The Treatment of Coxofemoral Luxation by Modified Synthetic Capsule Technique in Dogs: 6 Cases

A Three months of age, 4.5 kg, female mixed (cross) breed presented to our clinic with complaint of the left hind leg lameness. In the clinical, radiographic and ultrasonographic examination, ventral hip luxation was diagnosed. Based on the examination findings which indicated the case was chronic, surgical treatment was decided. Hip joint was exposed firstly by craniodorsal approach. Flattened and full acetabulum, fractured greater trochanter, ruptured gluteal muscle attachment and irreparably broken joint capsule were determined. Excision arthroplasty was performed by ventral approach. Greater Trochanter was attached to its position by an L shape Steinman pin using craniodorsal approach. Then, a drill hole was created on the greater trochanter, and a screw was inserted to dorsal acetabular rim. A synthetic suture passed through the hole was tied to the screw in a figure of eight mode. Postoperative antibiotics and anti-inflammatory drugs were used. Physiotherapy such as swimming and massage treatments was proposed following skin sutures removal. In the 4th week control postoperatively, the dog began to use the operated leg effectively despite the moderate quadriceps’ contracture. The contracture was mostly resolved 12th week by continuing physiotherapy.

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Section: Discussionmentioning

confidence: 99%

Treatment of Ventral Hip Luxation in a Puppy

Bozkan

Bulut

Bellek

2021

J Hellenic Vet Med Soc

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“…Originally, synthetic capsule technique is performed by placing two screws on the dorsal acetabular rim, drilling femoral neck and placing a figure of eight suture between screws and drilled hole (Holsworth and De Camp, 2003;Johnson and Dunning, 2005). In this case, the hole was drilled on the greater trochanter as described by some studies which modified synthetic capsule technique (Belge et al, 2014), and one screw was placed on the dorsal acetabular wall because the dog was too small. The flattening of the acetabular cavity in our case suggests that presence of the femoral head in the acetabulum contributes in the development of acetabular depth during growth of the dog, as also theoretically known for the patellar groove.…”

Section: Case Presentationmentioning

confidence: 99%

Whole issue

Εταιρεία¹

2021

J Hellenic Vet Med Soc

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“…Coxofemoral luxation (CFL) is the most common traumatic luxation in dogs [1][2][3]7,8,17,24] and open reduction is one of the treatment options [8,12,21]. Numerous surgical methods have been described, including capsulorrhaphy [5,22], transposition of the greater trochanter [10], De Vita pinning [4,23], tenodesis of the deep gluteal muscle [18], transarticular pinning [10], replacement of the femoral head ligament [1,4,16,23], excision arthroplasty [15,16] and iliotrochanteric suture [11,13,14,20,21,24].…”

Section: Introductionmentioning

confidence: 99%

Isometry of Potential Attachment Sites for the Iliotrochanteric Suture in Dogs: an ex vivo Study

Cintra

Dias

et al. 2020

Acta Scientiae. Vet.

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Background: Coxofemoral luxation is the most common traumatic luxation in dogs and the iliotrochanteric suture is one of the surgical treatment options. The orthopedic suture aimed at surgically restoring joint movement should be employed in an isometric manner in order to maintain adequate tension throughout the arc of motion. This study aimed to determine the isometric points for the iliotrochanteric suture in dogs during the joint extension and flexion movements. This evaluation was performed both in the intact hip joint and in the luxation model, establishing the best combination, among the determined points, for the reestablishment of normal joint movement.Materials, Methods & Results: Radiographic analyses of 12 canine cadaveric hips, both intact and in craniodorsal luxation model, were performed in a neutral position, flexion at 50°, and extension at 150°. In the trochanteric segment, two parallel lines were drawn, creating the central vertical axis and the secondary vertical axis. Three points were then determined on each axis, from proximal to distal, corresponding to 25, 50, and 75% of the height of the axis, and were labelled as T1, T2, and T3 and T4, T5, and T6, respectively. In the iliac segment, a line perpendicular to the longitudinal axis of the ilium was drawn, and 25, 50, and 75% of this height corresponded to points I1, I2, and I3, respectively. The lengths between the points were measured, with the objective of evaluating which combination of points presented less variation in the joint positions. The central location of the iliac and trochanteric segments, determined respectively by I2 and T2, provided smaller variations during the maximal movements of hip flexion and extension.Discussion: The surgical techniques of iliotrochanteric suture target to maintain the internal rotation of the femoral head inside the acetabulum and abduction of the femur until the soft tissues have healed. The described techniques for the iliotrochanteric suture present a great anatomical variety in the arrangement of the anchor points of the suture. It is known that if during motion, the attachment sites move closer to one another, the suture will become lax and, if the attachment sites move away from one another, the suture will tighten. Therefore, the implantation in isometric sites assists in reducing the variation of the distance between the points of origin and insertion of the suture during joint movement, keeping the suture tension constant and allowing the functional recovery of the joint. This study demonstrates that there are some locations for the origin and insertion of an iliotrochanteric suture that are associated with less length change than others. I2-T2 combination is the point closest to isometry for the iliotrochanteric suture during hip extension and flexion, so that, T2 is the most central point of the greater trochanter, corresponding to 50% of the height of its central vertical axis, as well as I2, which corresponds to the most central point of the ilium, representing 50% of the height of the most caudal portion of its body. The isometric point found by us details the exact location of perforation in all aspects (height and length), both in the ilium and the trochanter. In addition, it is a personalized point created for each patient from its radiographic examination and taking into consideration its anatomical variations, so that there is no damage to the suture during hip extension and flexion movements.

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The Treatment of Coxofemoral Luxation by Modified Synthetic Capsule Technique in Dogs: 6 Cases

Cited by 3 publications

References 25 publications

Treatment of Ventral Hip Luxation in a Puppy

Treatment of Ventral Hip Luxation in a Puppy

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Isometry of Potential Attachment Sites for the Iliotrochanteric Suture in Dogs: an ex vivo Study

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