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Evaluation of sixty-eight cases of fracture stabilisation by external hybrid fixation and a proposal for hybrid construct classification.

Jiménez-Heras M, Rovesti GL, Nocco G, Barilli M, Bogoni P, Salas-Herreros E, Armato M, Collivignarelli F, Vegni F, Rodríguez-Quiros J - BMC Vet. Res. (2014)

Bottom Line: Complications, radiographic, functional and cosmetic results were evaluated at the time of fixator removal.Radiographic results at the time of frame removal were excellent in 59% of the cases, good in 38% and fair in 3%, while functional and cosmetic results were excellent in 69% of the cases, good in 27% and fair in 4%.The classification used enables to determine the number of linear and circular elements used in the frame.

View Article: PubMed Central - PubMed

ABSTRACT

Background: Hybrid external fixation (HEF) is an emerging technique for fracture stabilization in veterinary orthopedics, but its use has been reported in few papers in the veterinary literature. The linear and circular elements that form hybrid fixators can be connected in a very high number of combinations, and for this reason just referring to HEF without any classification is often misleading about the actual frame structure. The aim of this study was to retrospectively evaluate fracture stabilization by HEF in 58 client-owned dogs and 8 cats, and to extend the already existing classification for hybrid constructs to include all frame configurations used in this study and potentially applicable in clinical settings. Animal signalment, fracture classification, surgical procedure and frame configuration were recorded. Complications, radiographic, functional and cosmetic results were evaluated at the time of fixator removal.

Results: Sixty-eight fractures in 58 dogs and eight cats were evaluated. Two dogs had bilateral fractures. Fifty-one percent were radio-ulna, 34% tibial, 9% humeral, 3% femoral and 3% scapular fractures. One ring combined with one or two linear elements was the most widely employed configuration in this case series. Radiographic results at the time of frame removal were excellent in 59% of the cases, good in 38% and fair in 3%, while functional and cosmetic results were excellent in 69% of the cases, good in 27% and fair in 4%.

Conclusions: HEF is a useful option for fracture treatment in dogs and cats, particularly for peri and juxta-articular fractures. It can be applied with a minimally invasive approach, allows adjustments during the postoperative period and is a versatile system because of the large variety of combinations that can fit with the specific fracture features. The classification used enables to determine the number of linear and circular elements used in the frame.

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Related in: MedlinePlus

Clinical (A) and radiographic (B) pictures of a construct IB for stabilisation of a radius-ulna fracture. The distal short segment was stabilised by two K wires tensioned on the ring and a threaded pin on a post, and the proximal long segment by three threaded pins on a rail. Note the use of a radiolucent ring to allow for an unobstructed visualization of the fracture area.
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Fig1: Clinical (A) and radiographic (B) pictures of a construct IB for stabilisation of a radius-ulna fracture. The distal short segment was stabilised by two K wires tensioned on the ring and a threaded pin on a post, and the proximal long segment by three threaded pins on a rail. Note the use of a radiolucent ring to allow for an unobstructed visualization of the fracture area.

Mentions: Thirty-five cases were radius-ulna fractures: 22 (63%) were transverse, 7 (20%) comminuted, 4 (11%) oblique, and 2 (6%) spiroidal. The most used configurations were IB in 20 (57%) cases (Figure 1), IIB in 6 (17%) and IA in 3 (9%). Two of the remaining 6 cases (6%) were treated with configuration IIA, two with IC, one with IIIB and one with IID configuration. The rings used for radius-ulna fractures were 360° in 29 (83%) cases and 270° in 2 (6%); a combination of 360° rings distally and 270° and 180° rings proximally was used in 4 (11%) cases. Twenty-one (60%) frames contained orthogonal linear elements, 11 (31%) inclinable ones and 3 (9%) both of them. One or two-bar strut constructs were used in 8 (29%) constructs: one IA and 7 (35%) IB configurations. The healing time for radius-ulna fractures was 75.6 ± 30.6 days (median, 67 days; range, 36 to 167 days).Figure 1


Evaluation of sixty-eight cases of fracture stabilisation by external hybrid fixation and a proposal for hybrid construct classification.

