CLINICAL STUDY ON THE USE OF LIMITED CONTACT DYNAMIC COMPRESSION PLATE (LC-DCP) FOR STABILIZATION OF LONG BONE FRACTURES IN DOGS
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Date
2019-11-04
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PVNR TVU
Abstract
The present clinical study was conducted on six dogs presented with femur and tibia fractures to The Department of Veterinary Surgery and Radiology at the College of Veterinary Science, Rajendranagar, Hyderabad. The age of the six dogs ranged from 5 - 36 months. Out of these six dogs, five were males and one was a female. Among them two dogs belonged to Labrador Retriever breed, two were Mongrels, one each belonged to Sptiz and Pomeranian breeds. The body weight of the dogs ranged from 10 to 23 kg.
The six cases of femur and tibia fractures were diagnosed by clinical signs, orthopaedic examination and survey radiography. The symptoms observed in the dogs presented for treatment were pain on manipulation, abnormal angulation and lameness immediately after trauma, swelling, non-weight bearing, dangling of the limb and crepitation at the fracture site.
Pre-operative radiographic examination in two plain orthogonal views, i.e., craniocaudal and mediolateral radiographs revealed mid-diaphyseal fractures in five dogs and distal diaphyseal fracture in one dog. Pre-operative radiographs also showed the type of femur and tibia fractures as transverse fractures in four dogs and short oblique fractures in two dogs. All the six dogs had closed fractures.
These fractures were stabilized with 2.7 mm LC-DCP in two dogs and 3.5 mm LC-DCP in four dogs and resulted in good fracture fixation and immobilization. The length of the plates to be used was determined by the length of the bone as measured from the mediolateral radiographs obtained pre-operatively. The length of the screws was determined by measuring the transcortical diameter of the bone at different regions from the craniocaudal radiographs obtained pre-operatively.
Immediate post-operative radiographic evaluation confirmed proper placement of the plates and screws, apposition and alignment of the fracture fragments in all the six dogs. Immobilization was considered satisfactory in all the cases. The plate length, size and position were appropriate in all the cases. Screw length, size and position were found to be appropriate in all the cases. Follow-up radiographs taken on 7th, 15th, 30th, 45th and 60th post-operative days revealed primary bone healing with minimal callus formation. Good implant stability throughout the treatment period without any complications was achieved in five dogs. In one dog with femur fracture, screw (proximal most) breakage was observed by 30th post-operative day and alignment of fracture line was slightly disturbed. However, intermittent weight bearing was noticed by 45th post-operative day.
All the dogs which were diagnosed as femur and tibia fractures showed grade V lameness before surgical treatment. Post-operatively, five dogs progressed to grade I lameness by the end of 30th post-operative day and one dog progressed to grade II lameness by the end of 45th post-operative day. Haematological evaluation revealed that the progressive increase of haemoglobin level, packed cell volume and total erythrocyte count on post-operative days indicated erythropoiesis. The total leukocyte count was significantly decreased on post-operative days indicated leucocytopenia which is suggestive of gradual decrease in inflammatory reaction. The differential leucocyte count like neutrophils was significantly decreased on post-operative days indicated neutropenia. Contrary to this, the lymphocyte count was statistically increased on 14th and 45th post-operative days indicated gradual decrease of inflammatory reaction.
Serum biochemical evaluation revealed that the serum alkaline phosphatase and serum calcium values significantly increased from day 0 to 14th day and thereafter reached to normal values by 45th post-operative day. The increased serum alkaline phosphatase levels during the first two weeks indicated increased chondroblastic proliferation to cause bone formation during fracture repair. The serum phosphorous values showed no significant variation and the values were within the normal range.
Based on present study, it was concluded that Limited Contact Dynamic Compression Plates (LC-DCP) was successful in the treatment of long bone fractures in dogs and offered good recompense and remarkable improvement in the limb function, with good fracture stability till the completion of the bone healing in five out of six dogs. The application of LC-DCP plates was found to be effective with features like undercut between the holes had even levels of stiffness along the entire plate, allowing smoother, easier contouring and distributed stress more evenly and also maintaining less plate-bone contact area, thereby reducing cortical ischaemia and preserving viability of the bone fragments. The implant used in this technique was economical, making it amenable for use in veterinary practice.
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D-666
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