Ch. 46: ALD Flashcards
Cooley Vet Sx 2018 PQ
Assessment of overall thoracic limb axial alignment in dogs with antebrachial deformity
Mean overall TL rotation deg of normal dogs?
Mean overall TL rotation deg in uniapical? biapical deformity?
Which deformity rotation was different from normal?
Rotation % at elbow in ALD dogs? How did it differ to normal?
Torsion difference? Correlated with what?
Conclusion re: rotation? Torsion?
Mean overall thoracic limb ROTATION of normal dogs was 35°
Mean overall limb ROTATION in uniapical 42° & biapical deformity 54° but not statistically different
Only overall limb rotation in limbs with biapical ALD different from normal limbs
Rotation at the lvl of the elbow was 77% in normal and 85% limb rotation in deformity limbs & was increased from normal in limbs w/ ALD
Radial torsion did not differ among groups but was moderately correlated w/ overall limb rotation
Conclusion: ROTATION arising in the elbow of limbs w/ ALD was higher than in normal limbs & accounted for the greatest contribution of overall limb rotation – assessing radial TORSION alone is thus not sufficient
Worth VCOT 2019
Computer-assisted surgery using 3D printed saw guides for acute correction of antebrachial angular limb deformities in dogs
Conclusion re: saw guide?
did radial closing wedge ostectomy and ulnar osteotomy, CT planned production of 3D saw guide
Radiographically 5/7 limbs corrected in the frontal plane (2/7 under-corrected)
5/7 limbs were corrected in sagittal plane & 2/7 over-corrected in sagittal
CONC: 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
Carwardine VCOT 2021
Three-dimensional-printed patient-specific osteotomy guides, repositioning guides and titanium plates for acute correction of antebrachial limb deformities in dogs
Conclusion re guides?
All limbs corrected to within 3.5 deg and 7.5 deg of the preplanned deformity correction in the frontal and sagittal planes respectively
No complications encountered
Sx eliminated the main presenting complaint of buckling over of the carpus in all cases
Conclusion: use of 3D printed repositioning guides and titanium plates facilitated accurate acute correction of antebrachial deformities
Vezzoni VCOT 2022
Hemiepiphysiodesis for the correction of distal femoral valgus in growing dogs
What side was hemiepiphysiodesis performed on for valgus deformity?
What direction was MC current patellar lux?
How did they do hemiepiphysiodesis?
Pre op aLDFA? At final post op evaluation? What is normal femur?
Mean difference between pre and final outcome degrees?
Did they over correct or under correct in 2?
Rebound growth in how many after implant removal?
Conclusions re hemiepiphysiodesis?
Medial hemiepiphysiodesis of the distal femur was performed in 17 limbs
6/11 dogs underwent bilateral hemiepiphysiodesis
Concurrent diagnosis MC lateral patellar luxation
Hemiepiphysiodesis was achieved using staples in 10/17 limbs and plates in 7/17 limbs
Preoperatively, the mean aLDFA was 82 deg
mean aLDFA at final re-evaluation was 93 deg
reference value of normal femurs (94 degrees)
The mean difference between the preoperative and final aLDFA was +11 degrees, which was significant.
Undercorrection occurred in 2/17 cases, whereas overcorrection was not recorded.
The implants were removed in 12/17 cases, and rebound growth occurred in 3 of these. (25%)
Conclusions: Hemiepiphysiodesis for the treatment of distal femoral valgus is a technique that allows for increase in aLDFA and should be considered as an early treatment in affected immature dogs.
Monitoring for possible overcorrection using serial radiography is important.
Implant removal when the desired aLDFA has been achieved is recommended because the incidence of rebound growth is uncommon in dogs.
De Armond JAVMA 2022
Accuracy of virtual surgical planning and custom three-dimensionally printed osteotomy and reduction guides for acute uni- and biapical correction of antebrachial deformities in dogs
VSP and guides successfully used?
Post-op assessment of correction acceptable in how many %?
What is the acceptable range you want to correct within (degrees of rotation/ angulation and mm translation)?
report clinical experience using virtual surgical planning (VSP) and surgical application of 3D printed custom surgical guides to facilitate uni- and biapical correction of antebrachial deformities in dogs
11 dogs (13 antebrachial deformity corrections)
The guides were used to execute osteotomies and align bone segments.
Guides were successfully utilized and postoperative analysis was available for 10 of 13 deformities.
Guides were abandoned in 2 deformities due to soft tissue tension.
Postoperative frontal, sagittal, axial, and translational limb alignment revealed that over 90% of parameters were within the acceptable range of ≤ 5° angulation and rotation or ≤ 5 mm of translation from the VSP.
Lameness scores were improved in 7/8 deformities with associated preoperative lameness, and posture was improved in 10/10 deformities in which guides were deployed.
Complications included reduced range of carpal motion (n = 2), implant sensitivity (n = 2), fracture (n = 1), and tendon laceration (n = 1).
VSP and customized surgical guide application facilitated accurate antebrachial limb deformity correction in the majority of deformities in this case series
Longo VSURG 2022
Three-dimensional volume rendering planning, surgical treatment, and clinical outcomes for femoral and tibial detorsional osteotomies in dogs
Patellar tracking returned to normal in %?
What measurement did they make to correct what deformity?
Outcome overall?
Major comps were (2)?
Conclusion?
Retrospective, 18 dogs
femoral (FTA) and tibial torsion angle (TTA); patellar luxation (PL)
Mean preoperative FTA was 14 for medial-PL and 45 for lateral-PL
Mean preoperative TTA was 11 for medial-PL
22 detorsional osteotomies were performed.
Physiological patellar tracking was restored in 22/22 of cases 100%
Cortical arch length (CAL) measurement allowed for correction of abnormal TORSION in 19/22 of cases
17/18 dogs had full or acceptable functional outcome.
Major complications occurred in 2/22 cases, which suffered an iatrogenic abnormal femoral internal torsion and a persistent hindlimb lameness.
Conc: CAL can be measured with CT and used intraoperatively to guide the correction of abnormal torsion in dogs.
Knapp VSURG 2016 PQ (in Tobias)
Classification of Angular Limb Deformities Affecting the Canine Radius and Ulna Using the Center of Rotation of Angulation Method
Found what difference in incidence of biapical vs uniapical in what breed class?
What type of deformities were associated with ___? Most common affected what joint?
incidence of biapical deformities was statistically higher in chondrodystrophic compared to non-chondrodystrophic dogs (P=.02).
– Chondrodystrophic 3x more likely to have biapical than uniapical (Tobias)
When breeds were combined, biapical deformities were associated with a significantly higher incidence of adjacent radiographic joint disease, more frequently affecting the elbow
