Köpeklerde Karşılaşılan Tibia Kırıklarının Interlocking Pin ve Akrilik Eksternal Fiksatör Kombinasyonu ile Sağaltımı
Abstract
Bu çalışmada, köpeklerde meydana gelen diyafizer tibia
kırıklarının sağaltımında interlocking pin ve uniplanar bilateral akrilik
eksternal fiksatörlerin kombinasyonu kullanılarak, interlocking pinlerin
dizaynından dolayı, pinin distal ve proksimalinde yüksek stres biriktirme
potansiyelinden dolayı oluşması muhtemel implant hatalarının önüne geçmek ve postoperatif erken dönemde ilgili ekstremiteye
ağırlık verilmesiyle oluşan torsiyonel ve bükülme kuvvetlerinin yol açtığı
instabiliteye bağlı olarak fonksiyonel iyileşme kayıplarının oluşma riskini
azaltmak amaçlandı.
Çalışma materyalini, travma sonrası, ilgili arka
ekstremitesini kullanamama şikayetiyle getirilen, yapılan kinik ve radyolojik
muayeneler sonrasında tibiasında kırık tespit edilen 6 köpek oluşturdu. Sağaltım için farklı uzunluklarda 6 mm çapında
interlocking pinler, 2 ve 2,5 mm çapında yarım ve tam pin olarak Steinmann
pinleri, akrilik ve içine enjekte edilip akriliğe şekil verebilmesi için 9 mm endotracheal
tüpler kullanıldı. Postoperatif 10., 30., ve 45. günlerde radyografiler alındı,
klinik takip süreci 45. günde sona erdirildi. Ancak olgu no 5’in postoperatif
takip süresi, gelişen enfeksiyondan dolayı, 58. güne kadar devam etti.
İntramedullar pin uygulamalarına alternatif oluşturan
interlocking pin ile sağaltım tekniği, eksternal fiksatörlerle kombine edilerek
kullanıldığında başarılı sonuçlar vermiştir. Interlocking pin ve akrilik eksternal
fiksatör kombinasyonu ile sağaltım tekniği, interlocking pin ile sağaltım
tekniğinin tek başına kullanılmasından dolayı oluşabilecek instabilitenin önüne
geçilmesi ve iyileşmenin hızlı bir şekilde sağlanması açısından alternatif bir
tedavi yöntemi olarak düşünülebilir.
References
- Bergsma EJ, Rozema FR, Bos RRM, De Bruıjn WC (1993) Foreign Body Reactions to Resorbable Poly(L-Lactide) Bone Plates and Screws Used for the Fixation of Unstable Zygomatic Fractures. J Oral Maxillofac Surg 51:666-670. DOI: 10.1016/S0278-2391(10)80267-8
- Bhat AK, Rao SK, Bhaskaranand K (2006) Mechanical failure in intramedullary interlocking nails. J Orthop Surg 14(2):138-41. DOI: 10.1177/230949900601400206
- Bos RRM, Rozema FR, Boering G, Nijenhuis AJ, Pennings AJ, Verwey AB, Nieuwenhuisf P, Jansent HWB (1991) Degradation of and tissue reaction to biodegradable poly (Llactide) for use as internal fixation of fractures: a study in rats. Biomaterials 12(1):32-36. DOI: 10.1016/0142-9612(91)90128-W
- Dueland RT, Berglund L, Vanderby R, Chao EYS (1996) Structural Properties Of Interlocking Nails, Canine Femora, And Femur Interlocking Nail Constructs. Vet Surg 25:386-396. DOI: 10.1111/j.1532-950X.1996.tb01432.x
- Duhautois B (2003) Use of Veterinary Interlocking Nails for Diaphyseal Fractures in Dogs and Cats: 121 cases. Vet Surg 32(1), 8-20. DOI:10.1053/jvet.2003.50008
- Fossum TW (2013) Fundamentals of Orthopedic Surgery and Fracture Management. In: Small Animal Surgery, 4th Edn. Mosby Inc., St. Louis, pp 1082-1083.
- Goett SD, Sinnott MT, Ting D, Basinger RR, Haut RC, Dejardin LM (2007) Mechanical comparison of an interlocking nail locked with conventional bolts to extended bolts connected with a type Ia external skeletal fixator in a tibial fracture model. Vet Surg 36:279-286. doi:10.1111/j.1532-950x.2007.00265.x
- Lu Y, Nemke B, Lorang DM, Trip R, Kobayashi H, Markel MD (2009) Comparison of a new braid fixation system to an interlocking intramedullary nail for tibial osteotomy repair in an ovine model. Vet Surg 38: 467-476. DOI: 10.1111/j.1532-950X.2009.00517.x
- McLaughlin R (1999) Internal Fixation: Intramedullary Pins, Cerclage Wires, and Interlocking Nails. Vet Clin North Am Small Anim Pract 29(5):1097-1116. DOI: 10.1016/S0195-5616(99)50104-6
- Piórek A, Adamiak Z, Jaskólska M, Zhalniarovich Y (2012) Treatment of comminuted tibial shaft fractures in four dogs with the use of interlocking nail connected with type I external fixator. Pol J Vet Sci 15:661-666. DOI: 10.2478/v10181-012-0103-6
- Stiffler KS (2004) Internal Fracture Fixation. Clin Tech Small Anim Pract 19:105-113. DOI:10.1053/j.ctsap.2004.09.002
- Van der Elst M, Klein CPAT, De Blieck-Hogervorst JM, Patka P, Haarman HJ.Th.M (1999) Bone tissue response to biodegradable polymers used for intra medullary fracture fixation: A long-term in vivo study in sheep femora. Biomaterials 20:121-128. DOI:10.1016/S0142-9612(98)00117-3
- Yavuz Ü, Atalan G (2013) Köpeklerde Humerus ve Tibia Kırıklarının Akrilik Eksternal Fiksatör ile Sağaltımlarının Klinik ve Radyografik Yöntemlerle Değerlendirilmesi. Sağlık Bilimleri Dergisi 23(3):192-202. https://dergipark.org.tr/tr/download/article-file/693556. Accessed 9 June 201866
Treatment of Tibial Fractures with the Use of Interlocking Nail and Acrylic External Fixator Combination in Dogs
Abstract
In
this study, a combination of interlocking nailing and uniplanar bilateral
acyrlic external fixators has been used in the treatment of dogs with
diaphyseal tibial fractures. Via this method, it is both aimed to prevent
possible implant failures due to the potential of high stress acumulation in
the distal and proximal parts because of the design of interlocking pins and
also is aimed to reduce the risk of functional recovery losses due to
instability caused by torsional and bending forces because of weight bearing in
the postoperative period.
