Peer-reviewed veterinary case report
Early detection and treatment of screw loosening in dogs after pelvic
By Bogoni, Paolo & Rovesti, Gian Luca·Published in Veterinary surgery : VS·2005·Ambulatorio Veterinario Bogoni-De Giuli-Pasotti, Italy·View original on PubMed →
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Original publication title: Early detection and treatment of screw loosening in triple pelvic osteotomy.
- Species:
- dog
Plain-English summary
A group of 16 dogs that underwent a surgical procedure called triple pelvic osteotomy (TPO) to correct hip problems were monitored for loose screws in the surgical plates. By 10 days after surgery, 12 of the dogs had loose screws, which could lead to misalignment of the hip joint. The veterinarians were able to retighten these screws using a minimally invasive technique guided by X-ray, which helped realign the hip joint without needing more invasive surgery. All the dogs healed well, and their outcomes were considered excellent.
People also search for: dog hip surgery recovery · loose screws after dog surgery · TPO surgery for dogs
Abstract
OBJECTIVE: To detect early screw loosening in triple pelvic osteotomy (TPO) and to evaluate the efficacy of retightening using fluoroscopic guidance and minimally invasive surgery to maintain acetabular alignment and achieve bone healing. STUDY DESIGN: Prospective clinical study. SAMPLE POPULATION: Sixteen dogs that had TPO. METHODS: Dogs (16) had TPO (21) by using pre-angled plates secured with 3.5 and 4.0 mm screws, with ischiatic or iliac cerclage, for osteosynthesis. In all but 1 TPO at least 1 screw was inserted into the sacral body (43 screws). The mean radiographic screw length inserted in the sacrum was 10.2 mm, and the mean percent sacral engagement was 22%. Dogs were examined clinically and radiographically immediately postoperatively, and at 10, 30, 60, and 90 days to evaluate screw position. Loose screws were retightened through stab incisions using fluoroscopy to locate the screw. RESULTS: TPO was performed without operative complications. At 10 days, 12 TPOs (57%; 11 dogs) had loose screws primarily located in the cranial aspect of the plate. This represented 20% (25) of the inserted screws. In 5 dogs, screw loosening resulted in medial rotation of the acetabular segment. All loose screws were retightened; 3 screws loosened again in 2 dogs and were detected at 60 days. However, the osteotomies healed with the planned acetabular rotation without further intervention. Screw tightening corrected the acetabular segment displacement. Screws correctly seated at 10 days did not subsequently loosen. Clinical and radiographic outcome was judged excellent in all dogs. CONCLUSION: Loose screws in TPO plates can be identified by 10 days postoperatively and retightened using fluoroscopic guidance to achieve acetabular realignment and healing without need for further surgery. CLINICAL RELEVANCE: Postoperative radiographic evaluation of screw position at 10 days after TPO is recommended to detect loose screws. Retightening loose screws should be considered as an alternative to TPO revision or confinement, especially in immature dogs.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/16115074/