Evaluation of Bone Healing Using Contrast-Enhanced Ultrasonography in Non-Operative Treatment of Tibial Fracture in a Puppy Dog.

Francesco Macrì,Simona Di Pietro,Vito Angileri,Marco Tabbì,Teresa Russo,Maria Tomiko Russo

doi:10.3390/ani11020284

Abstract

Simple SummaryThis report describes the clinical presentation of a tibial fracture in a young dog. treated with a conservative approach and subjected to X-ray, B-mode, Color Doppler and contrast-enhanced ultrasound (CEUS) examinations during the bone healing, in order to assess hemodynamic changes during fracture healing. This report showed the application of CEUS in controlling the fracture healing process.A 10-month-old mixed-breed male dog was presented with an oblique tibial fracture. The dog was treated with a Robert Jones-like bandage as a conservative approach, and was subjected to X-ray, B-mode, Color Doppler and contrast-enhanced ultrasound (CEUS) examinations during the fracture healing, in order to assess bone hemodynamic changes. B-mode, Power Doppler and CEUS examinations of the fracture gap were performed at 7, 20, 35, and 50 days post-trauma. Quantitative analysis of CEUS and perfusion parameters were obtained. On CEUS, a steep incline in signal numbers was visible in fracture gap at 7 days with peaks at 35 days, after which the vascularization decreases gradually over the next days. In this study, CEUS provided important information on the early stages of the callus formation and on the healing of neighboring tissues, allowing recognition of a correct bone healing. Moreover, the number of vascular signals on CEUS was greater than that on Doppler images on the same day. This report showed the application of CEUS in controlling the fracture healing process. CEUS could be a method of monitoring the remedial processes, assessing the tibial fracture perfusion characterized by low-velocity, small-volume blood flows.

Highlights

Introduction published maps and institutional affilFracture of the long bone is a commonly-encountered orthopedic problem in puppy dogs
Italian Regulation D.Lgs n. 26/2014 because all the data derives from routine veterinary clinical practices
The radiographic study at T0 highlighted a tibial oblique non-displaced fracture; the fibula was intact

Summary

Introduction

Fracture of the long bone is a commonly-encountered orthopedic problem in puppy dogs. Bone regeneration is evaluated employing several clinical and radiologic criteria such as the absence of pain on weight-bearing and periosteal callus observed on radiograph or computed tomography, which appears after several weeks [1,2]. Ultrasonography was reported as a technique that can evaluate complete fracture healing earlier than conventional radiography in models of animals’ fractures [2,3,4,5]. Blood perfusion of the fracture gap and surrounding soft tissues is critical to bone healing and influences the treatment choice. In first week after bone fractures, the capillaries adjacent to the fracture site point out signs of neoangiogenesis [6].

Methods

Discussion

Conclusion