Clinical application of intraoperative skeletal traction in the dog

Abstract

The purpose of this clinical study was to evaluate the technical feasibility of a method for pre-operative and intra-operative traction for reduction of fractures of the appendicular skeleton. Traction was used in 24 diaphyseal fractures in 21 dogs. For each dog, the data pertaining to signalment, limb circumference, fracture type, interval between fracture and surgery, and the traction modalities were recorded. In patients with a latency between trauma and surgery of less than three days, the duration of traction required to realign the bone segments was shorter than that required for older fractures (P = 0.02). Intraoperative malalignments were corrected by manoeuvres performed with the traction stand. Once realigned, fracture segments were kept stable for prolonged periods, without the need for a surgical assistant. Postoperative radiographs were evaluated for fracture reduction and axial alignment. Postoperative alignment was judged excellent in 21 fractures and good in three fractures. Fractures were stabilized using external skeletal fixation (n = 10), plates (n = 11) or locked nails (n = 3), depending on the fracture type. The use of the technique was straight-forward and easily applied in a surgical setting. However, its use requires careful application because of the potential for iatrogenic tissue damage.

Virtual surgical planning and use of a 3D‐printed, patient‐specific reduction system for minimally invasive plate osteosynthesis of diaphyseal tibial fractures in dogs: A historic case control study

“…None of the dogs in either group were painful on palpation of the stabilized tibia or implants at the 1-month follow-up examination. At the time of the 1-month follow-up examination, there was no difference in fracture healing scores between the 3D-MIPO (2.5 [1][2][3][4]) and c-MIPO groups (2.8 [1.5-4]; p = .652). Six fractures (40%) in the 3D-MIPO group and five fractures (35.6%) in the c-MIPO group had obtained radiographic union by 1-month following surgery.…”

“…Obtaining acceptable alignment and reduction during MIPO can be challenging and is a frequently reported limitation of MIPO in dogs. 1,2 Application of external traction, 3,4 placement of an intramedullary pin, 1,4 anatomical plate contouring, 5,6 and transient application of an external fixator have been utilized to facilitate indirect closed reduction during tibial MIPO applications. [7][8][9][10] Virtual surgical planning (VSP) and threedimensional (3D) printing have increasingly been used in small animal orthopedics to create custom surgical devices.…”

Evaluation of sixty-eight cases of fracture stabilisation by external hybrid fixation and a proposal for hybrid construct classification

“…Open minimally invasive surgery was performed in 45 (66%) fractures, fluoroscopy-assisted closed reduction was accomplished intraoperatively in 20 (30%), and in 3 (4%) cases closed reduction without fluoroscopy was carried out. Intraoperative skeletal traction for fracture reduction was used in 4 cases [ 16 , 17 ].…”