Traumatic Luxation Research Articles

Clinical Presentation, Surgical Treatment, and Outcome of Traumatic Patellar Luxation in 11 Dogs and 5 Cats: A Single-Centre Retrospective Study between 2011 and 2022.

Patellar luxation (PL) is commonly diagnosed in dogs and cats; however, a traumatic cause is poorly reported in the literature. The aim of this study was to report the clinical presentation, surgical treatment, and outcome in dogs and cats surgically treated for traumatic PL. This is a retrospective study. Medical records of dogs and cats operated for traumatic PL were reviewed. Short- and long-term follow-ups were assessed with medical records and telephone interviews with owners and referring veterinarians. Data on signalment, lameness, PL characteristics, surgery, complications, and outcome were recorded. Eleven dogs and 5 cats were included. Both species had a median lameness grade of 4/5 and a median PL grade of 3/4. PL was medial in most cases (13/16). Joint capsule lesions were identified in 15 cases, 4 cases had trochlear ridge cartilage damage. All cases had a capsular imbrication, 12 cases had a fabello-patellar suture (FPS). Mean long-term follow-up time was 70.8 ± 42.5 months in 9 dogs and 4 cats. Ten cases out of 13 had no lameness at the 2-month follow-up, and 11/13 cases had no long-term lameness. Eleven cases out of 13 had no PL at the 2-month follow-up. No long-term PL was reported by owners. Complications were mild in 5 cases, moderate in 1, severe in 3. Functional outcome was full in 10 cases and acceptable in 3. Soft tissue techniques and FPS were effective in the surgical treatment of traumatic PL in dogs and cats, resulting in acceptable to full long-term function in all cases, with limited severe complications.

Outcome of traumatic elbow luxation managed with temporary transarticular external skeletal fixation in eight cats.

The aim of this study was to report the clinical outcomes in a series of traumatic elbow luxations in cats treated with closed reduction and a temporary transarticular type II external skeletal fixator (ESF). A retrospective review was conducted of traumatic elbow luxation cases in cats at two referral centres. Data collected included signalment, history, clinical assessment, radiographic findings, surgical procedures and complications. Short-term follow-up was based on clinical evaluations at 2 and 6 weeks postoperatively. Long-term follow-up was based either on a telephone interview with the owner or a clinical evaluation. Eight cats were included. Five cats experienced lateral elbow luxation, while three cats had medial elbow luxation. All cats with medial elbow luxation exhibited radiographic signs of medial humeral epicondylitis. The median age was 9 years (range 3-15). The elbow luxation was treated by closed reduction and percutaneous placement of a temporary transarticular type II ESF, which was removed 2 weeks postoperatively. Two minor complications were recorded. Elbow reluxation and major complications were not encountered. The 6-week postoperative evaluation and long-term follow-up revealed a lameness of grade 1 in 1/8 cats and 0 in the remainder. Elbow range of motion was normal in all cats. None of the cases treated with this protocol experienced recurrence of elbow luxation. All cats demonstrated an excellent outcome based on the lameness score, the low complication rate and the follow-up telephone interview. The technique is minimally invasive and carries a low incidence of complications. Concurrent orthopaedic disease, such as medial humeral epicondylitis, may predispose to medial elbow luxation.

Traumatic globe luxation- A case series

Traumatic globe luxation- A case series

Treatment of traumatic elbow luxation and radius fracture with non-rigid transarticular external fixation and paraosseous clamp cerclage in a cat

An 8-year-old, female, neutered mixed-breed cat presented with traumatic elbow luxation and radius fracture due to high-rise syndrome. According to the anamnesis, the trauma had occurred 10 days prior. Therefore, the patient was treated with an open reduction technique. The reduction of the elbow joint was performed with the cerclage transarticular external fixation (CTEF) method. Fixation of the radius fracture was performed using the paraosseous clamp cerclage method. The follow-up time for the patient was 1 year, and the functional outcome was considered fair due to humero-ulnar ankylosis of the elbow joint with 110° of extension. In this case report, post-operative long-term clinical and radiographic results were not as desired. This can be explained by the inability to perform surgery at the desired time, the severity of the trauma, and cartilage damage. However, further cases are required to determine whether this procedure is optimal for the treatment of traumatic elbow luxation in cats.

