Normal Limb Function Research Articles

Osteochondritis Dissecans of the Medial Trochlear Ridge of the Talus in the Dog

SummaryThe medical records of 12 dogs with osteochondritis dissecans (OCD) of the medial trochlear ridge of the talus were reviewed. Long-term treatment results were obtained from client questionnaires and clinical and radiographic re-examinations. After a mean follow-up time of 52 months, only three of 12 dogs treated for OCD of the medial trochlear ridge of the talus had regained full function of the affected joint(s). In all cases available for radiographic re-examination, osteoarthritic changes had progressed. The medial approach to the hock joint by osteotomy of the medial malleolus was associated with a high complication rate.A meta-analysis of 38 cases (55 joints) of previous clinical studies and the present clinical study indicated that the Labrador Retriever and the Rottweiler were the most frequently affected breeds. Seventy-five percent of the affected Labrador Retrievers and Bull Terriers had bilateral involvement. The data suggested that in young dogs with an acute lameness, due to osteochondritis dissecans of the medial trochlear ridge in the talus, treatment resulted in 18% of the affected limbs in a normal limb function, in 27% in an intermittent lameness and in 55% in a chronic lameness. In dogs with a more chronic lameness, treatment results were better and approximately 40% of the affected limbs returned to normal function, while chronic lameness following treatment was unusual. In dogs older than a year at the time of treatment initiation, treatment became less successful because of the presence of severe osteoarthritic changes before treatment. Only 24% obtained normal limb function following treatment, while in 42% of the dogs treatment resulted in a chronic lameness.

The treatment of 143 tibial shaft fractures by Ender's nailing and early weight-bearing

A prospective study of 141 patients with 143 tibial shaft fractures has been carried out; 102 fractures were closed and 41 open. All the patients were treated by Ender's nailing and early weight-bearing. The average healing time was 15.2 weeks. There were no cases of bone infection and complications were minimal, the commonest being slight malalignment. Using this method, rapid restoration of bone continuity was achieved, combined with almost normal limb function during treatment.

Kirschner Wire Fixation of Lateral Humeral Condylar Fractures in Small Dogs

Successful treatment of humeral condylar fractures requires accurate reduction and rigid internal fixation. Lag screw fixation is the traditional method of repair for these fractures. An alternative method using Kirschner wire fixation was used to repair humeral condylar fractures in eight small dogs. Long‐term follow‐up was available for seven dogs: all were reported to have normal limb function.

Radical Radiotherapy as Primary Treatment for Ewing??s Sarcoma Distal to the Elbow and Knee

This article is a review of 22 cases of Ewing's sarcoma peripheral to the elbow and knee treated with moderate dose radiotherapy, with special reference to local control, functional result and risk of irradiation induced sarcoma. Eleven patients (50%) are alive two to 16 years following radiotherapy. Two of these had local recurrences, one being salvaged by reirradiation and the other by amputation. The functional results of treatment were assessed in the nine survivors who did not have a recurrence . Eight had normal limb function and one had a 3 cm leg-length discrepancy. Nine patients in the total experience of the hospital who survived more than ten years after radiotherapy were assessed for evidence of postirradiation sarcoma and none were found. The excellent results of radiotherapy in terms of local control, function and lack of irradiation induced sarcomas is attributed to the use of moderate doses of irradiation.

Arterial injuries associated with fractures of the lower limbs in childhood

Three children with arterial injuries associated with fractures of the lower limb were treated by vascular reconstruction. Intimal damage was more extensive than was macroscopically apparent and rethrombosis immediately followed thrombectomy or resection of a short segment of artery. When the extent of adventitial damage was used as a guide to the length of artery to be resected, permanent restoration of the circulation was achieved. Decompression of the four fascial compartments of the leg was performed in each child. Decompression through the fibular periosteum, leaving the fibula intact, gave a better cosmetic result than methods requiring multiple skin incisions. In each child the circulation was restored within six hours. Normal limb function and growth was achieved in two children and the residual abnormalities in the third child were the result of direct injury to muscle and growth plate.

The surgical treatment of equine fractures.

The current trends in equine fracture treatment are reviewed. Surgical approach, method of fixation, the advantages of Association for the Study of Internal Fixation (ASIF) implants and the complications of treatment are discussed with reference to 21 fracture cases. Normal limb function was restored in four horses with fractures of the olecranon and one with a mid shaft fracture of the tibia following stabilisation of the fracture with plates. A horse with a chip fracture of the distal radius and three other animals with fractures of the lateral condyle of the third metacarpal bone were also successfully treated with lag screws to stabilise the fractures. Treatment of the remaining 13 horses was unsuccessful as a result of refracture or infection. This group included horses with fractures of the radius (three cases), the third metatarsal bone (three cases), proximal epiphysis of the tibia (two cases) and five foals with mid shaft fractures of the femur.