EVALUATION OF ANTIBIOTIC IMPREGNATED IMPLANTS AND BEADS FOR STABILIZATION OF LONG BONE DIAPHYSEAL COMPOUND FRACTURES IN DOGS
| dc.contributor.advisor | DHANA LAKSHMI, N(MAJOR) | |
| dc.contributor.advisor | RAGHUNATH, M | |
| dc.contributor.advisor | RAJU, N.K.B. | |
| dc.contributor.advisor | ADILAXMAMMA, K | |
| dc.contributor.author | PHANEENDRA, M.S.S.V. | |
| dc.date.accessioned | 2018-12-03T06:36:59Z | |
| dc.date.available | 2018-12-03T06:36:59Z | |
| dc.date.issued | 2017-11 | |
| dc.description | THESES | en_US |
| dc.description.abstract | ABSTRACT: The study was undertaken in 30 dogs with compound long bone diaphyseal fractures presented to Veterinary Clinical complex, Department of Veterinary Surgery and Radiology, Tirupati. The detailed history and signalment including sex, breed, age, weight, time since injury and limb involved were collected from the owner and incidence was analyzed. The cases were divided into two groups, in which 24 dogs with various compound long bone diaphyseal fractures were stabilized by Locking compression plates or intramedullary pins along with local antibiotic (gentamicin) + biodegradable bone cement (hydroxyapatite or Poly D,L lactide) (Group I) and 6 dogs with various compound long bone diaphyseal fractures were stabilized by Locking Compression Plates or intramedullary pins without local antibiotic therapy as control group (Group II). The outcome was evaluated by clinical, radiographical and biochemical analysis in both the groups. In Group I, 18 dogs out of 24 cases were stabilized by using antibiotic bone cement impregnated Locking Compression Plates and 6 dogs of humerus and femur fractures were stabilized using intramedullary pinning with local application of antibiotic bone cement beads. Post-operatively, the operated limb was supported by Robert- jones bandaging and systemic antibiotics were given in both the groups. Clinical evaluation was routinely carried out at periodical intervals for the signs of swelling, exudation, weight bearing and stability of the fixation in all the dogs. Post-operative swelling was not much in Group I compared to Group II. The degree of lameness was graded from I to V on 1st, 7th, 14th, 28th, 45th and 60th day of the surgery in all the cases and thereafter every two weeks until implant removal in case of plating. All the dogs showed grade V lameness preoperatively. In Group I, all dogs with radius-ulna and tibia compound fractures stabilized by antibiotic impregnated Locking Compression Plating (LCP) technique showed grade I lameness by 14th post-operative day except for two cases in which grade I lameness was seen by 19th and 21st post-operative day whereas all dogs in control group (Group II) stabilized with LCP showed complete weight bearing only after 45th post-operative day. In case of humerus and femur compound fractures in Group I, which were stabilized with intramedullary pinning with placement of a local antibiotic bead, full weight bearing with paw touching on the ground associated with normal gait was observed on 25th postoperative day. On 45th day, all the cases showed no lameness (grade I) whereas all dogs in control group (Group II) showed grade I lameness by 60th post-operative day. Medio-lateral and anterio-posterior radiographs of the operated bones were obtained immediately after surgery and on 3rd, 5th, 7th and 9th week postoperatively and whenever needed on later dates in all the cases for assessing alignment of fragments and implant position to assess the progress of bone healing. Radiographs showed progressive healing of the fractures. In case of plating in Group I, obliteration of the fracture line with the bony callus bridging the fracture area was observed on 7th post-operative week and by 11th post-operative week in all cases of Group II. In case of Intramedullary Pinning in Group I, on 6th post-operative week remodeling of the callus with obliteration of the fracture line was observed in all the cases whereas in the same Intramedullary Pinning cases of Group II postoperative healing was observed by 9th postoperative week. Physiotherapy of the limb was advised after two weeks of surgery for 10-15 minutes thrice a day to retain normal joint movement for 6- 8 weeks. Haematological studies showed neutrophilia, leucocytosis and high erythrocyte sedimentation rates persisted for upto 14th post-operative day and 28th post-operative day in Group I and Group II (control group) respectively. Blood biochemistry showed serum alkaline phosphatase values significantly increased from preoperative day to 14th day and there after the levels decreased reaching normal by 60thday in both the groups. CRP values in Group II were higher compared to Group I, owing to prolonged post-operative inflammation in Group II. Swab samples were taken from the wound at fracture site on the preoperative day and on 12th postoperative day, which were assessed for microbial load. The microbial load values in Group I on 12th day was in the range of 3.73±0.84×102 to 3.92±1.27×103 CFU/ml and in Group II was ranging from 4.97±0.97×106 to 3.52±0.86×107 CFU/ml. The use of poly-(D,L)-lactide bone cement was limited to three cases as it turned about to be less cost effective, which was replaced by the use of another high efficiency biodegradable hydroxyapatite bone cement. The implants were well tolerated in all the cases except in one case of intramedullary pinning in Group II, which showed slight pin migration resulting in seroma formation. In the present clinical study, the technique of improvised use of antibiotic impregnated implants and beads along with biodegradable bone cement for stabilization of long bone diaphyseal compound fractures in dogs resulted in favorable functional limb outcome and bone healing. The infection was controlled by adding gentamicin and the bone healing was facilitated by the use of biodegradable bone cements like hydroxyapatite and poly-(D,L)-lactide. Unnecessary long term systemic antibiotic usage for open and infected fractures in dogs may be avoided by using antibiotic biodegradable impregnated implants in future. | en_US |
| dc.identifier.uri | http://krishikosh.egranth.ac.in/handle/1/5810085087 | |
| dc.keywords | DOGS;FRACTURES;ANTIBIOTIC IMPREGNATED IMPLANTS;BEADS;STABILIZATION;BONE DIAPHYSEAL | en_US |
| dc.language.iso | en | en_US |
| dc.pages | 235 | en_US |
| dc.publisher | SRI VENKATESWARA VETERINARY UNIVERSITY TIRUPATI - 517 502. (A.P.) INDIA | en_US |
| dc.sub | Veterinary Surgery and Radiology | en_US |
| dc.subject | null | en_US |
| dc.theme | EVALUATION OF ANTIBIOTIC IMPREGNATED IMPLANTS AND BEADS FOR STABILIZATION OF LONG BONE DIAPHYSEAL COMPOUND FRACTURES IN DOGS | en_US |
| dc.these.type | Ph.D | en_US |
| dc.title | EVALUATION OF ANTIBIOTIC IMPREGNATED IMPLANTS AND BEADS FOR STABILIZATION OF LONG BONE DIAPHYSEAL COMPOUND FRACTURES IN DOGS | en_US |
| dc.type | Thesis | en_US |