Single oblique osteotomy for correction of antebrachial angular and torsional deformities in a dog

Abstract

CASE DESCRIPTION A 9-month-old 4.6-kg (10.1-lb) spayed female Shih Tzu was examined for a 4-week history of left forelimb lameness. CLINICAL FINDINGS Moderate left forelimb lameness was present when weight bearing, accompanied by buckling of the left carpal joint and moderate signs of pain with hyperextension of the elbow joint. A 32° angular deformity of the left radius in a 45° craniomedial oblique plane (equivalent to 23° valgus and 23° procurvatum) and a 55° external torsional deformity were measured on 3-D reconstructed CT images. Humeroulnar incongruity of the left elbow joint was also evident. Single oblique osteotomy (SOO) and dynamic proximal ulnar osteotomy were recommended. TREATMENT AND OUTCOME Creation of a 3-D printed bone model from reconstructed CT images aided surgical planning. The SOO was located 45° medial to the sagittal plane of the left radius at the level of the center of rotation of angulation. The SOO was oriented 32° distolaterally from the transverse plane of the radius and traversed the left ulna. The bones were rotated along the osteotomy into grossly proper alignment and stabilized with a plate and bone screws. Dynamic proximal ulnar osteotomy was then performed. Six months after surgery, radiographs showed remodeling at the SOO site and the lameness had resolved. The owners expressed satisfaction with the outcome. CLINICAL RELEVANCE In dogs with angular and torsional long bone deformities, SOO may be a viable alternative to wedge osteotomies. The SOO simultaneously addressed angular and torsional deformities without bone loss and provided rigid internal fixation.

Single oblique osteotomy for correction of congenital radial head luxation with concurrent complex angular limb deformity in a dog: a case report

“…SOO is an effective technique to surgically correct angulation and torsion simultaneously. It has the advantage of maintaining osseous contact and allowing rigid internal fixation without bone loss [ 9 ]. However, surgical planning is considered complex, and accurate execution of the planning is challenging [ 11 ].…”

“…The true magnitude of the angulation was 16 degrees at the 30-degree oblique to the frontal plane. The orientation of SOO was determined as described by Kim et al [ 9 ]. The orientation of SOO was calculated to be 22 degrees from the bisector plane (transverse plane) on the convex surface in the oblique angulation plane.…”

“…Single oblique osteotomy (SOO), as a surgical technique for simultaneous correction of a uniapical angular and torsional deformity of the long bone while maintaining osseous contact and avoiding bone loss was recently reported in a dog [ 9 ]. The purpose of this case report is to describe SOO, followed by temporary ESF, for congenital radial head luxation with concurrent complex angular limb deformity of the antebrachium.…”

Three-Dimensional-Printed Patient-Specific Osteotomy Guides, Repositioning Guides and Titanium Plates for Acute Correction of Antebrachial Limb Deformities in Dogs

“…We chose to only correct the distal radial deformity as correction of only the distal CORA has been previously described for partially compensated biapical deformities with good clinical success. 8,11,29 In our experience, addressing the distal deformity alone can lead to good clinical results (despite the lack of complete deformity correction) and results in a simpler surgical technique. The owners of dogs in this study all report that the primary clinical sign of "buckling over" resolved following surgical correction and all cases had a normal median canine orthopaedic index score postoperatively.…”

Guidelines for the Execution of True Spherical Osteotomies Using a Modified Dome Blade Design

“…1 Correction of the deformity aims to optimize limb biomechanics and ameliorate discomfort. Simple transverse, 2,3 oblique, [3][4][5] clos-ing, opening and complex wedges, [3][4][5][6] stair-step 7 and dome osteotomies 8 stabilized with internal or external fixation have been described in the veterinary literature for the management of antebrachial growth deformities.…”