Estudo preliminar in vivo da avaliação radiográfica da translação cranial da tíbia em cães em estação com diferentes técnicas de mensuração

A ruptura do ligamento cruzado cranial (RLCCr) é problema comum em cães, resultando em acentuada instabilidade craniocaudal da articulação do joelho. Dois testes físicos para diagnóstico da instabilidade do joelho em casos de ruptura do ligamento cruzado cranial foram descritos e são amplamente utilizados: o teste de compressão tibial (TCT) e teste de gaveta cranial (TGC). No entanto a sensibilidade e especificidade destes testes são questionadas, pela falha em diagnosticar consistentemente a RLCCr. Dentre as técnicas para corrigir a RLCCr, destaca-se a osteotomia de nivelamento do platô tibial (TPLO), como uma das mais utilizadas e para a realização da TPLO deve-se determinar o ângulo do platô tibial (APT). O presente estudo teve como objetivos investigar o uso de duas técnicas de mensuração do deslocamento cranial da tíbia em cães na projeção lateromedial (estação) comparando com a projeção mediolateral (decúbito lateral) e comparar a mensuração do ângulo do platô tibial na projeção lateromedial (estação) e na projeção mediolateral (decúbito lateral). Para quantificar a magnitude do deslocamento tibial cranial foram utilizadas duas técnicas de mensuração: a distância entre o eixo mecânico tibial (EMT) e o eixo condilar femoral (ECF) e a distância entre a origem e a inserção do ligamento cruzado cranial. Os valores médios normalizados encontrados para distância entre a origem e a inserção do ligamento cruzado cranial foram 1,14 ± 0,07 e 1,13 ± 0,04 para as projeções em estação e em decúbito lateral, respectivamente. E para a distância entre o EMT e o ECF foram, os valores médios normalizados foram 0,04 ± 0,03 e 0,16 ± 0,04 para projeções em estação e em decúbito lateral, respectivamente. Os ângulos obtidos em projeção lateromedial (estação) e na mediolateral (decúbito lateral) pelo avaliador mais experiente (Avaliador A) não apresentaram diferença significativa, entretanto para avaliador menos experiente (Avaliador B) foi observado diferença significativa. Na comparação entre avaliadores, foi encontrado diferença significativa no APT mensurado com paciente em estação e ausência de diferença significativa no posicionamento em decúbito lateral. Conclui-se que a avaliação em estação do deslocamento tibial cranial, com ambas as técnicas utilizadas, é passível de execução. A variação encontrada entre ângulos na projeção convencional e em estação neste trabalho pode ser considerada excessiva, tornando a projeção em estação inadequada para a mensuração do ângulo com finalidade de planejamento cirúrgico.Cranial cruciate ligament rupture (CrCLR) is a common problem in dogs, resulting in marked craniocaudal instability of the stifle joint. Two tests for diagnosing stifle instability in cases of cranial cruciate ligament rupture have been described and are widely used: the tibial compression test (TCT) and the cranial drawer test (CDT). However, the sensitivity and specificity of these tests are questioned, due to the failure to consistently diagnose CrCLR. Among the techniques to correct CrCLR, the tibial plateau leveling osteotomy (TPLO) stands out as one of the most used and to perform the TPLO, the tibial plateau angle (TPA) must be determined. The aim of this study was to investigate the use of two techniques for measuring tibial cranial displacement in dogs in the lateromedial projection (standing position) compared to the mediolateral projection (lateral decubitus) and to compare the measurement of the tibial plateau angle in the lateromedial projection (standing position) and in the mediolateral projection (lateral decubitus). To quantify the magnitude of the cranial tibial displacement, two measurement techniques were used: the distance between the tibial mechanical axis (TMA) and the femoral condylar axis (FCA) and the distance between the origin and insertion of the cranial cruciate ligament. The normalized mean values found for the distance between the origin and insertion of the cranial cruciate ligament were 1.14 ± 0.07 and 1.13 ± 0.04 for the standing position and lateral decubitus projections, respectively. And for the distance between the TMA and the FCA, the normalized mean values were 0.04 ± 0.03 and 0.16 ± 0.04 for standing position and lateral decubitus projections, respectively. The angles obtained in lateralomedial and mediolateral projections by the more experienced evaluator did not present significant difference, however, for the less experienced evaluator a significant difference was observed. In the comparison between evaluators, a significant difference was found in the PTA measured with the patient in a standing position and no significant difference in the position in the lateral decubitus position. It is concluded that the in standing position evaluation of the cranial tibial displacement, with both techniques used, is feasible. The variation found between conventional and stationary projection angles in this work can be considered excessive, making stationary projection inadequate for measuring the angle for surgical planning purposes

Elaboração de iogurte probiótico a base de leite orgânico

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Plate-rod osteosynthesis in dogs and cats

