Immediate treatment of incisional drainage or method to prevent incisional infections may decrease hernia formation.
This technique offers a similar chance of success as has been reported with debridement and may allow for a shorter period of convalescence. If unsuccessful, the option remains to debride the cyst in a second surgery.
The objective of this study was to determine if damage to the articular cartilage alone or articular cartilage plus subchondral bone of the distal medial femoral condyle of young, exercised horses resulted in the formation of subchondral cystic lesions. Twelve Quarter Horses (age 1-2 years), free of clinical and radiographic signs of osteochondrosis and lameness were used. In 6 horses (Group 1), a 15 times 1 mm linear full thickness defect in the articular cartilage was made arthroscopically on the weightbearing surface of the distal aspect of the medial femoral condyle. In the other 6 horses (Group 2), a 15 times 3 mm full thickness elliptical cartilage defect was made, followed by burring a 5 mm diameter, 4 mm deep hole into the subchondral bone. Three weeks after surgery, all horses were hand walked and trotted for 2 weeks and then exercised for 6 min daily, 5 days a week for the next 14 weeks on a treadmill. They were then turned onto a small paddock for 6 weeks (6 months total). The development of subchondral cystic lesions was determined using radiography. Bone activity in the femoral condyle was monitored with nuclear scintigraphy. All horses that developed subchondral cystic lesions radiographically were subjected to euthanasia for gross and histological examination of the lesions. No subchondral cystic lesions and no clinical abnormalities were detected in the horses in Group 1. Subchondral cystic lesions developed radiographically in 5 of 6 horses in (Group 2). Scintigraphic findings of horses with subchondral cystic lesions were inconsistent. Histological examination of lesions revealed variable quantities of fibrous connective tissue, fibrocartilage and bone, with evidence of bone remodelling adjacent to the subchondral cystic lesion. The results suggest that damage to articular cartilage plus subchondral bone, but not articular cartilage alone, of the distal medial femoral condyle may lead to the development of subchondral cystic lesions. These findings indicate that all subchondral cystic lesions in horses may not be osteochondrosis-type lesions and that trauma to weightbearing articular surfaces of young horses may be a predisposing factor.
Purpose Magnetically controlled growing rod systems have been introduced over recent years as an alternative to traditional growing rods for management of early onset scoliosis. The purpose of this paper is to report our early experience of a magnetically controlled growing rod system (MAGEC, Ellipse). Methods Review of pre-operative, postoperative and follow-up Cobb angles and spinal growth in case series of eight patients with a minimum 23 months' follow-up (23-36 months). Results A total of six patients had dual rod constructs implanted and two patients received single-rod constructs. Four patients had MAGEC rods as a primary procedure. Four were revisions from other systems. Mean age at surgery in the primary group was 4.5 years (range 3.9-6.9). In patients who had MAGEC as a primary procedure, mean pre-operative Cobb angle was 74°(63-94), with postoperative Cobb angle of 42°(32-56) p B 0.001 (43 % correction). Mean Cobb angle at follow-up was 42°(35-50). Spinal growth rate was 6 mm/year. One sustained proximal screw pull out. A final patient sustained a rod fracture. Mean age at surgery in the revision group was 10.9 years (range 9-12.6). Mean pre-operative Cobb angle was 45°( 34-69). Postoperative Cobb angle was 42°(33-63) (2 % correction). Mean Cobb angle at follow-up was 44°( 28-67). Mean spinal growth rate was 12 mm/year. Two patients developed loss of distraction.Conclusion MAGEC growing rod system effectively controls early onset scoliosis when used as either a primary or revision procedure. Although implant-related complications are not uncommon, the avoidance of multiple surgeries following implantation is beneficial compared with traditional growing rod systems.
One hundred thirteen of 172 horses (66%) undergoing exploratory celiotomy for a small intestinal lesion survived 4 or more days after surgery. Intra-abdominal adhesions causing clinical problems requiring additional surgery or euthanasia were documented in 25 horses (22.1%). Problems developed in significantly more males than females. The most common initial small bowel lesion was ileal impaction (12 horses); 21 horses underwent small intestinal resection or bypass. However, there was no significant difference in the incidence of intra-abdominal adhesions between horses that underwent intestinal resection or bypass and those that did not. Only 4 of the 25 horses (16%) with problems associated with postoperative adhesions survived. The mean interval between surgical procedures or between the initial procedure and euthanasia for all horses was 84 days (range, 7-512 days; median, 25 days). However, 70% of the subsequent celiotomies were performed within 60 days of the previous surgery. The mean interval between celiotomies was 221 days (range, 9-512 days) for the survivors and 61 days (range, 7-358 days) for the nonsurvivors. These results indicated that most of the problems related to postoperative intra-abdominal adhesions occurred within 2 months of the initial small intestinal surgery. Furthermore, the earlier development of postoperative adhesions was associated with a poorer prognosis for survival.
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