Application of locking compression plates as type 1 external fixators to treat unilateral mandibular fractures in four equids and one dromedary

Objectives To describe a novel fixation of open, unstable, unilateral mandibular fractures applying a locking compression plate as an external skeletal fixator (ESF-LCP). Animals Four horses and one dromedary. Study design Short case series. Methods Animals presented with unstable, open, unilateral fractures of the mandible. Fracture fixation was performed under general anesthesia. A 4.5/5.5 narrow LCP was applied externally above the level of the skin and combined with intraoral tension band wiring. Results Fracture fixation was achieved successfully using an ESF-LCP. Minimal tissue manipulation was required during application and removal of the construct. The ESF-LCPs provided adequate access to the wounds at the fracture site, were well tolerated, and did not interfere with any objects in the animals’ environment. Mild drainage at the screw-skin interface developed in all cases, requiring early implant removal due to surgical site infection in one case. The use of longer plates was associated with superficial pressure necrosis of the skin in the masseter area in two cases. Implants were removed after 3 to 12 weeks, and the long-term functional outcome after 11 to 41 (median 13) months was good in all cases. Conclusion Stabilization of mandibular fractures with ESF-LCP led to good outcomes in this case series. The use of longer plates positioned more caudally and in a ventrolateral position seemed associated with surgical site infection and pressure necrosis of the skin. Clinical significance Use of a locking compression plate as an external skeletal fixator seems to offer a viable alternative to treat unilateral mandibular fractures, especially when these are open and/or infected

Angiosarcoma cutáneo de párpado

Galería Fotográfica (sin resumen

Diagnosis and outcome following tenoscopic surgery of the digital flexor tendon sheath in German sports and pleasure horses

Background Digital flexor tendon sheath (DFTS) pathology is an important cause of lameness in horses. The outcome after surgical treatment is variable and depends on the exact diagnosis. Objectives To (1) describe the prevalence of lesions associated with lameness caused by nonseptic DFTS tenosynovitis in a large population of German sports and pleasure horses; (2) determine the sensitivity and specificity of diagnostic imaging techniques for identifying lesions within the DFTS with tenoscopic diagnosis being the gold standard; (3) explore associations between tenoscopically diagnosed lesions and signalment, purpose, and limb affected; and (4) describe the outcome following DFTS tenoscopy with nonseptic DFTS tenosynovitis in this population. Study design Retrospective case series. Methods Medical records of horses admitted for tenoscopic surgery of nonseptic DFTS tenosynovitis between 2011 and 2020 were reviewed. Follow‐up information was obtained via telephone contact. Sensitivity and specificity of ultrasonography and contrast tenography were determined using tenoscopic diagnosis as gold standard and univariable analysis was used to explore associations between signalment, case history, and tenoscopic diagnosis. Results Medical records from 131 horses were retrieved, of which 8 horses had bilateral disease and 6 horses were presented for tenoscopy on two separate occasions (3 for tenoscopy in the same limb, 3 in a different limb), thus, making a total of 145 limbs. Lesions were most commonly diagnosed in the deep (DDFT; n = 55 limbs) and superficial (SDFT; n = 55 limbs) digital flexor tendons. Manica flexoria (MF) lesions were detected in 44 limbs and palmar/plantar annular ligament (PAL) constriction in 99 limbs. In 36 limbs, only one structure within the DFTS was injured, whereas in 109 limbs a combination of lesions was noted, the most common being the combination of a SDFT lesion with PAL constriction. All affected limbs were examined with diagnostic ultrasonography; contrast tenography was performed in 86 limbs. For diagnosis of MF and DDFT tears, tenography was more sensitive (89% [confidence interval, CI: 65.4%–95.2%]; 72% [CI: 46.4%–89.3%], respectively) than specific (64% [CI: 52.5%–77.6%]; 53% [CI: 42.2%–73.3%], respectively) whereas ultrasonography was more specific (92% [CI: 84.5%–96.3%]; 92% [CI: 83.6%–96.0%]) with lower sensitivity (64% [CI: 47.7%–77.2%]; 54% [CI: 39.5%–67.9%]). For SDFT lesions, ultrasonography was highly specific (94% [CI: 86.9%–97.9%]) with lower sensitivity (66% [CI: 51.3%–77.4%]). Follow‐up information following first surgery was obtained for 118 horses (132 limbs): 18 (15.3%) of 118 horses remained chronically lame, 40 (33.8%) performed at a reduced level and 60 (50.8%) performed at the same or higher level following rehabilitation after tenoscopy. Horses with DDFT lesions had the poorest outcomes with only 36.6% returning to the same or higher level of exercise. Main limitations Retrospective analysis of clinical records and subjective outcome assessment based on owner follow‐up with potential recall bias. Findings on diagnostic imaging are impacted by many factors including equipment quality and operator expertise and experience. Conclusion Diagnostic imaging techniques were complimentary and contrast tenography was sensitive and ultrasonography was specific for the diagnosis of MF and DDFT lesions. Following tenoscopic surgery for nonseptic tenosynovitis of the DFTS, approximately half the cases were able to return to preinjury level of exercise

