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Immediate arthrodesis in dogs with severe shearing carpal wounds
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Shearing wounds especially on the legs can be the surgeon´s nightmare: they tend to become infected, show delayed wound healing with diverse complications, require skin grafts and so on. An arthrodesis, if done at all, generally is recommended as a second step. Does this new approach, an immediate arthrodesis, improve the prognosis?
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The medical records of seven dogs with severe, grade 3, open shearing wounds of the carpus or tarsus that were treated with an immediate arthrodesis were reviewed.
Six dogs were managed with a transarticular external skeletal fixator (ESF), and one dog was treated with plate fixation.
The soft tissues were managed simultaneously along with the definitive joint stabilization in all cases.
Minor complications occurred in four dogs: one dog that required a skin graft, one dog in which a skin graft was recommended but not performed, one dog in which a secondary skin closure was performed, and one dog in which a delayed cancellous bone graft was placed.
Major complications occurred in three dogs: two dogs that required restabilization of the arthrodesis and one dog that required implant (i.e., plate) removal due to infection.
All dogs healed with acceptable functional and cosmetic results.
Further long-term evaluation of five dogs revealed that all but one dog had either excellent or good functional outcomes, and the remaining dog had a fair outcome.
Similarly, five dogs had either excellent or good cosmetic outcomes, with the remaining dog having a fair outcome. All owners were very satisfied with the overall results.
This clinical study demonstrated that an immediate, definitive management technique, in which bone fusion and wound management are undertaken as simultaneous objectives, is a viable technique of managing severe periarticular shearing injuries. Transarticular stabilization with an ESF is the technique recommended.
Source: John A. Benson, Randy J. Boudrieau (2002): Severe Carpal and Tarsal Shearing Injuries Treated With an Immediate Arthrodesis in Seven Dogs. In: Journal of the American Animal Hospital Association 38:370-380 (2002)
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