İki Kedi ve On Köpekte Quadriceps Femoris Kası Kontraktürünün Sağaltım Teknikleri

Abstract

SummaryThis study was performed on 10 dogs and 2 cats, were shown quadriceps contracture (QC). The etiological history was indicated that QC occurred as a result of improper bandage application or operations due to femoral fractures in 11 cases or congenital in one case. Long-term immobilization (for 35-45 days) in a bandage and deficiency of rigid fixation with hyperextention on stifl e joint caused QC. Hyperextension on stifl e and hock joints, hardness on femoral quadriceps muscle (FQM), atrophy of FQM and aff ected limb, genu recurvatum, patella alta and coxofemoral luxations were observed on cases. According to the degrees of QC, combined treatment methods such as; external skeletal fixation, cuneiform osteotomy of femur, isolation of adhesions, "Z" type myoplasty of FQM, tibial tuberosity transposition, stifl e arthrodesis or extremity amputation were applied on cases. The outcomes were "good" for 9 cases, "poor" for 2 cases and one case couldn't be followed. Prognosis of QC is altered for ages, immobilization time and period, femoral shortening, coxofemoral luxation and patella alta, etc. The whole recovery of QC is extremely poor and lameness is permanent on aff ected limb, in spite of treatment. In conclusions, distal femoral fractures on juvenile dogs and cats (especially 0-3 months age period) should be treated with an appropriate method and performed rigid fixation. In postoperative period, long-term immobilization in a bandage can be prevented. Keywords: Cat, Dog, Femoral quadriceps muscle contracture, Stifl e joint İki Kedi ve On Köpekte Quadriceps Femoris Kası Kontraktürünün Sağaltım Teknikleri ÖzetBu çalışma Quadriceps kontraktürlü (QK), 10 köpek ve 2 kedi üzerinde gerçekleştirildi. Olguların etiyolojilerinde QK'nün 11 olguda femur kırıklarının ardından hatalı bandaj uygulanması ya da operasyonu sonucunda, 1 olguda ise, konjenital olarak şekillendiği görülmüştür. Uzun süreli bandaj uygulaması (35-45 gün) ve hiperekstensiyondaki diz ekleminde rijid fiksasyonun bozulması QK'ne yol açmaktadır. Olgularda diz ve tarsal eklemlerinde hiperekstensiyon, quadriceps kasında sertleşme, atrofi ve coxofemoral luksasyon görülmüştür. Quadriceps kontraktürü'nün derecesine bağlı olarak, olgulara; eksternal fiksatör, femurun kuneiform osteotomisi, adezyonların açılması, quadriceps kasının "Z" tip miyoplastisi, tuberositas tibia'nın transpozisyonu, diz eklemi artrodezi ya da amputasyon şeklinde kombine sağaltım seçenekleri uygulanmıştır. 9 olguda "iyi", 2 olguda "zayıf" sonuç elde edilirken, 1 olgu'nun takibi yapılamamıştır. Quadriceps kontraktürü'nde prognoz; yaşa, immobilizasyonun süresi ve periyoduna, femoral kısalığa, coxofemoral luksasyona ve patella alta'ya bağlı olarak değişmektedir. Quadriceps kontraktürü'nde iyileşme genelde zayıftır ve ilgili ekstremite de topallık kalıcıdır. Sonuç olarak; juvenil köpek ve kedilerde (genellikle 0-3 aylık dönemde) distal femur kırıkları uygun tedavi yöntemi ile sağaltılmalı ve rijid fiksasyon uygulanmalıdır. Postoperatif dönemde ise bandaj ile uzun süreli immobilizasyondan ...

Usefulness of Ultrasound Shear Wave Elastography for Detection of Quadriceps Contracture in Immobilized Rats

“…In our study, we found that the range of stifle and ankle joint motion in the immobilization group decreased compared with that in the control group. These results are similar to those described in previous studies [ 1 , 3 , 4 , 23 ]. We assume that quadriceps muscle contracture was induced in all periods of the immobilization.…”

“…Quadriceps contracture is characterized by the replacement of the quadriceps muscle–tendon unit with fibrous tissue, resulting in a shortening of the quadriceps muscle, limiting the range of stifle joint motion, and leading to muscle atrophy and fibrosis [ 1 , 2 ]. The important factor of quadriceps contracture is long-term stifle joint immobilization following orthopedic surgery [ 3 , 4 ]. The prognosis for limb function depends on the degree of quadriceps contracture [ 3 , 4 , 5 ]: the earlier the diagnosis, the better the prognosis [ 2 ].…”

“…The important factor of quadriceps contracture is long-term stifle joint immobilization following orthopedic surgery [ 3 , 4 ]. The prognosis for limb function depends on the degree of quadriceps contracture [ 3 , 4 , 5 ]: the earlier the diagnosis, the better the prognosis [ 2 ].…”

Effects of Neuromuscular Electrical Stimulation and Therapeutic Ultrasound on Quadriceps Contracture of Immobilized Rats

“…In contrast, arthrogenic contracture occurred in the late stage of the disease (>2 weeks of immobilization) [11][12][13]. Although there are various surgical techniques for quadriceps contracture treatment [14,15], the prognosis of surgical treatment is guarded to poor depending on the progression of muscle contracture [1,4,5,15,16]. In some cases, amputation is the outcome when the quadriceps contracture progresses to a late stage [3,16].…”

“…Although there are various surgical techniques for quadriceps contracture treatment [14,15], the prognosis of surgical treatment is guarded to poor depending on the progression of muscle contracture [1,4,5,15,16]. In some cases, amputation is the outcome when the quadriceps contracture progresses to a late stage [3,16]. If initiated early in the course of the disease, rehabilitation for quadriceps contracture can be expected to control disease progression, avoid surgery, and improve prognosis [2,4].…”