Vet Comp Orthop Traumatol 2015; 28(02): 131-139
DOI: 10.3415/VCOT-14-02-0020
Clinical Communication
Schattauer GmbH

Augmentation of diaphyseal fractures of the radius and ulna in toy breed dogs using a free autogenous omental graft and bone plating

W. I. Baltzer
1   Oregon State University, College of Veterinary Medicine, Department of Clinical Sciences, Corvallis, Oregon, USA
,
S. Cooley
2   Cornell University, College of Veterinary Medicine, Department of Clinical Sciences, Ithaca, New York, USA
,
J. J. Warnock
1   Oregon State University, College of Veterinary Medicine, Department of Clinical Sciences, Corvallis, Oregon, USA
,
S. Nemanic
1   Oregon State University, College of Veterinary Medicine, Department of Clinical Sciences, Corvallis, Oregon, USA
,
S. M. Stieger-Vanegas
1   Oregon State University, College of Veterinary Medicine, Department of Clinical Sciences, Corvallis, Oregon, USA
› Author Affiliations
Further Information

Publication History

Received:03 February 2014

Accepted:11 February 2014

Publication Date:
26 December 2017 (online)

Summary

Objectives: Evaluation of the short-term outcome, duration of bone healing, and complications following bone plate fixation in dogs weighing [uni2264]6 kg, with and without the use of a free autogenous greater omental graft (OG).

Materials and methods: A retrospective clinical study reviewed the medical records of 25 dogs of body weight <6 kg with mid to distal diaphyseal fractures of the radius and ulna (29 fractures) treated with open reduction bone plate fixation. Thirteen out of 29 fractures were implanted with an additional 2–3 cm3 OG lateral, cranial, and medial to the fracture site, adjacent to the bone plate.

Results: Median time to radiographic healing in OG fractures (n = 11) was 70 days (range 28–98) compared to 106 days (range: 56–144) in non-OG grafted fractures (n = 14). The OG dogs had no major complications; minor complications included oedema, erythema, and mild osteopenia. Six of the eight non-OG dogs for which follow-up could be obtained developed osteopenia necessitating implant removal, four of which re-fractured the radius one to five months after implant removal, with one dog re-fracturing the limb a second time and resulting in amputation. Telephone follow-up of owners of OG dogs (n = 11) three to 15 months (median 10) post-surgery did not identify any signs of lameness or other complications. Owners of the non-OG dogs (n = 8) reported that there were not any signs of lameness six to 48 months (median 36) post-surgery.

Clinical relevance: Free autogenous omen-tal grafting of diaphyseal fractures of the radius and ulna was associated with radial and ulnar healing with minimal complications in dogs weighing less than 6 kg.

* The spelling of the last name of the last author, as noted in the erratum from issue 2/2017, has been corrected from Stieger-Vanagas to Stieger-Vanegas. This correction was made on January 26, 2017.


