Immobilizer Removable Articulate in Rehabilitation of Dogs Submitted to Tenorrhaphy Patellar

Background: In cases of patellar tendon ruptures, there is a need for primary repair by sutures aiming to restore the extensor mechanism of the knee and prevent degenerative sequelae. Even though the need for temporary immobilization of the joint reconstruction surgeries involving tendons and ligaments, seeks to avoid or minimize the undesirable effects of disuse without any interference at the surgical site. Thus, the objective of this research was to propose a model of joint immobilization adjustable in dogs undergoing patellar tenorrhaphy to allow, in the immediate postoperative period, the achievement of physical therapy modalities without interfering with the healing of the involved structures.Materials, Methods & Results: The dogs were randomly divided into two groups called fixed immobilization or GF (6 dogs) and adjustable or GA (5 dogs) immobilization. Once on plane and restrained in dorsal decubitus, lateral incision was performed on the right knee in dogs GF and GA for total section of the patellar tendon at its insertion 10 mm at the tibial crest. Immediately, it was made with tenorrhaphy modified Kessler suture pattern using monofilament nylon wire nº 1, followed by a Wolff point involving modified Kessler suture with the same type of wire. In both groups, the joint was immobilized femorotibiopatelar percutaneous external fixation biplanar at an angle of 110° for 30 days. The groups differed by the material used to connect the percutaneous pins, being employed in the GF acrylic resin, and in GA dogs was made adjustable apparatus which consisted of two stainless steel plates with rounded ends with three equally spaced holes 2.5 mm between them in the central part of the plate and the edge of 6mm, which is joined with the other plate by a nut and bolt and allowing to adjust the desired angle of the device. Were utilized four Steinmann pins 2.5 mm, two in the femur and two tibia, introduced perpendicularly to the bone. The assembled apparatus was encased in percutaneous pins and stuck with stainless steel nuts and lock washers causing immobilization of the knee joint, however adjustable in the period of application of physiotherapy protocol. The results demonstrated a reduction in measures in the period of 30 days, indicating that there was muscle atrophy. At 60 days post-operative values demonstrating increased muscle mass gain probably the bearing of the affected limb to the ground. In this study, was possible to observe that the values at 60 days did not return to the same found preoperatively, and the dogs GF and GA were on average 92.19% of the initial values. As for gait analysis, all dogs GF and GA were grade 5, 1 and 3 of lameness in the preoperative period and after 30 and 60 days after surgery, respectively.Discussion: The joint immobilization in dogs submitted to tenorrhaphy is required, however, the member cannot be used properly, which can lead to sequelae such as muscle atrophy from disuse and especially joint blockage. Currently in human medicine assisted rehabilitation in the immediate post-operative recovery involving the reconstruction of tendons and ligaments, without the need for joint immobilization is required, because patients are instructed to restrict the movements postoperatively. In veterinary medicine, however, it becomes risky this type of conduct, especially the lack of control the movements made by animals, arousing interest in this research to propose joint that could be undone each day to allow implementation of a method of immobilization physiotherapy and at the end of the session, the joint was immobilized again. According to the results, we can conclude that the temporary immobilization with adjustable articulating fixator in dogs submitted to patellar tenorrhaphy allows the use of a physical therapy protocol during the period of immobilization, without interfering with the healing of tendon anastomosis

Immobilizer Removable Articulate in Rehabilitation of Dogs Submitted to Tenorrhaphy Patellar