Comparison of intraoperative outcomes in excision arthroplasty with or without partial tenotomy of deep gluteal muscle in dogs

Background: Excision arthroplasty is a commonly performed surgical technique for treating coxofemoral luxation in dogs. Favourable outcomes have been reported in dogs up to 15 kg. Aim: This study aimed to compare the intraoperative findings of two surgical approaches i.e., with or without partial deep gluteal muscle tenotomy in the excision arthroplasty in dogs. Methods: A total of 15 dogs having average body weight 15.6 kg (3.5-26) and 29.5 months (6-72) of age were brought to the Veterinary Surgery Clinics at University Veterinary Hospital, Samsun, Turkey with traumatic coxofemoral luxation or femur head/neck fracture. Craniolateral incision was used to approach the craniodorsal aspect of the hip joint in all cases. Myotomy of the superficial gluteal muscle and partial tenotomy of the deep gluteal was performed in one group. While blunt dissection approach was performed for elevation of gluteal muscles in another group. Results: Fifteen dogs (myotomy and tenotomy in 8 dogs and without tenotomy in 7 dogs) were diagnosed having lesions along with coxofemoral luxation in 9 cases, femoral neck fracture in 5 cases and caput femur fracture in 1 case. Partial tenotomy improved the exposure of joint capsule and femur neck. Discussion and Conclusion: The remnants of femoral neck after excision arthroplasty may contact the acetabulum and cause pain in the postoperative period. By applying the partial deep gluteal muscle tenotomy technique, surgeons can readily expose joint capsule, femoral head, femoral neck, and great and lesser trochanter.

Traumatic lateral patellar luxation in a dog

AbstractA 2‐year‐old, female, entire, German shepherd dog presented for investigation of non‐weight‐bearing right hindlimb lameness following a suspected road traffic accident 1 day prior. Orthopaedic examination confirmed right lateral patellar luxation. Stifle radiographs revealed normal patella positioning with stifle joint effusion and periarticular soft tissue swelling. A surgical approach to the stifle was performed via a craniomedial parapatellar incision. A 10 cm proximodistal tear was present in the medial retinacular muscular fascia, vastus medialis, medial parapatellar fibrocartilage and joint capsule. The soft tissues were meticulously reconstructed using absorbable monofilament sutures. Surgical repair of the traumatised medial soft tissues allowed for complete resolution of the traumatic lateral patellar luxation. Moderate right hindlimb lameness persisted immediately postoperatively and improved to only a mild lameness before discharge (4 days postoperatively). The dog returned to normal exercise, with no lameness or postoperative complications reported at short‐ or long‐term follow‐up (42 and 424 days, respectively).

A case report of a cementless total hip replacement performed in a pelvic limb amputee after a failed surgical reduction of a traumatic coxo-femoral luxation with a toggle rod.

Coxo-femoral luxation is the most common luxation seen in dogs after road traffic accidents. There are multiple surgical techniques to repair the luxation. These range from a capsular reconstruction to a total hip replacement. This case report describes a total hip replacement to repair a failed toggle rod repair of a coxo-femoral luxation in a Greyhound pelvic limb amputee. The dog returned to normal activity as a household pet three months post-surgery and at the last follow-up consultation at 12 months post-surgery the dog was able to maintain an acceptable activity level as an amputee with no radiographic signs of complications.

Frequency of Intrusive Luxation in Potential Orthodontic Patients with Increased Over-Jet

OBJECTIVE: To find out the frequency of intrusive luxation in potential orthodontic patients with increased over-jet. METHODOLOGY:Total 50 orthodontic patients having permanent dentition with increased overjet was included in the study and were examined in OPD as per selection criteria. The patients were examined for the presence of intrusive luxation of upper front teeth as per defined criteria. STUDY DESIGN:A Cross Sectional Study. SETTING: Orthodontic Center of Rashid Latif Dental College, Lahore DURATION: January 2021 to June 2023 RESULTS: The results showed that frequency of traumatic upper maxillary incisors intrusive luxation was found to be 3%, out of which 80% were females and 20% were males. CONCLUSION: There is increased frequency of traumatic upper maxillary incisors intrusive luxation in orthodontic patients having increased over-jet. KEYWORDS: Intrusive luxation; Orthodontic repositioning, Re-eruption; Orthodontic extrusion.

