MANAGEMENT OF DISTAL FEMORAL SHAFT FRACTURES WITH STRING OF PEARLS LOCKING PLATE IN DOGS
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Date
2015-07
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SRI VENKATESWARA VETERINARY UNIVERSITY , TIRUPATI – 517 502 ,A.P
Abstract
ABSTRACT :
Dogs with distal femoral shaft fractures presented to College Hospital were diagnosed by clinical signs, orthopaedic examination and survey radiography. The breed, age and sex wise incidence of these fractures were studied. Six selected cases of distal femoral Shaft fractures (10-22 months old with body weight ranging from 12-25 kg) were stabilized with String of Pearls (SOP) locking plate along with standard cortical and cancellous screws following standard AO/ASIF principles. Selection of appropriate size of plate and screws according to body weight and type of fracture (2.7mm plate for dogs below 12 kg body weight and 3.5 mm plate for dogs above 12 kg body weight) provided good fracture stability. No technical difficulties were observed while contouring and application of SOP locking plate on distal shaft fractures of femur.
The outcome of fracture stabilization and healing was evaluated with lameness grading, radiography and biochemical analysis. All animals, which were diagnosed with unstable distal femoral Shaft fractures showed grade V lameness before surgical management. Postoperatively, all the animals showed weight bearing with early
functional limb usage of grade I lameness and good joint mobility in an average of 7 weeks. Functional outcome was excellent in two cases and good in four cases. The results of radiographic evaluation for plate stability, fracture alignment and callus formation in immediate post operative stage, after 3, 5, 7 and 9 weeks for all six animals and also long term follow up for some cases were studied. The overall average healing time in all the cases was 7-11 weeks. The fractures showed radiographically excellent postoperative healing of cortical union, absence of fracture lines with limited and also bridging callus.
Statistical analysis revealed a highly significant difference (P<0.01) in serum alkaline phosphatase and C-reactive protein values at different stages of postoperative intervals. The serum alkaline phosphatase values significantly increased from 0 day to 14th day and thereafter reached to normal values by 21st postoperative day. Lower C-reactive protein values were observed on the 60th postoperative day. The serum calcium mean values showed a significant rise upto 14 days followed by a gradual decrease in the value and reaching normalcy on 60th day of postoperative period. There was no significant variation in serum phosphorus level post-operatively and the values were within the normal range. No major postoperative complications were observed except cutaneous wound dehiscence in one case. Plate removal was done in two cases and in others not done.
Based on present study, it was concluded that String of Pearls (SOP) locking plates were good for stabilization of distal femoral shaft fractures for early limb ambulance and healing. The application of SOP plates was found effective with advantageous features like contouring to any shape of the bone, high bending strength, its central design to use standard cortical screws as locking screws and cost similar or less than that of conventional orthopaedic plating systems. All these attributes allow SOP plate to be used for stabilization of distal shaft fractures of other long bones.
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Keywords
DISTAL SHAFT FRACTURES; String of Pearls ; LOCKING PLATE; DOGS; femur