Background: In cases of patellar tendon ruptures, there is a need for primary repair by sutures aiming to restore the extensor mechanism of the knee and prevent degenerative sequelae. Even though the need for temporary immobilization of the joint reconstruction surgeries involving tendons and ligaments, seeks to avoid or minimize the undesirable effects of disuse without any interference at the surgical site. Thus, the objective of this research was to propose a model of joint immobilization adjustable in dogs undergoing patellar tenorrhaphy to allow, in the immediate postoperative period, the achievement of physical therapy modalities without interfering with the healing of the involved structures.Materials, Methods & Results: The dogs were randomly divided into two groups called fixed immobilization or GF (6 dogs) and adjustable or GA (5 dogs) immobilization. Once on plane and restrained in dorsal decubitus, lateral incision was performed on the right knee in dogs GF and GA for total section of the patellar tendon at its insertion 10 mm at the tibial crest. Immediately, it was made with tenorrhaphy modified Kessler suture pattern using monofilament nylon wire nº 1, followed by a Wolff point involving modified Kessler suture with the same type of wire. In both groups, the joint was immobilized femorotibiopatelar percutaneous external fixation biplanar at an angle of 110° for 30 days. The groups differed by the material used to connect the percutaneous pins, being employed in the GF acrylic resin, and in GA dogs was made adjustable apparatus which consisted of two stainless steel plates with rounded ends with three equally spaced holes 2.5 mm between them in the central part of the plate and the edge of 6mm, which is joined with the other plate by a nut and bolt and allowing to adjust the desired angle of the device. Were utilized four Steinmann pins 2.5 mm, two in the femur and two tibia, introduced perpendicularly to the bone. The assembled apparatus was encased in percutaneous pins and stuck with stainless steel nuts and lock washers causing immobilization of the knee joint, however adjustable in the period of application of physiotherapy protocol. The results demonstrated a reduction in measures in the period of 30 days, indicating that there was muscle atrophy. At 60 days post-operative values demonstrating increased muscle mass gain probably the bearing of the affected limb to the ground. In this study, was possible to observe that the values at 60 days did not return to the same found preoperatively, and the dogs GF and GA were on average 92.19% of the initial values. As for gait analysis, all dogs GF and GA were grade 5, 1 and 3 of lameness in the preoperative period and after 30 and 60 days after surgery, respectively.Discussion: The joint immobilization in dogs submitted to tenorrhaphy is required, however, the member cannot be used properly, which can lead to sequelae such as muscle atrophy from disuse and especially joint blockage. Currently in human medicine assisted rehabilitation in the immediate post-operative recovery involving the reconstruction of tendons and ligaments, without the need for joint immobilization is required, because patients are instructed to restrict the movements postoperatively. In veterinary medicine, however, it becomes risky this type of conduct, especially the lack of control the movements made by animals, arousing interest in this research to propose joint that could be undone each day to allow implementation of a method of immobilization physiotherapy and at the end of the session, the joint was immobilized again. According to the results, we can conclude that the temporary immobilization with adjustable articulating fixator in dogs submitted to patellar tenorrhaphy allows the use of a physical therapy protocol during the period of immobilization, without interfering with the healing of tendon anastomosis

Modificação da técnica de abordagem ventral à articulação atlantoxial sem a secção do músculo esternotireóideo Modification of ventral technique approach to the articulation atlantoxial with no section of the muscle sternothyreoid

O objetivo deste trabalho foi apresentar uma variação na técnica de acesso ventral à articulação atlantoaxial para tratamento da instabilidade atlantoaxial sem a secção do músculo esternotireóideo. Foram utilizados 15 cães, pesando entre oito e 12kg, sem raça definida, independente do sexo, distribuídos aleatoriamente em três grupos iguais de acordo com o período pós-operatório (PO) denominados de I (30dias), II (60 dias) e III (90 dias) para avaliações clínicas diárias. A articulação atlantoaxial foi submetida à artrodese por meio do acesso ventral utilizando pinos de Steinmann associados à resina acrílica autopolimerizável. O acesso e a exposição da articulação atlantoaxial sem a secção do músculo esternotireóideo foram realizados sem complicações ou limitações adicionais. Nenhum cão desta pesquisa apresentou tosse, dispnéia, regurgitação, paralisia laríngea ou Síndrome de Horner. Pode-se concluir que a secção do músculo esternotireóideo é um procedimento desnecessário e que não interfere na exposição da articulação atlantoaxial e na realização da artrodese em cães por meio do acesso ventral.The aim of this research was to present a variation of the ventral technique access to the atlantoaxial joint, for treatment of atlantoaxial instability with no section of sternothyreoid muscle. Fifteen dogs, with weight between 8 and 12kg, were randomly distributed in three groups denominated one (30 days), two (60 days) and three (90 days) for daily clinical evaluations. The atlantoaxial joint was submitted to the arthrodesis through the ventral access using pins of Steinmann associated to acrylic resin. The access and exhibition of the atlantoaxial joint with no section of the sternothyreoid muscle was obtained without complications or additional limitations. No dog of this research presented coughing, dyspnea, regurgitation, laryngeal paralysis or Horner's syndrome. It can be concluded that the section of sternothyreoid muscle is an unnecessary procedure and that there is is no interference in the exhibition of atlantoaxial joint and arthrodesis approach of dogs through ventral access