Surgical management of traumatic stifle luxation in cats with using fabelotibial and fibulopatellar sutures

Cats’ ligaments in the stifle joint may become damaged because of several accident kinds. Effective treatment of this condition requires surgical intervention. The objective of this article is to outline the most precise diagnostic process, surgical treatment, as well as investigate the outcomes and potential complications in the surgical treatment of stifle disruption in cats without a temporary transarticular pin. Five cats of various breeds, ranging in age from 1 to 5 years, were used in the study. Each animal has both cruciate ligaments damaged. As a therapeutic therapy, two stabilizing sutures (fabellotibial and fibulopatellar) were applied to the cats. At one, three, five, seven-, and nine-weeks following surgery, each patient underwent control and clinical gait evaluation. A phone call with the owners was conducted 4 months following the surgery to gauge their satisfaction with treatment results and find out whether the cat had fully recovered. After treatment, all patients regained their mobility. No one cat had major complications and required reoperation. Few patients were exposed to minor complications, including swelling, bacteril infection and rupture of sutures. Each owner was satisfied with the results of the therapy and their animal’s recovery. To preserve the entire functionality of the limb, the lateral fabellotibial and fibulopatellar suture technique can be effective in young animals. If the cruciate ligaments are the primary area of damage, the suture technique may be helpful.

Combination of TPLO, medial and lateral augmentation techniques for the treatment of traumatic stifle luxation in a cat

Case summary An 11-year-old female neutered domestic shorthair cat was referred for surgical management of a traumatic right stifle luxation. Orthopaedic examination of the affected stifle under general anaesthesia revealed joint effusion and craniocaudal and rotational instability. Cranial displacement of the tibia with respect to the femur and infrapatellar pad sign were identified on radiography. Intraoperatively, complete rupture of both cruciate ligaments and marked disruption of the mid and caudal poles of the medial and lateral menisci were observed. Both collateral ligaments appeared intact. The remnants of the injured cruciate ligaments were removed, and medial and lateral caudal hemimeniscectomies were performed. A tibial plateau levelling osteotomy (TPLO) was performed to address the craniocaudal stifle instability. Intraoperative assessment of the stifle revealed persistent instability with cranial tibial translation, internal and external rotation, and a positive caudal draw test. A lateral augmentation suture was employed to address the persistent cranial tibial translation and internal rotation. To successfully neutralise caudocranial and external rotational instability secondary to the caudal cruciate ligament deficiency, a medial augmentation suture was placed with the aid of three interference screws. Stifle stability was achieved. A modified Robert-Jones bandage was kept on for 24 h postoperatively. An excellent outcome was achieved, with successful limb function restoration. Relevance and novel information This case report represents the first documented instance of feline traumatic stifle luxation repair by combining a corrective tibial osteotomy and extra-articular augmentation. Notably, it introduces the novel technique of implementing a TPLO with medial and lateral augmentation sutures to address multidirectional stifle instability.

Challenging Management of Severe Traumatic Globe Luxation: A Rare Case Report

Challenging Management of Severe Traumatic Globe Luxation: A Rare Case Report

FIL SSF intraocular lens opacification after pars plana vitrectomy with gas tamponade for traumatic lens luxation and retinal detachment: a case report and literature review

BackgroundTo report a case of sutureless scleral-fixated hydrophilic intraocular lens (FIL SSF IOL, Soleko, Italy) opacification following pars plana vitrectomy surgery using sulfur hexafluoride (SF6) for traumatic lens luxation associated with retinal detachment.Case presentationA 77-year-old woman was referred to our emergency department after blunt trauma in her right eye. At the ophthalmic evaluation, visual acuity was hand movement, biomicroscopy showed pseudoexfoliation syndrome and a traumatic lens luxation in the vitreous chamber. The patient underwent pars plana vitrectomy, subluxated cataract explantation, and FIL SSF IOL implant. During surgery, an inferior retinal detachment was encountered, requiring 20% SF6 gas tamponade. No adverse events were encountered. One month postoperatively, visual acuity (BCVA) improved to 0,3 logMAR. At the 3-month follow-up, the patient presented with BCVA of 0,5 logMAR, and biomicroscopy showed a minimal IOL opacification. Six months postoperatively, BCVA decreased to 1.0 logMAR, and diffuse, IOL opacification was noted at slit lamp examination. The patient refused any other surgical intervention for IOL exchange.ConclusionsAlthough hydrophilic IOL opacification gas related is known, to the best of our knowledge, this is the first case reported in the literature of FIL SSF IOL opacification after pars plana vitrectomy with gas tamponade for retinal detachment.

