Ch. 60: Femur Fx Flashcards
Vedrine VCOT 2018
Veterinary cuttable plate in a plate-rod construct for repair of diaphyseal femoral fractures in the cat
- pin % IM cavity?
- # of cortices per fragment w/ screws?
- what was the only complication?
- Follow-up? Outcome?
Pin occupation of 39% & 53% of IM cavity. Median number of cortices engaged per fragment was 6
Quadriceps contracture was an unacceptable functional outcome in one cat – only complication reported here
FU was available in 20 cases – complete bone healing assessed in 16/20 cases w/ a functional outcome considered as full in 17/20 (85%), acceptable in 2/20 (10%), & unacceptable in 1/20 (5%)
Jones JSAP 2021
Simple ostectomy to address quadriceps impingement caused by distal femoral malunion in four dogs
- type of displacement and 2nd changes?
- where and how was ostectomy performed?
- long-term evaluation?
All dogs had caudo-proximal displacement and femoral shortening and increased procurvatum
Ostectomy of the segment that was causing quadriceps impingement with debridement of proliferative fracture callus proximal to the trochlear groove in all dogs (approximately 45° to the long axis of the proximal femur in the sagittal plane, with the osteotomy directed in a cranio-proximal to caudo-distal direction)
Long-term evaluation in three dogs revealed minimal to no lameness in two and mild residual lameness in 1
Rubinos JFMS 2022
Traumatic physeal fractures in cats: a review of 36 cases (2010-2020)
- locations of Fx’s?
- complications?
- % physeal closure?
- outcome?
17 distal femur, 11 distal tibia and fibula, 5 distal radius/ulna, 2 proximal tibia, 1 distal humerus
Complications observed in 14 (39%) fractures (12 minor)
Physeal closure reported in 23 (64%) fractures (15 considered premature)
Outcome was good in 28 (78%), fair in 4 (11%) and poor in 2 (5%) fractures.
Petazzoni VCOT 2018
CT trochlear depth measurement in normal dogs
- maximal depth in relation to patellar thickness?
- vague conclusion
mean maximal depth of the trochlea was 46% of the mean maximal-patellar thickness
Conclusion: A wide range of maximal–patellar–craniocaudal–thickness/ maximal trochlear-depth ratio was found suggesting that breed studies should be performed to determine a breed-specific patellar-thickness/trochlear-depth ratio. To make decisions on when and where to perform a sulcoplasty during patellar luxation surgery, patella/trochlea thickness relationship should be measured for each breed with patellar tracking from stifle hyperflexion to stifle hyperextension
De Andrade VCOT 2019
Accuracy in determining canal flare index using different radiographical positions for imaging canine femurs
single important finding?
craniocaudal radiograph taken using a horizontal beam provided greater accuracy vs. standard CrCd
Sevil-Kilimci VCOT 2020
Canal flare index in the canine femur is influenced by the measurement method
Peterson Vet Sx 2020
Radiographic determination of normal canine femoral alignment in the sagittal plane: a cadaveric pilot study
- what were the 2 centers of rotation measured? How many observers?
- correlation among/between observers?
The anatomic and mechanical axes, joint orientation, lines and joint orientation angles were determined in the sagittal plane by using the center of rotation of angulation methodology
Three observers with various degrees of experience measured two centers of rotation of normal angulation, the anatomic caudoproximal femoral angle, and the mechanical caudodistal femoral angle
A high degree of correlation was present both among and between observers for all measurements performed, as defined by an ICC >0.8 for each
Nicetto Vet Sx 2020
Computed tomographic localization of the deepest portion of the femoral trochlear groove in healthy dogs
- points measured?
- intra/inter-rater agreement?
- least accurate at which point?
- most accurate at which point?
- deepest points?
Five points were identified from proximal to distal (proximal point [PP], P25, P50, P75, and distal point [DP])
Good to excellent intrarater and interrater agreements were observed in four of five trochlear points (P25, P50, P75, and DP)
Computed tomography allowed precise measurements of trochlear groove depth except for the most proximal point.
The deepest trochlear points were P25 and P50.
P25 was the most precise and accurate point measured, while PP was the least consistent
Eby Vet Sx 2020
A computed tomographic graphical approach to guide correction of femoral torsion
Serck Vet Sx 2021
Comparison of canine femoral torsion measurements using the axial and biplanar methods on three-dimensional volumetric reconstructions of computed tomography images
- 3 types/ways of measurements?
- differences between?
- median femoral torsion angles?
- axial measurement method on three-dimensional (3D) volumetric reconstructions of computed tomography images AMM(CT)
- biplanar measurement method on 3D volumetric reconstructions of computed tomography images BMM(CT)
- reference standard using axial measurement method on stereolithographic bone models AMM (SBM)
No differences were noted among the measurement methods
Median measurement of femoral torsion using the AMM (CT) was 34.2°, the BMM (CT) was 36.7°, and the AMM (SBM) was 32.3°.
Murakami VCOT 2020
Effect of limb position on measurements of the quadriceps muscle length/femoral length ratio in normal beagle dogs
- ratio increased with what position?
- ratio influenced most by hip/stifle flexion or extension?
QML/FL was increased with the hip extended and with the stifle flexed
The QML/FL was more influenced by joint angles when the hip was flexed or the stifle was extended (inappropriate measurements). Hence, these positions should be avoided when evaluating the QML/FL so that the QML is less altered by slight positioning disparities.
Palumbo/Piccionello VCOT 2020
Good inter- and intra-observer reliability for assessment of radiographic femoral and tibial frontal and sagittal planes joints angles in normal cats
*note: I didn’t include the angles measured..
- Intra-observer correlation?
- inter?
- which two measurements did not have good/high agreement?
The intra-observer ICC indicated high correlation for 70% or more of the measurements.
The inter-observer agreement among observers was high.
These results show that the radiographic method for measuring femoral and tibial joint angles was good or high, except for femoral neck anteversion and mechanical cranial proximal tibial angle.
Longo VSURG 2023
Computed tomographic measurements of the femoral trochlea in dogs with and without medial patellar luxation
- deeper groove in non-MPL or MPL?
- shallow groove small or M/L dogs?
- which femoral trochlear groove angles might be cutoff for trochleoplasty?
Dogs without MPL had a deeper femoral trochlear groove than MPL dogs.
Small breeds had a shallower groove than M-L Breeds
Clinical relevance: femoral trochlear groove angle <134 (SB) and < 128 (MLB) may be considered as a cutoff for trochleoplasty decision-making.
(larger angle = flatter)
Vink VCOT 2022
Short-Term Clinical and Radiographic Outcome after Stabilization of Femoral Capital Physeal Fractures with Cortical Positional Screws in 39 Cats
- # fractures? # screws?
- what was seen on 6-week post-op rads? clinical?
- impact of OA + osteolysis on clinical outcome?
- long-term follow-up % abnormal gait?
39 cats with 46 FCPF repaired with minimum of 2 cortical positional screws
Significant increase in radiographic signs of OA and femoral neck osteolysis in 6 week follow-up rads. 90% walking normally at this time.
Pre- and postop OA and femoral neck osteolysis were NOT associated with clinical outcome
Long-term followup (mean 48 months): 7/25 (28%) owners reported a gait abnormality in the short-to long-term