Estado higiénico sanitario de los puestos de venta de comidas preparadas, jugos y refrescos del mercado central modelo – Huacho 2022

Objetivo: Se determinó el estado higiénico sanitario que presentan los puestos de venta de comidas preparadas, jugos y refrescos del mercado Central Modelo - Huacho 2022. Metodología: Tipo aplicada – observacional, nivel de investigación descriptivo, de diseño no experimental de enfoque cualitativo y cuantitativo. La población fue los 39 negocios de venta conformados por los 97 puestos de venta, con los 82 manipuladores de alimentos, se utilizó como técnica la observación y para la recolección de datos se utilizó dos formatos autoinstructivos en una Ficha – Acta Técnica N° 5 y 6 para la vigilancia sanitaria de mercado de abastos de los puestos de venta de comidas preparadas, jugos y refrescos. Resultados: La condición sanitaria e inocuidad de las comidas preparadas, jugos y refrescos obtuvo un total de 7.7 % de puestos no aceptable, 59 % regular y 33.3% aceptable. Las buenas prácticas de manipulación empleadas obtuvieron un total de 12.8% no aceptable, 53.8% se encuentra regular y el 33.3% aceptable. Las condiciones higiénicas sanitarias que presentan los manipuladores de alimentos obtuvo un total de 20.5% de puestos de venta no aceptable, 38.5% se encuentra regular y el 41.0% aceptable. Las condiciones higiénicas que presentan los ambientes y enseres obtuvo un total de 7.6% de puestos de venta no aceptable, 46.2% se encuentra regular y el 46.2% aceptable. Conclusión: Se determinó que el estado higiénico sanitario que presentan los puestos de venta de comidas preparadas, jugos y refrescos del mercado Central Modelo - Huacho 2022, en las inspecciones realizadas prevalece la calificación de regular

Single-cut osteotomy for correction of a complex multiplanar deformity of the radius in a Shetland pony foal

Objective To describe the surgical correction of a multiplanar deformity of the radius in a pony using a single-cut osteotomy. Study design Case report. Animals A 9-week-old male Shetland pony foal with a bodyweight of 47 kg. Methods The foal presented with a complex multiplanar deformity of the right radius. A 3-dimensional model of the bone was created based on computed tomography (CT) imaging. To correct the deformity, the cutting plane for a single-cut osteotomy was calculated following the mathematical approach described by Sangeorzan et al. After osteotomy, the bone was realigned and stabilized with two 4.5 locking compression plates (LCPs). Results Recovery from surgery was uneventful, and the foal remained comfortable. A CT exam 15 weeks after surgery revealed that diaphyseal deformities improved substantially in procurvatum (from 8° to 1°), varus (from 27° to 0°), and rotation (30° to 5°). The operated radius was 2.1 cm shorter than the left. Eighteen-month follow up confirmed a functionally and cosmetically acceptable outcome. Conclusion The single-cut osteotomy resulted in the successful correction of a multiplanar equine long-bone deformity with a favorable outcome in a Shetland pony. Clinical significance Single-cut osteotomy is an alternative surgical technique for the correction of complex diaphyseal long-bone equine deformities. Computed tomography data and the possibility of printing 3D models provides a significant advantage for rehearsing the procedure and for evaluating the correction that was achieved

Surgical treatment of a complicated distal tibia epiphyseal Salter–Harris type I fracture in a yearling

This article describes the management of a complicated distal epiphyseal Salter–Harris type I fracture of the left tibia in a yearling horse. Closed reduction and internal fixation was attempted in the first surgery using tension band wires. Due to fracture instability 2 weeks after surgery, a full‐limb transfixation pin cast was applied to the tibia and maintained for 7 weeks to prevent further fracture displacement and to achieve axial alignment. The full‐limb cast was maintained for a total of 12 weeks, including the time with the transfixation pin cast. Cast sores and tendon laxity resolved without further complications. Ten months after the first surgery, the fracture had radiographically healed, and the horse was sound at the walk and trot in a straight line