犬尾侧交叉韧带起源撕脱骨折合并颅交叉韧带破裂的单侧修复

VCOT Open Pub Date : 2022-11-02 DOI:10.1055/s-0043-1771232
A. A. Pike, R. Balfour
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摘要

摘要:股骨尾交叉韧带撕脱骨折很少有文献记载,其真实发生率尚不清楚。文献检索显示,很少有CaCL撕脱骨折或断裂合并颅十字韧带(CrCL)断裂的病例。只有一个病例报告描述了手术治疗这种联合碎片去除和肩关节囊外缝合稳定。1岁的拉布拉多雌性绝育猎犬后肢跛行。检查显示颅瓣抽屉,符合CrCL破裂。在x线片上可见明显的滑车沟骨积液和骨混浊。在手术中,关节切开术显示CrCL撕裂以及股骨内侧髁的CaCL起源撕脱性骨折。将撕脱性骨折复位,并将三枚0.035英寸克氏针(k -针)以发散方式穿过碎片置入股骨内侧髁。然后行胫骨平台水平截骨术(TPLO)。6周复查x线片显示TPLO愈合良好,撕脱骨折修复,尽管其中一根k针断裂。在6周的随访中,狗轻度跛行,随后在8个月的随访中四肢改善至临床正常,x线片显示骨愈合最佳。据作者所知,这是首例用k -钢丝联合TPLO修复撕裂的CrCL韧带撕脱骨折的病例报告,临床效果良好。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Unilateral Repair of an Avulsion Fracture of the Caudal Cruciate Ligament Origin Combined with a Ruptured Cranial Cruciate Ligament in a Dog
Abstract Caudal cruciate ligament (CaCL) femoral avulsion fractures are rarely documented, and a true incidence is unclear. A literature search revealed very few cases of a CaCL avulsion fracture or rupture combined with a cranial cruciate ligament (CrCL) rupture. Only a single case report described surgical treatment of this combination by fragment removal and stifle stabilization with an extracapsular suture. A 1-year-old female spayed Labrador Retriever presented with a hindlimb lameness. Examination revealed cranial drawer of the stifle, consistent with CrCL rupture. Stifle effusion, as well as a bone opacity seen in the trochlear groove, was evident on radiographs. At surgery, arthrotomy revealed a torn CrCL as well as an avulsion fracture of the CaCL origin from the medial femoral condyle. The avulsion fracture was reduced, and three 0.035-inch Kirschner's wires (K-wires) were placed in a divergent fashion through the fragment into the medial femoral condyle. A tibial plateau leveling osteotomy (TPLO) was then performed. Six-week recheck radiographs showed good healing of the TPLO as well as the repaired avulsion fracture, despite breakage of one of the K-wires. The dog was mildly lame at the 6-week follow-up and subsequently improved to clinically normal on the limb at 8-month follow-up with optimal bone healing on radiographs. To the authors' knowledge, this is the first case report to describe a CaCL avulsion fracture repair with K-wires combined with a TPLO for a torn CrCL, with an excellent clinical outcome.
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