Modificação da técnica de abordagem ventral à articulação atlantoxial sem a secção do músculo esternotireóideo

O objetivo deste trabalho foi apresentar uma variação na técnica de acesso ventral à articulação atlantoaxial para tratamento da instabilidade atlantoaxial sem a secção do músculo esternotireóideo. Foram utilizados 15 cães, pesando entre oito e 12kg, sem raça definida, independente do sexo, distribuídos aleatoriamente em três grupos iguais de acordo com o período pós-operatório (PO) denominados de I (30dias), II (60 dias) e III (90 dias) para avaliações clínicas diárias. A articulação atlantoaxial foi submetida à artrodese por meio do acesso ventral utilizando pinos de Steinmann associados à resina acrílica autopolimerizável. O acesso e a exposição da articulação atlantoaxial sem a secção do músculo esternotireóideo foram realizados sem complicações ou limitações adicionais. Nenhum cão desta pesquisa apresentou tosse, dispnéia, regurgitação, paralisia laríngea ou Síndrome de Horner. Pode-se concluir que a secção do músculo esternotireóideo é um procedimento desnecessário e que não interfere na exposição da articulação atlantoaxial e na realização da artrodese em cães por meio do acesso ventral

Recuperação funcional de cães com doença do disco intervertebral toracolombar submetidos ao tratamento cirúrgico Functional recovery of dogs with thoracolumbar intervertebral disk disease submitted the surgical treatment

O objetivo deste estudo foi avaliar a recuperação funcional de 33 cães com doença do disco intervertebral (DDIV) toracolombar submetidos ao tratamento cirúrgico, atendidos no Hospital Veterinário Universitário da Universidade Federal de Santa Maria (HVU-UFSM), no período entre 2004 e 2006. Os dados dos animais incluíram raça, idade, sexo, estado neurológico antes da cirurgia, interpretação da radiografia simples e contrastada, duração das deficiências neurológicas até o procedimento cirúrgico, tempo de recuperação pós-cirúrgico, função urinária e fecal e recidiva dos sinais clínicos. Quanto à duração dos sinais neurológicos antes da cirurgia, 27 (81,8%) permaneceram por um período inferior a 15 dias, 20 cães tiveram melhora dos sinais clínicos decorridos 30 dias do procedimento cirúrgico e seis, com mais de 30 dias, sendo que um desses demorou 60 dias para caminhar. Apenas um (3,8%) dos 26 cães que tiveram recuperação funcional satisfatória apresentou incontinência urinária e apenas um (3%) teve recidiva da DDIV. Pode-se concluir que o tratamento cirúrgico promove recuperação funcional satisfatória na maioria dos cães com DDIV toracolombar. O prognóstico para recuperação funcional após o tratamento cirúrgico é tanto melhor quanto menor for o grau de disfunção neurológica e o percentual de recidiva é baixo em animais submetidos a este tipo de terapia.This report aimed at evaluating the functional recovery of 33 dogs with thoracolumbar intervertebral disk disease (IVDD) admitted at the Veterinary Hospital of Santa Maria Federal University (HVU-UFSM), from 2004 to 2006. The animals underwent surgical treatment. Data obtained from the dogs included: breed, age, sex, neurological status before the surgery, interpretation of the simple x-ray and myelography, duration of clinical signs, days to walking after surgery, urinary and fecal function and disease recurrence. Neurological signs before the surgery kept for a period smaller than 15 days in 27 (81.8%) dogs. Twenty dogs presented involution of the neurological signs at 30 days after the surgical procedure, six after 30 days, and one dog elapsed 60 days to return walking. One of the twenty-six dogs that had satisfactory functional recovery had urinary incontinence and two of them presented recurrence of IVDD. This study showed that the surgical treatment promotes satisfactory functional recovery in most of the dogs with thoracolumbar IVD; the prognostic for functional recovery after the surgical treatment is better as smaller the degree of neurological dysfunction and the recurrence percentage is lower when submitted to this therapy type