The
study material involves 6 dogs. Each case was treated using 6 mm interlocking
pins of various lengths and 2-2.5 mm half and full Steinmann pins. Radiographs
were taken on the postoperative 10th, 30th, 45th days and clinical follow-up
period was ended on 45th day. However, postoperative follow-up period of case
no 5 has continued until day 58 due to infection.
As
an alternative to intramedullary nailing, interlocking pins has resulted in
success when combined with external fixators. Interlocking pin and acrylic external
fixation combination techniqe can be considered as an alternative method as it
prevents instability that can be caused by using only interlocking nailing and
as it provides a rapid healing.
References
- Bergsma EJ, Rozema FR, Bos RRM, De Bruıjn WC (1993) Foreign Body Reactions to Resorbable Poly(L-Lactide) Bone Plates and Screws Used for the Fixation of Unstable Zygomatic Fractures. J Oral Maxillofac Surg 51:666-670. DOI: 10.1016/S0278-2391(10)80267-8
- Bhat AK, Rao SK, Bhaskaranand K (2006) Mechanical failure in intramedullary interlocking nails. J Orthop Surg 14(2):138-41. DOI: 10.1177/230949900601400206
- Bos RRM, Rozema FR, Boering G, Nijenhuis AJ, Pennings AJ, Verwey AB, Nieuwenhuisf P, Jansent HWB (1991) Degradation of and tissue reaction to biodegradable poly (Llactide) for use as internal fixation of fractures: a study in rats. Biomaterials 12(1):32-36. DOI: 10.1016/0142-9612(91)90128-W
- Dueland RT, Berglund L, Vanderby R, Chao EYS (1996) Structural Properties Of Interlocking Nails, Canine Femora, And Femur Interlocking Nail Constructs. Vet Surg 25:386-396. DOI: 10.1111/j.1532-950X.1996.tb01432.x
- Duhautois B (2003) Use of Veterinary Interlocking Nails for Diaphyseal Fractures in Dogs and Cats: 121 cases. Vet Surg 32(1), 8-20. DOI:10.1053/jvet.2003.50008
- Fossum TW (2013) Fundamentals of Orthopedic Surgery and Fracture Management. In: Small Animal Surgery, 4th Edn. Mosby Inc., St. Louis, pp 1082-1083.
- Goett SD, Sinnott MT, Ting D, Basinger RR, Haut RC, Dejardin LM (2007) Mechanical comparison of an interlocking nail locked with conventional bolts to extended bolts connected with a type Ia external skeletal fixator in a tibial fracture model. Vet Surg 36:279-286. doi:10.1111/j.1532-950x.2007.00265.x
- Lu Y, Nemke B, Lorang DM, Trip R, Kobayashi H, Markel MD (2009) Comparison of a new braid fixation system to an interlocking intramedullary nail for tibial osteotomy repair in an ovine model. Vet Surg 38: 467-476. DOI: 10.1111/j.1532-950X.2009.00517.x
- McLaughlin R (1999) Internal Fixation: Intramedullary Pins, Cerclage Wires, and Interlocking Nails. Vet Clin North Am Small Anim Pract 29(5):1097-1116. DOI: 10.1016/S0195-5616(99)50104-6
- Piórek A, Adamiak Z, Jaskólska M, Zhalniarovich Y (2012) Treatment of comminuted tibial shaft fractures in four dogs with the use of interlocking nail connected with type I external fixator. Pol J Vet Sci 15:661-666. DOI: 10.2478/v10181-012-0103-6
- Stiffler KS (2004) Internal Fracture Fixation. Clin Tech Small Anim Pract 19:105-113. DOI:10.1053/j.ctsap.2004.09.002
- Van der Elst M, Klein CPAT, De Blieck-Hogervorst JM, Patka P, Haarman HJ.Th.M (1999) Bone tissue response to biodegradable polymers used for intra medullary fracture fixation: A long-term in vivo study in sheep femora. Biomaterials 20:121-128. DOI:10.1016/S0142-9612(98)00117-3
- Yavuz Ü, Atalan G (2013) Köpeklerde Humerus ve Tibia Kırıklarının Akrilik Eksternal Fiksatör ile Sağaltımlarının Klinik ve Radyografik Yöntemlerle Değerlendirilmesi. Sağlık Bilimleri Dergisi 23(3):192-202. https://dergipark.org.tr/tr/download/article-file/693556. Accessed 9 June 201866
Details
| Primary Language | English |
|---|---|
| Journal Section | Research Article |
| Authors | |
| Publication Date | July 13, 2020 |
| Published in Issue | Year 2020Volume: 2 Issue: 1 |
