当前位置: X-MOL 学术Equine Vet. Edu. › 论文详情
Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)
Comparison of 3D-assisted surgery and conservative methods for treatment of type III fractures of the distal phalanx in horses
Equine Veterinary Education ( IF 0.9 ) Pub Date : 2019-12-06 , DOI: 10.1111/eve.13232
C. Heer 1 , A. E. Fürst 1 , F. Del Chicca 2 , M. A. Jackson 1
Affiliation  

The aim of this retrospective study was to compare the outcome of conservative methods and 3D-assisted surgery for treatment of type III fractures of the distal phalanx with regard to recovery time and the development of osteoarthritis (OA) in the distal interphalangeal joint (DIPJ). The medical records of all horses with type III fracture of the distal phalanx referred to the Equine Department, Vetsuisse Faculty, University of Zurich, between 1992 and 2016 were reviewed. The severity of lameness at initial examination, radiographic evaluation, treatment (conservative, group A; 3D-assisted surgery, group B), complications, outcome and recovery time were determined. Follow-up examinations included clinical and radiographic examinations. Of 33 horses, 15 received conservative treatment and 18 underwent surgery. Eleven of the 15 (73.3%) horses in group A returned to their intended use and four were subjected to euthanasia or remained chronically lame. The median recovery time was 240 days (95% CI, 180–374). Thirteen of 15 (86.7%) horses developed OA of the DIPJ within 5 months of the fracture. In group B, 16 of 17 (94.1%) horses returned to their intended use, one horse remained chronically lame, and one horse was subjected to euthanasia because of unrelated reasons. The median recovery time was 139 days (95% CI, 120–270), and seven horses (38.9%) developed OA of the DIPJ within 5 months of the fracture. Overall, the screws had to be removed in five fluoroscopic-assisted surgery cases (three because of implant infection and two because of severe lameness), in one computer-assisted surgery case due to severe lameness and in one computed tomography-assisted surgery case because of implant infection. In conclusion, there was no significant difference in time for recovery of type III fractures of the distal phalanx between the two groups, but surgical treatment led to significantly fewer cases of OA in the DIPJ as determined by subjective radiographic evaluation (P = 0.015).

中文翻译:

3D辅助手术与保守治疗马远节指骨Ⅲ型骨折的比较

这项回顾性研究的目的是比较保守方法和 3D 辅助手术治疗远端指骨 III 型骨折的结果,包括恢复时间和远端指间关节 (DIPJ) 骨关节炎 (OA) 的发展. 回顾了 1992 年至 2016 年期间提交给苏黎世大学 Vetsuisse 学院马科系的所有远端指骨 III 型骨折马的医疗记录。确定了初次检查时跛行的严重程度、放射学评估、治疗(保守,A 组;3D 辅助手术,B 组)、并发症、结果和恢复时间。随访检查包括临床和放射学检查。33匹马中,15匹接受保守治疗,18匹接受手术。15 个中的 11 个 (73. 3%)A 组的马恢复了预期用途,其中四头被实施安乐死或长期跛行。中位恢复时间为 240 天(95% CI,180-374)。15 匹马中有 13 匹 (86.7%) 在骨折后 5 个月内出现 DIPJ 骨关节炎。在 B 组中,17 匹马中有 16 匹(94.1%)恢复了预期用途,一匹马长期跛行,一匹马因无关原因被实施安乐死。中位恢复时间为 139 天(95% CI,120-270),7 匹马(38.9%)在骨折后 5 个月内出现 DIPJ 骨关节炎。总体而言,在 5 例透视辅助手术病例中必须移除螺钉(其中 3 例是因为植入物感染,2 例是因为严重跛行),一例因严重跛行而进行计算机辅助手术的病例和一例因植入物感染而进行的计算机断层扫描辅助手术。总之,两组远端指骨 III 型骨折的恢复时间没有显着差异,但根据主观影像学评估确定,手术治疗导致 DIPJ OA 病例显着减少(P = 0.015)。
更新日期:2019-12-06
down
wechat
bug