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Redalyc.Use of a Locking Plate “Notched Head T-Plate®” for the Fixation of an Ilial Body Fracture in A

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Redalyc.Use of a Locking Plate “Notched Head T-Plate®” for the Fixation of an Ilial Body Fracture in A Semina: Ciências Agrárias ISSN: 1676-546X [email protected] Universidade Estadual de Londrina Brasil Auada Ferrigno, Cassio Ricardo; Tertuliano Marinho, Paulo Vinícius; Poletto Ferreira, Márcio; França dos Santos, Jaqueline; dos Santos Dal-Bó, Ísis; Paes, Fernanda; Sanchez Galeazzi, Viviane Use of a locking plate “notched head T-plate®” for the fixation of an ilial body fracture in a dog Semina: Ciências Agrárias, vol. 37, núm. 5, septiembre-octubre, 2016, pp. 3215-3221 Universidade Estadual de Londrina Londrina, Brasil Available in: http://www.redalyc.org/articulo.oa?id=445748363049 How to cite Complete issue Scientific Information System More information about this article Network of Scientific Journals from Latin America, the Caribbean, Spain and Portugal Journal's homepage in redalyc.org Non-profit academic project, developed under the open access initiative RELATOS DE CASOS/CASE REPORTS DOI: 10.5433/1679-0359.2016v37n5p3215 Use of a locking plate “notched head T-plate®” for the fixation of an ilial body fracture in a dog Utilização de placa bloqueada “notched head T-plate®” no tratamento de fratura do corpo do ílio em um cão Cassio Ricardo Auada Ferrigno1; Paulo Vinícius Tertuliano Marinho2*; Márcio Poletto Ferreira3; Jaqueline França dos Santos4; Ísis dos Santos Dal-Bó4; Fernanda Paes5; Viviane Sanchez Galeazzi6 Abstract Several types of implants may be used to treat iliac fractures in dogs, of which osteosynthesis with plate is the most described and recommended in the literature. The type of plate and screw are major factors in osteosynthesis success. The use of locking plates has been advocated for this purpose, as they do not allow the plate-bone-screw unit to shift, providing angular stability and rigidity to the system. The present study aimed to describe the unprecedented use of a locking notched head T-plate in the treatment of a caudal body of ilium fracture. A two year old male mongrel dog was attended after falling from a third floor height, with two days of evolution. The animal was in standing position, and during orthopedic examination non-weight bearing lameness of the right hind limb, instability, and crepitus in the right body of ilium, with considerable swelling and pain. The radiographic examination allowed diagnosing a complete fracture of the caudal body of ilium with decrease of the pelvic canal diameter. The patient underwent surgery, and the fracture was stabilized with an LCP notched head T-plate. The patient evolved satisfactorily, with good weight-bearing of the affected limb within 24 hours of surgery, and complete recovery with medical discharge after 60 days of postoperative period, with consolidation of the fracture. Key words: Orthopedics. Traumatology. Pelvis. LCP. Resumo Vários tipos de implantes são utilizados no tratamento de fraturas de ílio em cães, sendo a osteossíntese com uso de placa a mais descrita e recomendada pela literatura. O tipo de placa, assim como o tipo de parafuso, são fatores preponderantes no sucesso da osteossíntese. Tem sido defendido o uso de placas bloqueadas, que não permitem movimentação entre a unidade placa-osso-parafuso, conferindo estabilidade angular e rigidez ao sistema. Objetivou-se descrever o uso inédito da placa bloqueada “notched head T-plate” no tratamento de fratura caudal de corpo de ílio. Um cão, macho, sem raça definida, de dois anos de idade foi atendido apresentando histórico de queda de terceiro andar, com dois dias de evolução. O animal apresentava-se em estação e durante a avaliação ortopédica observou-se deambulação com impotência funcional do membro pélvico direito, instabilidade e crepitação em corpo 1 Prof., Universidade de São Paulo, USP, São Paulo, SP, Brasil. E-mail: [email protected] 2 Discente de Doutorado, USP, São Paulo, SP, Brasil. E-mail: [email protected] 3 Prof., Universidade Federal do Rio Grande do Sul, UFRGS, Porto Alegre, RS, Brasil. E-mail: [email protected] 4 Discentes de Doutorado, USP, São Paulo, SP, Brasil. E-mail: [email protected]; [email protected] 5 Discente de Mestrado, USP, São Paulo, SP, Brasil. E-mail: [email protected] 6 Médica Veterinária, USP, São Paulo, SP, Brasil. E-mail: [email protected] * Author for correspondence Received: July 05, 2015 - Approved: June 15, 2016 3215 Semina: Ciências Agrárias, Londrina, v. 37, n. 5, p. 3215-3222, set./out. 2016 Ferrigno, C. R. A. et al. do ílio direito com aumento de volume considerável e muita dor. Diagnosticou-se fratura completa caudal do corpo do ílio com diminuição do diâmetro do canal pélvico, através de exame radiográfico. O paciente foi submetido à cirurgia e a fratura foi estabilizada com o uso de