 
  • References

  • 1 Fox DJ. Radius and ulna. In Tobias KM, Johnston SA. editors Veterinary Surgery: Small Animal. St. Louis, MO: Elsevier Saunders; 2012: 760-784.
  • 2 Harasen G. Common long bone fracture in small animal practice—Part 2. Canadian Vet J 2003; 44: 333-334.
  • 3 Harasen G. Common long bone fractures in small animal practice—Part 1. Canadian Vet J 2003; 44: 503-504.
  • 4 Lappin MR, Aron DN, Herron HL. et al. Fractures of the radius and ulna in the dog. J Am Anim Hosp Assoc 1983; 19: 643-650.
  • 5 Larsen LJ, Roush JK, McLaughlin RM. Bone plate fixation of distal radius and ulna fractures in small- and miniature-breed dogs. J Am Anim Hosp Assoc 1999; 35: 243-250.
  • 6 Saikku-Backstrom A, Raiha JE, Valimaa T. et al. Repair of radial fractures in toy breed dogs with self-reinforced biodegradable bone plates, metal screws, and light-weight external coaptation. Vet Surg 2005; 34: 11-17.
  • 7 Sumner-Smith G. A comparative investigation into the healing of fractures in miniature Poodles and mongrel dogs. J Small Anim Pract 1974; 15: 323-328.
  • 8 Muir P. Distal antebrachial fractures in toy-breed dogs. Compend Contin Educ Pract Vet 1997; 19: 137–&.
  • 9 Welch JA, Boudrieau RJ, Déjardin LM. et al. The intraosseous blood supply of the canine radius: implications for healing of distal fractures in small dogs. Vet Surg 1997; 26: 57-61.
  • 10 DeAngelis MP. Causes of delayed union and nonunion of fractures. Vet Clin North Am 1975; 5: 251-258.
  • 11 Woo SLY, Lothringer KS, Akeson WH. et al. Less rigid internal fixation plates: Historical perspectives and new concepts. J Orthop Res 1983; 1: 431-449.
  • 12 Gauthier CM, Conrad BP, Lewis DD. et al. In vitro comparison of stiffness of plate fixation of radii from large- and small-breed dogs. AM J Vet Res 2011; 72: 1112-1117.
  • 13 Farouk O, Krettek C, Miclau T. et al. Minimally invasive plate osteosynthesis: Does percutaneous plating disrupt femoral blood supply less than the traditional technique?. J Orthop Trauma 1999; 13: 401-406.
  • 14 Song D. The greater omentum: its use in the surgical management of severely infected leg soft tissue and bone injuries. Report of two cases. CEnt Af J Med 1989; 35: 423-425.
  • 15 Saifzadeh S, Pourreza B, Hobbenaghi R. et al. Autogenous greater omentum, as a free nonvascularized graft, enhances bone healing: An experimental nonunion model. J Invest Surg 2009; 22: 129-137.
  • 16 Bigham-Sadegh A, Mirshokraei P, Karimi I. et al. Effects of adipose tissue stem cell concurrent with greater omentum on experimental long-bone healing in dog. Connect Tissue Res 2012; 53: 334-342.
  • 17 Whelan DB, Bhandari M, McKee MD. et al. Interobserver and intraobserver variation in the assessment of the healing of tibial fractures after intramedullary fixation. J Bone Joint Surg 2002; 84: 15-18.
  • 18 Pozzi A, Risselada M, Winter MD. Assessment of fracture healing after minimally invasive plate osteosynthesis or open reduction and internal fixation of coexisting radius and ulna fractures in dogs via ultrasonography and radiography. J Am Vet Med Assoc 2012; 241: 744-753.
  • 19 Pierrmatti DL, Johnson KA. An Atlas of Surgical Approaches to the Bones and Joints of Dogs and Cats. 4th ed. Philidelphia, PA: Saunders; 2004
  • 20 Worth AJ, Danielsson F, Bray JP. et al. Ability to work and owner satisfaction following surgical repair of common calcanean tendon injuries in working dogs in New Zealand. N Z Vet J 2004; 52: 109-116.
  • 21 Johnson A, Houlton J, Vannini R. AO Principles of Fracture Management in the Dog and Cat. Dübendorf, Switzerland: AO Publishing; Thieme; 2005
  • 22 Kos J, Nadinic V, Huljev D. et al. Healing of bone defect by application of free transplant of greater omentum. Veterinarski Arhiv 2006; 76: 367-379.
  • 23 Rhinelander FW. The normal microcirculation of diaphyseal cortex and its response to fracture. J Bone Joint Surg Am 1968; 50: 784-800.
  • 24 Hausman MR, Schaffler MB, Majeska RJ. Prevention of fracture healing in rats by an inhibitor of angiogenesis. Bone 2001; 29: 560-564.
  • 25 Singh AK, Patel J, Litbarg NO. et al. Stromal cells cultured from omentum express pluripotent markers, produce high amounts of VEGF, and engraft to injured sites. Cell Tissue Res 2008; 332: 81-88.
  • 26 Street J, Bao M, deGuzman L. et al. Vascular endothelial growth factor stimulates bone repair by promoting angiogenesis and bone turnover. Proc Natl Acad Sci U S A 2002; 99: 9656-9661.
  • 27 Oloumi MM, Derakhshanfar A, Molaei MM. et al. The angiogenic potential of autogenous free omental graft in experimental tibial defects in rabbit: Short-term preliminary histopathological study. Journal of Experimental Animal Science 2006; 43: 179-187.
  • 28 Matoba Y, Katayama H, Ohami H. Evaluation of omental implantation for perforated gastric ulcer therapy: Findings in a rat model. J Gastroenterol 1996; 31: 777-784.
  • 29 Liang H, Pun S, Wronski TJ. Bone anabolic effects of basic fibroblast growth factor in ovariectomized rats. Endocrinology 1999; 140: 5780-5788.
  • 30 Rosier RN, O'Keefe RJ, Hicks DG. The potential role of transforming growth factor beta in fracture healing. Clin Orthop Rel Res 1998; 355 S S294-S300.
  • 31 Litbarg NO, Gudehithlu KP, Sethupathi P. et al. Activated omentum becomes rich in factors that promote healing and tissue regeneration. Cell Tissue Res 2007; 328: 487-497.
  • 32 Piras L, Cappellari F, Peirone B. et al. Treatment of fractures of the distal radius and ulna in toy breed dogs with circular external skeletal fixation: a retrospective study. Vet Comp Orthop Traumatol 2011; 24: 228-235.
  • 33 McCartney W, Kiss K, Robertson I. Treatment of distal radial/ulnar fractures in 17 toy breed dogs. Vet Rec 2010; 166: 430-432.