Jiménez-Heras M, Rovesti GL, Nocco G, Barilli M, Bogoni P, Salas-Herreros E, Armato M, Collivignarelli F, Vegni F, Rodríguez-Quiros J - BMC Vet. Res. (2014)

Clinical (A) and radiographic (B) pictures of a construct IB for stabilisation of a radius-ulna fracture. The distal short segment was stabilised by two K wires tensioned on the ring and a threaded pin on a post, and the proximal long segment by three threaded pins on a rail. Note the use of a radiolucent ring to allow for an unobstructed visualization of the fracture area.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4197305&req=5

Fig1: Clinical (A) and radiographic (B) pictures of a construct IB for stabilisation of a radius-ulna fracture. The distal short segment was stabilised by two K wires tensioned on the ring and a threaded pin on a post, and the proximal long segment by three threaded pins on a rail. Note the use of a radiolucent ring to allow for an unobstructed visualization of the fracture area.
Mentions: Thirty-five cases were radius-ulna fractures: 22 (63%) were transverse, 7 (20%) comminuted, 4 (11%) oblique, and 2 (6%) spiroidal. The most used configurations were IB in 20 (57%) cases (Figure 1), IIB in 6 (17%) and IA in 3 (9%). Two of the remaining 6 cases (6%) were treated with configuration IIA, two with IC, one with IIIB and one with IID configuration. The rings used for radius-ulna fractures were 360° in 29 (83%) cases and 270° in 2 (6%); a combination of 360° rings distally and 270° and 180° rings proximally was used in 4 (11%) cases. Twenty-one (60%) frames contained orthogonal linear elements, 11 (31%) inclinable ones and 3 (9%) both of them. One or two-bar strut constructs were used in 8 (29%) constructs: one IA and 7 (35%) IB configurations. The healing time for radius-ulna fractures was 75.6 ± 30.6 days (median, 67 days; range, 36 to 167 days).Figure 1

Bottom Line: Complications, radiographic, functional and cosmetic results were evaluated at the time of fixator removal.Radiographic results at the time of frame removal were excellent in 59% of the cases, good in 38% and fair in 3%, while functional and cosmetic results were excellent in 69% of the cases, good in 27% and fair in 4%.The classification used enables to determine the number of linear and circular elements used in the frame.

View Article: PubMed Central - PubMed

ABSTRACT

Background: Hybrid external fixation (HEF) is an emerging technique for fracture stabilization in veterinary orthopedics, but its use has been reported in few papers in the veterinary literature. The linear and circular elements that form hybrid fixators can be connected in a very high number of combinations, and for this reason just referring to HEF without any classification is often misleading about the actual frame structure. The aim of this study was to retrospectively evaluate fracture stabilization by HEF in 58 client-owned dogs and 8 cats, and to extend the already existing classification for hybrid constructs to include all frame configurations used in this study and potentially applicable in clinical settings. Animal signalment, fracture classification, surgical procedure and frame configuration were recorded. Complications, radiographic, functional and cosmetic results were evaluated at the time of fixator removal.

Results: Sixty-eight fractures in 58 dogs and eight cats were evaluated. Two dogs had bilateral fractures. Fifty-one percent were radio-ulna, 34% tibial, 9% humeral, 3% femoral and 3% scapular fractures. One ring combined with one or two linear elements was the most widely employed configuration in this case series. Radiographic results at the time of frame removal were excellent in 59% of the cases, good in 38% and fair in 3%, while functional and cosmetic results were excellent in 69% of the cases, good in 27% and fair in 4%.

Conclusions: HEF is a useful option for fracture treatment in dogs and cats, particularly for peri and juxta-articular fractures. It can be applied with a minimally invasive approach, allows adjustments during the postoperative period and is a versatile system because of the large variety of combinations that can fit with the specific fracture features. The classification used enables to determine the number of linear and circular elements used in the frame.

Show MeSH
Related in: MedlinePlus