Bone reconstruction with FCBA is effective in the treatment of radial and ulnar nonunion fractures associated with large bone defects, regardless of the infection status of the surgical site.
The aim of this study was to examine the effect of long-term locking plate fixation on the cortical bone of the canine radius. Locking compression plates were fixed to the left and right radius in dogs (n = 3). The left radius was fixed with a locking head screw (Locking Plate group, LP). The locking compression plate was compressed periosteally in the right radius using a cortex screw (Compression Plate group, CP). Radial bones from dogs that were euthanized for other purposes were collected as an untreated control group (Control group). After euthanasia at 36 weeks following plate fixation, radial bones were evaluated for bone mineral density and underwent histological analysis. Bone metabolic markers were analyzed by quantitative polymerase chain reaction (qPCR). Statistical analyses were performed for comparisons between groups. The LP group showed no significant difference in bone mineral density after plate fixation, whereas the CP group showed significantly lower bone mineral density. Histological analysis indicated that the number of osteoclasts and rate of empty lacunae increased significantly in the CP group relative to the Control and LP groups. qPCR analysis indicated increased expression of inflammatory cytokines, such as tumor necrosis factor-alpha, interleukin-6, and tumor necrosis factor ligand superfamily member 11 in the CP group, whereas Runt-related transcription factor 2, an osteoblast marker, was similar in all groups. The expression of hypoxia-inducible factor-1α in the CP group was also increased relative to that in the Control and LP groups. Thus, locking plate fixation is a biologically superior fixation method that does not cause implant-induced osteoporosis in the bone in the long term.
Objective This study aimed to evaluate implant-induced osteoporosis (IIO) development in toy breed dogs treated using internal fixation with digital radiographs as the index of pixel values. Study Design There were 226 cases (236 limbs) of toy breed dogs with radial–ulnar fractures. Pixel values were measured on radiographs immediately, 2 weeks and 1 to 12 months after surgery. The ratio of pixel values (PVR) represented the bone mineral areal density based on the humeral condyle in the same image. The dogs were grouped based on the fixation methods, age and status of destabilization. Results There was a significant decrease in the PVR at 1 to 12 months postoperatively for all cases. There were not any significant differences in PVR of antebrachial fractures between those repaired with plates using locking head screws, cortex screws or a combination of locking and cortex screws. Implant-induced osteoporosis persisted at 1 to 12 months postoperatively in dogs aged ≧6 months, while the PVR increased after 3 months in dogs aged <6 months. Based on the destabilization method, there was a significant increase in the PVR at 3 months in the plate removal group. Conclusion This study suggests that IIO occurs in small dogs treated with plates and screws. Moreover, patients aged < 6 months showed an early postoperative recovery of bone mineral areal density. Further, screw and plate removal could contribute to the recovery of bone mineral areal density.
Two dogs with non-union fractures and osteomyelitis in the femoral diaphysis were referred to the authors’ hospital. During surgery, the defects were reconstructed using autologous cortical bones harvested from the contralateral femoral diaphysis. Graft fixation was performed by a double-plate technique in both cases. Autogenous cancellous bone was also grafted between the host bone and the graft in both cases. Antibiotics were administered for two to three weeks. In cases 1 and 2, no loosening of the implant or lameness was observed after 31 months and 10 months, respectively. Autologous cortical bone grafts are useful in reconstructing large-sized bone defects of the femoral diaphysis associated with non-union fracture and osteomyelitis.
Background. An 8-year-old, 18.9 kg, male, intact Kai Ken with a femoral shaft fracture experienced recurrent implant breakage after two fracture reductions using an internal fixator. Objectives. This case report is aimed at using a three-dimensional (3-D) printer to diagnose residual femoral rotational deviation. Implant failures and malunion occurred after two attempts at synthesis. Thus, a 3-D model was designed for preoperative planning of a third surgery. Methods. To evaluate the alignment in the postoperative state after the second surgery, we removed a broken plate from the affected limb. Subsequently, a computed tomography image produced a bone replica using 3-D printing. The distal fragment was fixed and rotated externally by 42°. In addition to correcting the rotational deformity of the femur, we used an intramedullary pin and two locking plates to stabilize the proximal and distal femoral fracture segments. Results. The bone union was confirmed four months after surgery, and no postoperative complications were observed 11 months after surgery. Conclusion. 3-D printing is a valuable tool that increases the accuracy of presurgical planning.
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