Successful Medical Management of an Acute Traumatic Sternal Luxation in a Cat.

A 5 yr old indoor-outdoor domestic longhair red tabby cat presented for evaluation of a 1-day history of hiding, urinating and defecating outside the litterbox, and vocalizing when picked up. Physical examination revealed significant pain on palpation of the caudal sternum where an approximately 8 × 6 cm contusion was noted. Sedated thoracic radiographs revealed a luxated fifth intersternebral joint with the sixth sternebra being cranioventrally displaced (along with the seventh and eight sternebrae) to the level of the mid fourth sternebra. There were sharply marginated, short oblique fractures of the distal sixth costal cartilages bilaterally with mild dorsal displacement of the distal segment. The sternal luxation was palpated more aggressively once the patient was sedated and deemed to be stable. Because of the stability of the luxation and absence of sternebral fractures, conservative medical management in the form of analgesics and rest was instituted. Repeat thoracic radiographs 2 wk after presentation revealed an unchanged sternal luxation. Twelve months after presentation, the patient presented for an unrelated lameness and, in that timeframe, has exhibited no sequelae to the sternal luxation, which still palpates stable and is radiographically unchanged.

Complications and Long-Term Outcomes After Prosthetic Capsule Replacement in 15 Dogs with Traumatic Hip Luxation.

Complications and long-term clinical outcomes for 15 dogs surgically treated for traumatic craniodorsal hip luxation by prosthetic capsule replacement (PCR) with a prosthetic ligament were retrospectively reviewed. A PCR technique with capsulorrhaphy was performed in all dogs using acetabular screws with washers and a femoral tunnel as anchor points for the polyester prosthetic ligament. A non-weight-bearing sling was not placed. Minimum 1 yr follow-up period was required for study inclusion. Two major complications (13.3%) consisting of craniodorsal hip reluxation (n = 1) and capital physeal fracture (n = 1) were observed. Minor complications (superficial skin necrosis) occurred in one case (6.7 %). The patient with craniodorsal hip reluxation underwent femoral head and neck ostectomy and was excluded from long-term analysis. In the 11 cases that returned for long-term (median, 3.8 yr; range, 19-75 mo) evaluation at the authors' institution, 10/11 of the dogs were clinically sound. Three dogs did not return for long-term evaluation. However, telephone interview with owners minimum1 yr after surgery indicated normal limb function and absence of complications in all three cases. These results suggest that PCR with polyester prosthetic ligament can be successful in maintaining hip reduction in dogs with craniodorsal hip luxation.

Zurich Mini Cementless Total Hip Arthroplasty in 42 Small Breed Dogs and 8 Cats: Surgical Technique and Outcomes

AbstractThis report aims to describe implant characteristics and procedure for implantation, and comment on and report the clinical outcomes in small dogs and cats using the new Zurich mini cementless total hip system. This study involved 8 cats and 42 dogs, with 3 cats and 6 dogs having bilateral total hip arthroplasties (THA). The mean body weight for cats was 6.5 kg, and the mean body weight for dogs was 9.2 kg. In the group of THAs in cats, capital physeal fracture was the reason for performing a THA in six cases (60%), hip dysplasia was the underlying reason in four cases (30%) and hip luxation in one case (10%). Among the 48 THAs in dogs, hip dysplasia was the underlying cause for performing THA in 27 cases (56%), avascular necrosis of the femoral head in 12 cases (25%), traumatic luxation with underlying hip dysplasia in 4 cases (8.5%), capital physeal fracture in 4 cases (8.5%), and traumatic femoral head fracture in 1 adult dog (2%). Seven postoperative complications were encountered, and all were solved without the need for explanting the prosthesis, except in one case because of the owner's decision. In conclusion, the Zurich mini cementless total hip system performed well in this study, with most dogs and cats having an excellent outcome and no patient being too small for the available implant sizes.

