Michael D DeTora, Randy J Boudrieau1. 1. Randy J. Boudrieau, DVM, Diplomate ACVS & ECVS, Cummings School of Veterinary Medicine at Tufts University, Department of Clinical Sciences, 200 Westboro Road, N. Grafton, MA 01536, United States, E-mail: randy.boudrieau@tufts.edu.
Abstract
OBJECTIVE: To describe the surgical technique of complex distal femoral deformity correction with the aid of stereolithography apparatus (SLA) biomodels, stabilized with locking plate fixation. METHODS: Full-size replica epoxy bone biomodels of the affected femurs (4 dogs/ 5 limbs) were used as templates for surgical planning. A rehearsal procedure was performed on the biomodels aided by a guide wire technique and stabilized with locking plate fixation. Surgery performed in all dogs was guided by the rehearsal procedure. All pre-contoured implants were subsequently used in the definitive surgical procedure with minimal modification. RESULTS: All dogs had markedly improved, with near normal functional outcomes; all but one had a mild persistent lameness at the final in-hospital follow-up examination (mean: 54.4 weeks; range: 24-113 weeks after surgery). All femurs healed without complications (mean: 34 weeks, median: 12 weeks; range: 8-12 weeks for closing osteotomies, and 26-113 weeks for opening wedge osteotomies). Long-term follow-up examination (mean: 28.6 months; range: 5-42 months) revealed all but one owner to be highly satisfied with the outcome. Complications were observed in two dogs: prolonged tibiotarsal joint decreased flexion that resolved with physical therapy. In one of these dogs, iatrogenic transection of the long digital extensor tendon was repaired, and the other had a peroneal nerve neurapraxia. CLINICAL SIGNIFICANCE: Stereolithography apparatus biomodels and rehearsal surgery simplified the definitive surgical corrections of complex femoral malunions and resulted in good functional outcomes.
OBJECTIVE: To describe the surgical technique of complex distal femoral deformity correction with the aid of stereolithography apparatus (SLA) biomodels, stabilized with locking plate fixation. METHODS: Full-size replica epoxy bone biomodels of the affected femurs (4 dogs/ 5 limbs) were used as templates for surgical planning. A rehearsal procedure was performed on the biomodels aided by a guide wire technique and stabilized with locking plate fixation. Surgery performed in all dogs was guided by the rehearsal procedure. All pre-contoured implants were subsequently used in the definitive surgical procedure with minimal modification. RESULTS: All dogs had markedly improved, with near normal functional outcomes; all but one had a mild persistent lameness at the final in-hospital follow-up examination (mean: 54.4 weeks; range: 24-113 weeks after surgery). All femurs healed without complications (mean: 34 weeks, median: 12 weeks; range: 8-12 weeks for closing osteotomies, and 26-113 weeks for opening wedge osteotomies). Long-term follow-up examination (mean: 28.6 months; range: 5-42 months) revealed all but one owner to be highly satisfied with the outcome. Complications were observed in two dogs: prolonged tibiotarsal joint decreased flexion that resolved with physical therapy. In one of these dogs, iatrogenic transection of the long digital extensor tendon was repaired, and the other had a peroneal nerve neurapraxia. CLINICAL SIGNIFICANCE: Stereolithography apparatus biomodels and rehearsal surgery simplified the definitive surgical corrections of complex femoral malunions and resulted in good functional outcomes.