Background: Most fractures are caused by traumatic processes due to car accidents, but they can also occur due to bullets, fights and falls. Surgical stabilization is often necessary and shows high rates of bone healing when its basic concepts are followed. The objective of this study is to report cases of shaft fracture in long bones stabilized with intramedullary pin and plate (IMPP) in order to evaluate pre- and postoperative clinical and radiographic signs, correlating the ideal surgical technique described on recent studies with complications resulting from the surgical procedure. Cases: This study includes patients undergoing osteosynthesis with intramedullary pin and plate from January 2015 to December 2016 at the Veterinary Medical Teaching Hospital of UFRGS. During this period, 13 animals (five cats and eight dogs) with long bone fractures were treated with the abovementioned association. Information on breed, age, sex, etiology of the fracture, affected bone, clinical signs, osteosynthesis technique, clinical progress, fracture healing, and postoperative complications was collected for the study. Late postoperative recovery was evaluated by telephone contact with owners. The mean age was 5.4 years (3 months - 15 years) and body weight 17.66 kg (3 - 28.4 kg). The fractures were due to being hit by a vehicle (5), bites (1), accident with a toy (1), and unknown (6). Discussion: All cases included in this study were in the femur, humerus or tibia. Fractures in the radius are also frequent in small animal traumatology, but in this case the use of an intramedullary pin is not recommended. All animals had diaphyseal fractures, which is an important prerequisite for IMPP stabilization. The IMPP association is mainly indicated in cases of comminuted fractures, when it is anatomically impossible to reduce fracture fragments, as occurred with nine patients in this study. The plate did not break of fail in any of the cases, as the association of an intramedullary pin with the plate significantly reduces tension on the plate, increasing bending strength up to ten times. One of the animals presented severe postoperative pain and could not adequately lean on the operated limb. Orthopedic and neurological evaluation led to the conclusion that the long pin in the region of the subtrochanteric fossa could be injuring the sciatic nerve and the animal was reoperated to cut the pin shorter. Pain stopped and after seven months the animal could lean on the limb and move normally, being proprioceptive and showing no pain on palpation and manipulation. The pin used in the IMPP technique should fill 30 to 40% of the diameter of the intramedullary canal at its narrowest portion. Of the 13 patients included in this study, six received pins within the recommended diameter, one received a pin larger than recommended, and five received pins smaller than recommended. The mean diameter of the pin related to the diameter of the medullary canal was 32.3% (19% - 54.8%). The bone healing rate described for IMPP is high (98%), three patients returned for this study reevaluation and all of them presented visible radiographic bone healing. We concluded that osteosynthesis associated with the use of intramedullary pin and plate resulted in adequate stabilization of fractures in the femur, tibia and humerus, allowing fast functional recovery with low complication rates

Plate-rod osteosynthesis in dogs and cats

Background: Most fractures are caused by traumatic processes due to car accidents, but they can also occur due to bullets, fights and falls. Surgical stabilization is often necessary and shows high rates of bone healing when its basic concepts are followed. The objective of this study is to report cases of shaft fracture in long bones stabilized with intramedullary pin and plate (IMPP) in order to evaluate pre- and postoperative clinical and radiographic signs, correlating the ideal surgical technique described on recent studies with complications resulting from the surgical procedure. Cases: This study includes patients undergoing osteosynthesis with intramedullary pin and plate from January 2015 to December 2016 at the Veterinary Medical Teaching Hospital of UFRGS. During this period, 13 animals (five cats and eight dogs) with long bone fractures were treated with the abovementioned association. Information on breed, age, sex, etiology of the fracture, affected bone, clinical signs, osteosynthesis technique, clinical progress, fracture healing, and postoperative complications was collected for the study. Late postoperative recovery was evaluated by telephone contact with owners. The mean age was 5.4 years (3 months - 15 years) and body weight 17.66 kg (3 - 28.4 kg). The fractures were due to being hit by a vehicle (5), bites (1), accident with a toy (1), and unknown (6). Discussion: All cases included in this study were in the femur, humerus or tibia. Fractures in the radius are also frequent in small animal traumatology, but in this case the use of an intramedullary pin is not recommended. All animals had diaphyseal fractures, which is an important prerequisite for IMPP stabilization. The IMPP association is mainly indicated in cases of comminuted fractures, when it is anatomically impossible to reduce fracture fragments, as occurred with nine patients in this study. The plate did not break of fail in any of the cases, as the association of an intramedullary pin with the plate significantly reduces tension on the plate, increasing bending strength up to ten times. One of the animals presented severe postoperative pain and could not adequately lean on the operated limb. Orthopedic and neurological evaluation led to the conclusion that the long pin in the region of the subtrochanteric fossa could be injuring the sciatic nerve and the animal was reoperated to cut the pin shorter. Pain stopped and after seven months the animal could lean on the limb and move normally, being proprioceptive and showing no pain on palpation and manipulation. The pin used in the IMPP technique should fill 30 to 40% of the diameter of the intramedullary canal at its narrowest portion. Of the 13 patients included in this study, six received pins within the recommended diameter, one received a pin larger than recommended, and five received pins smaller than recommended. The mean diameter of the pin related to the diameter of the medullary canal was 32.3% (19% - 54.8%). The bone healing rate described for IMPP is high (98%), three patients returned for this study reevaluation and all of them presented visible radiographic bone healing. We concluded that osteosynthesis associated with the use of intramedullary pin and plate resulted in adequate stabilization of fractures in the femur, tibia and humerus, allowing fast functional recovery with low complication rates