and stabilized with a bone plate.

Results Five limbs healed without complications. One limb was re-operated due to a poorly resolved rotational component of the deformity. One limb required additional stabilisation with external fixation due to screw loosening. The owners of five dogs completed a Canine Orthopedic Index survey at a follow-up period of 37 to 81 months. The median preoperative score was 3.5 and the median postoperative score was 1, representing an overall positive effect of surgery. Radiographically, 5/7 limbs were corrected in the frontal plane (2/7 were under-corrected). Similarly, 5/7 limbs were corrected in the sagittal plane, and 2/7 were over-corrected in the sagittal place.

Conclusions Computer-aided design and rapid prototyping technologies can be used to create saw guides to simplify one-stage corrective osteotomies of the antebrachium using internal fixation in dogs. Despite the encouraging results, accurate correction of rotational deformity was problematic and this aspect requires further development.

Keywords

angular limb deformity - three-dimensional printing - rapid prototyping - saw guide - computed tomography

Author Contributions

All authors have contributed to the conception, design, acquisition of data, analysis and interpretation of data, drafting or revising, and final approval of the manuscript.


Supplementary Material

 

  • References

  • 1 Johnson JA, Austin C, Breur GJ. Incidence of canine appendicular musculoskeletal disorders in 16 Veterinary Teaching Hospitals from 1980 through 1989. Vet Comp Orthop Traumatol 1994; 7: 56-69
    Article in Thieme ConnectPubMedGoogle Scholar
  • 2 Fox SM. Premature closure of distal radial and ulnar physes in the dog 1. Pathogenesis and diagnosis. Compend Contin Educ Pract Vet 1984; 6: 128-139
    PubMedGoogle Scholar
  • 3 Ramadan RO, Vaughan LC. Premature closure of the distal ulnar growth plate in dogs--a review of 58 cases. J Small Anim Pract 1978; 19 (11) 647-667
    CrossrefPubMedGoogle Scholar
  • 4 O'Brien TR, Morgan JP, Suter PF. Epiphyseal plate injury in the dog: a radiographic study of growth disturbance in the forelimb. J Small Anim Pract 1971; 12 (01) 19-36
    CrossrefPubMedGoogle Scholar
  • 5 Morgan PW, Miller CW. Osteotomy for correction of premature growth-plate closure in 24 dogs. Vet Comp Orthop Traumatol 1994; 7: 129-135
    Article in Thieme ConnectPubMedGoogle Scholar
  • 6 Henney LHS, Gambardella PC. Premature closure of the ulnar physis in the dog – a retrospective clinical study. J Am Anim Hosp Assoc 1989; 25: 573-581
    PubMedGoogle Scholar
  • 7 Knapp JL, Tomlinson JL, Fox DB. Classification of angular limb deformities affecting the canine radius and ulna using the center of rotation of angulation method. Vet Surg 2016; 45 (03) 295-302
    CrossrefPubMedGoogle Scholar
  • 8 Fox DB, Tomlinson JL, Cook JL, Breshears LM. Principles of uniapical and biapical radial deformity correction using dome osteotomies and the center of rotation of angulation methodology in dogs. Vet Surg 2006; 35 (01) 67-77
    CrossrefPubMedGoogle Scholar
  • 9 Marcellin-Little DJ, Ferretti A, Roe SC, DeYoung DJ. Hinged Ilizarov external fixation for correction of antebrachial deformities. Vet Surg 1998; 27 (03) 231-245
    CrossrefPubMedGoogle Scholar
  • 10 Deruddere KJ, Snelling SR. A retrospective review of antebrachial angular and rotational limb deformity correction in dogs using intraoperative alignment and type 1b external fixation. N Z Vet J 2014; 62 (05) 290-296
    CrossrefPubMedGoogle Scholar
