In phase I, tissue expanders were implanted subcutaneously over the lateral crural region of four dogs. The expanders were inflated daily to maintain a constant intraluminal pressure for 7 days. All animals tolerated the pressurized expanders well. Some animal patient discomfort was associated with repeated injections into the subcutaneous filling port. One dog developed a limited area of tissue loss and exposure of the expander. Tissue response to the expanders included epidermal hyperplasia, dermal collagen compression with early fibroplasia, and subcutaneous granulation tissue formation adjacent to the expander pocket. In phase II, a second group of four dogs underwent rapid skin expansion over 7 days. The pressure applied to the expanding skin was determined daily and adjusted to approximate the value reported for capillary pressure in the dog. Tissue discoloration occurred in two dogs, suggestive of impaired circulation. Skin flaps were developed from expanded skin and rotated over the talocrural region. Wound dehiscence occurred along the distal flap margin in three phase II dogs. These wounds healed by second intention. Branches of the caudal saphenous artery were identified, using angiography, as the primary blood supply to the skin flaps.

Transarticular external skeletal (TES) fixators were applied unilaterally to the stifle joints of 10 young adult dogs. After 4 weeks, the fixators were removed from all dogs. Two dogs were not allowed a remobilization period, whereas 8 dogs were provided with 4 additional weeks of weight-bearing activity in a kennel run. Four dogs were given high-molecular weight hyaluronic acid by intra-articular injection weekly during the remobilization period. Clinical gait evaluations and range of motion were determined during the remobilization period. Articular cartilage samples from both stifle joints of all dogs were evaluated histologically and histochemically. No significant differences in gait scores or range of motion were noted between treated and untreated dogs. Articular cartilage proteoglycan content was reduced after 4 weeks of trans-stifle external skeletal fixation as determined by loss of alcian blue (AB) histochemical staining. Improved homogeneity of histochemical staining was observed after remobilization. However, remobilization was associated with histological damage to the surface and tangential layers of articular cartilage. Remobilization combined with hyaluronic acid (HA) therapy improved histochemical staining and reduced structural damage to articular cartilage when compared with remobilization alone.

SummaryAn intramedullary (IM) pin external skeletal fixator “tie-in” configuration is described, for use as a stabilizing device, in the treatment of fractures of the humerus and femur in the dog and cat. With in vitro testing of the configuration using cadaver bones, more resistance to bending was gained by the tie-in arrangement than was possible with one not tied-in. Forty-one clinical cases documented the use of the tie-in configuration for fracture repair. Twenty-four dogs and 17 cats were treated over the past seven years. Fourteen were used to stabilize fractures of the humerus and 27 for the femur. Migration of the IM pin or external fixation frame was not seen and all of the cases went to bone union. The unconventional method of leaving the IM pin protruding from the skin did not lead to complications. All of the owners, contacted from one to two months after removal of the implants, reported their animals to have excellent or good results. Five animals were lost to follow-up.