uma placa LCP em “T” com a cabeça chanfrada. O paciente apresentou evolução satisfatória com bom apoio do membro 24 horas após a cirurgia e completa recuperação com alta médica aos 60 dias de pós-operatório com consolidação da fratura. Palavras-chave: Ortopedia. Traumatologia. Pelve. LCP. Introduction and dystocia in breeding females (PIERMATTEI et al., 2009; DECAMP, 2012). Pelvic fractures are relatively common in clinical practice, accounting for 20-30% of fractures in cats Surgical treatment, which involves stabilizing and dogs (OLMESTEAD, 1998). Ilium fractures the fractured fragments and restoring the normal occur in 18-46% of traumatic pelvic injuries, the anatomy, should be considered for dogs with pelvic majority of which involve multiple fractures, fractures involving weight-bearing areas, such as compromising more than three bones (TROGER; the sacroiliac joint, the acetabulum, and the body VIRGUIER, 2008). of ilium. These fractures can cause considerable narrowing of the pelvic canal (PIERMATTEI et The ilium is an important weight-bearing al., 2009). In the case of ilium osteosynthesis, interface between components of the pelvis and various techniques are described in literature, the spine during locomotion. Fractures of the ilium including placement of screws, bolts, steel wire, compromise the mechanical interaction and decrease polymethylmethacrylate-augmented screws, the motor function of the pelvis (OLMSTEAD; external fixators, and different types of plates MATIS, 1998); long oblique fractures in the medial (FITZPATRICK et al., 2008; CHOU et al., 2013). ilium are the most common. Fracture location may vary. It can extend through the cranial aspect In the vast majority of fractures involving the of the wing of ilium or along the dorsal aspect caudal segment of the ilium, traditional plates of the acetabulum, along with the caudal pelvic present limited functionality, which prevents the obliquity, without involving the coxofemoral joint. application of at least two or three screws per bone Comminuted or transverse fractures, though also segment in locked or unlocked plates, respectively; observed, are much less common than oblique thus, requiring the (often laborious) procedure of fractures. The caudal fragment of ilium fractures modeling over the acetabulum. The goal of the usually suffers medial and cranial displacement, present report lies on the unprecedented use of a compromising the diameter of the pelvic canal, Locking Notched Head T-plate® in the treatment of which may damage the lumbosacral trunk located a fracture in the caudal body of the ilium in a dog. medially to the ilium body (DECAMP, 2012). Treatment options for pelvic fractures range Case Report from surgical interventions to conservative therapies. Fractures that are relatively stable A two-year-old male mongrel dog was attended or slightly displaced can be treated with rest, to two days after a fall from a considerable height. moderate activity, nursing care, analgesics, and Physical examination revealed physiological physiotherapy. However, if it was possible to parameters within the normal reference range and critically evaluate patients months or years after the bladder repletion. The animal was in the standing injury, many would likely exhibit a high degree of position during the orthopedic evaluation, which dysfunctionality, including constipation, dysuria, revealed functional limitation of the right hind 3216 Semina: Ciências Agrárias, Londrina, v. 37, n. 5, p. 3215-3222, set./out. 2016 Use of a locking plate “notched head T-plate®” for the fixation of an ilial body fracture in a dog limb, instability, crepitus in the right body of ilium service for an abdominal ultrasonography and during walking, and considerable swelling and radiographs of the chest and pelvic area. The former pain. The neurological examination revealed no two exams revealed no significant alterations; the alterations. latter exam showed a complete fracture of the body of ilium, ischial body, and cranial branch of After sedation and analgesia (acepromazine1 the right pubic bone, with deviation of the bone 0.05 mg/kg/IM + meperidine2 3 mg/kg/IM), the segment containing the right coxo-femoral joint patient was referred to the diagnostic imaging towards the pelvic canal (Figure 1A and B). Figure 1. Radiographic image of the pelvic region of a dog showing complete fracture of the body of ilium, ischium body, and caudal branch of the right pubis with deviation of the bone fragment containing the right coxo-femoral joint towards the pelvic canal. The surgical procedure was scheduled for three was shaved. Anesthesia was induced using propofol9 days after the initial exam and after a pathological (3 mg/kg) and maintained with isoflurane10 and and clinical evaluation (hemogram and serum oxygen (fixed amount of 250 mL + 30 mL/kg) in biochemistry) confirmed normal parameters for a
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