  • 11 Atilola MAO, Sumner-Smith G. Nonunion fractures in dogs. J Vet Orthoped 1984; 3: 21-24
    PubMedGoogle Scholar
  • 12 Welch JA, Boudrieau RJ, DeJardin LM, Spodnick GJ. The intraosseous blood supply of the canine radius: implications for healing of distal fractures in small dogs. Vet Surg 1997; 26 (01) 57-61
    CrossrefPubMedGoogle Scholar
  • 13 Fox D. Radius and Ulna. In: Tobias KM, Johnston SA. , eds. Veterinary Surgery Small Animal Surgery. 1st ed. St Louis, MO: Elsevier; 2012: 780-781
    Google Scholar
  • 14 Paley D, Herzenberg JE. Principles of Deformity Correction. ISBN: 978–3-642–63953–1. Berlin: Springer; 2002
    Google Scholar
  • 15 Piras LA, Peirone B, Fox D. Effects of antebrachial torsion on the measurement of angulation in the frontal plane: a cadaveric radiographic analysis. Vet Comp Orthop Traumatol 2012; 25 (02) 89-94
    Article in Thieme ConnectPubMedGoogle Scholar
  • 16 Dismukes DI, Fox DB, Tomlinson JL, Essman SC. Use of radiographic measures and three-dimensional computed tomographic imaging in surgical correction of an antebrachial deformity in a dog. J Am Vet Med Assoc 2008; 232 (01) 68-73
    CrossrefPubMedGoogle Scholar
  • 17 Mahaisavariyaa B, Sitthiseripratipb K, Orisc P. Rapid prototyping model for surgical planning of corrective osteotomy for cubitus varus: report of two cases. Inj Extra 2006; 37: 176-180
    CrossrefPubMedGoogle Scholar
  • 18 Crosse KR, Worth AJ. Computer-assisted surgical correction of an antebrachial deformity in a dog. Vet Comp Orthop Traumatol 2010; 23 (05) 354-361
    Article in Thieme ConnectPubMedGoogle Scholar
  • 19 Brown DC. The Canine Orthopedic Index. Step 3: Responsiveness testing. Vet Surg 2014; 43 (03) 247-254
    CrossrefPubMedGoogle Scholar
  • 20 Murase T, Oka K, Moritomo H, Goto A, Yoshikawa H, Sugamoto K. Three-dimensional corrective osteotomy of malunited fractures of the upper extremity with use of a computer simulation system. J Bone Joint Surg Am 2008; 90 (11) 2375-2389
    CrossrefPubMedGoogle Scholar
  • 21 Tack P, Victor J, Gemmel P, Annemans L. 3D-printing techniques in a medical setting: a systematic literature review. Biomed Eng Online 2016; 15 (01) 115
    CrossrefPubMedGoogle Scholar
  • 22 Hespel AM. Three-dimensional printing role in neurologic disease. Vet Clin North Am Small Anim Pract 2018; 48 (01) 221-229
    CrossrefPubMedGoogle Scholar
  • 23 Hamilton-Bennett SE, Oxley B, Behr S. Accuracy of a patient-specific 3D printed drill guide for placement of cervical transpedicular screws. Vet Surg 2018; 47 (02) 236-242
    CrossrefPubMedGoogle Scholar
  • 24 Oxley B, Behr S. Stabilisation of a cranial cervical vertebral fracture using a 3D-printed patient-specific drill guide. J Small Anim Pract 2016; 57 (05) 277
    CrossrefPubMedGoogle Scholar
  • 25 Adams BD. Effects of radial deformity on distal radioulnar joint mechanics. J Hand Surg Am 1993; 18 (03) 492-498
    CrossrefPubMedGoogle Scholar
  • 26 Cooney III WP, Dobyns JH, Linscheid RL. Complications of Colles' fractures. J Bone Joint Surg Am 1980; 62 (04) 613-619
    CrossrefPubMedGoogle Scholar
  • 27 Franczuszki D, Chalman JA, Butler HC. , et al. Postoperative effects of experimental femoral shortening in the mature dog. J Am Anim Hosp Assoc 1987; 23: 429-437
    PubMedGoogle Scholar
  • 28 Franklin SP, Dover RK, Andrade N, Rosselli D. , M Clarke K. Correction of antebrachial angulation-rotation deformities in dogs with oblique plane inclined osteotomies. Vet Surg 2017; 46 (08) 1078-1085
    CrossrefPubMedGoogle Scholar