Summary of the Panel Discussion “Traumatic Luxation and Fracture of the Tarsal Joint” at the 105th Meeting of the Japanese Society of Veterinary Anesthesia and Surgery

Summary of the Panel Discussion “Traumatic Luxation and Fracture of the Tarsal Joint” at the 105th Meeting of the Japanese Society of Veterinary Anesthesia and Surgery

Evaluation of the treatment of traumatic coxofemoral luxations in dogs using toggle pin technique

This study was performed on 11 dogs diagnosed with traumatic coxofemoral luxation. The direction of the luxations, the operation details, postoperative complications, and radiographic evaluation were recorded during the study. The study utilized the toggle pin technique, which provided open-reduction techniques for the treatment of coxofemoral luxations. Polyester multifilament braided sutures with commercial toggle pins were employed in three cases, whereas toggle pins obtained from Kirschner wire and monofilament nylon suture material were performed in eight patients. Clinical and radiographic monitoring of postoperative lameness, complications, pain, and infection were assessed and recorded for comparison. Postoperative reluxation was observed in two cases in which multifilament braided polyester suture material was performed without other complications. In the cases without reluxation, it was noted that the animals used their limbs comfortably on the 1st postoperative day, and their lameness scores were 0 on the 7th postoperative day. As a result of the findings, the toggle pin technique using monofilament nylon suture could effectively treat coxofemoral luxations in dogs.

Traumatic Coxofemoral Luxation in Cats Treated with Hip-Toggle Stabilization Using the Mini Tightrope® Fixation System

Abstract The aim of this retrospective study was to evaluate the clinical and radiographic outcomes of 21 cats that underwent coxofemoral toggle stabilization using the Mini TightRope® Fixation System (mTR®). Data were compiled from client-owned cats with traumatic hip luxation. Each cat underwent the same protocol including orthopedic assessment, preoperative radiographic evaluation, surgical procedure, postoperative management and clinical re-examination at 14 days, 8 weeks and 12 months following surgery. Age, body weight, implants and osteoarthritis progression were recorded. A lameness score 0-4 was assigned to each cat. Pain upon hip extension was not quantified but as pain reaction or no pain reaction. Major complications and osteoarthritic (OA) changes were recorded. Osteoarthritic changes were classified on a 0-4 scale. Twenty-one cats were included in the study. Coxofemoral luxations were stabilized using a mTR®. At 8 weeks, weight bearing was considered normal (grade 0) in all cats and no pain reaction was elicited during hip extension. One year after surgery, orthopedic examination was within the normal limits and according to the owners, all animals exhibited a normal physical activity. No complications were recorded. Evidence of slight OA changes were observed in 5 out of 21 cats. The final outcome was considered excellent in 16/21 patients and good in 5/21 cats. The application of the mTR® system can be considered a suitable surgical treatment in cats affected by traumatic hip luxation.

Repair of an Isolated Traumatic Cranial Luxation of the Radial Head Using a TightRope System in a Cat

AbstractA 4.4 kg, a 6-year-old Domestic Shorthair male neutered outdoor cat was diagnosed with an isolated traumatic cranial luxation of the left radial head. Surgical stabilization was achieved using a mini TightRope system (Arthrex Vet Systems, Naples, Florida, United States) to hold the radial head to the ulna without attempting to reconstruct the annular ligament. A range of motion within the normal range was achieved after reduction. At 7-week follow-up after surgery, the cat was walking without lameness; at follow-up by telephone 3 years postoperatively, the owner described the overall quality of life as excellent with good mobility in everyday activities such as jumping, running, and playing. Many publications in veterinary medicine detail congenital radial head luxation, Monteggia lesions, or complete elbow luxation, but traumatic radial head luxation is barely cited as the occurrence is rare. To our knowledge, this is the first reported case of a feline isolated traumatic radial head luxation managed with this technique.

Traumatic Stapes Luxation into the Vestibule.

We report a rare case of traumatic stapes luxation into the vestibule. A 31-year-old female visited an emergency room with sudden onset of vertigo and conductive hearing loss after accidental penetrating injury to the right ear. Temporal bone computed tomography detected pneumolabyrinth, with a shade of whole intact stapes in the vestibule. Under exploratory tympanotomy, we observed a separated incudostapedial joint, and the stapes was depressed into the vestibule. The stapes was pulled out to the middle ear, and stapedectomy was performed; the crus were cut, the suprastructure was removed, and the fractured footplate and the long process of the incus were connected with a piston wire. The stapes footplate was sealed with soft tissue and surgical glue. Vertigo rapidly subsided after surgery, and hearing was improved to normal range. However, hearing loss at high frequencies was not recovered, probably because of inner ear damage due to the stapes depressed into the vestibule or surgical manipulation within the vestibule. Traumatic ossicular dislocation is not an uncommon occurrence in otolaryngologic practice, but stapes luxation is rare. Here, we report a rare case with successful repair. This report could serve as a basis for proper treatment in similar cases in the future.