Osteotomia em cunha de fechamento e osteossíntese com fixador esquelético externo para correção de desvio angular de rádio e ulna em cão – relato de caso

Abstract

Angular deformities are highly complex alterations in Veterinary Medicine, characterized by bone deviation in relation to its normal axis, associated with congenital, developmental or acquired alterations. The aim of this study was to describe the planning of the closing wedge ostetomy surgery and the use of an external skeletal fixator to correct angular deviation of the radius and ulna in a seven-month-old German Shepherd weighing 28 kg and to discuss potential complications arising from the choice of moment. surgery and postoperative management. A male German Shepherd dog, three months old, was treated with a history of lameness and alteration in the conformation of the right forelimb when compared to the contralateral side. Radiographic images were taken in the craniocaudal and laterolateral projections, and a lesion compatible with a Salter-Harris type VI fracture was identified. A tomography image was requested to perform the CORA calculation and to make a 3D mold to simulate the surgical procedure. The patient returned after four months for surgery and, due to the remaining growth, it was necessary to perform another radiographic image in the craniocaudal and laterolateral projections to perform a new CORA calculation and adequate management. During this period, it was possible to notice an increase in angular deviation, weight gain of approximately ten kilos and lesions compatible with radiocarpal subluxation. Therefore, surgical correction was performed using the technique of closing wedge osteotomy and osteosynthesis using an external skeletal fixator. The result obtained in the immediate postoperative period was satisfactory, as the limb was aligned and the bone axis of the radius and ulna was reestablished. However, after 30 days it was possible to identify, radiographically, the establishment of an osteomyelitis with positive culture for Enterobacter sp., possibly due to the patient's interference with the surgical wound and the licking of the pins. The slow recovery of the patient can also be associated with the delay in the institution of surgical treatment, the reserved prognosis of the clinical condition of angular deviation, failures in postoperative care, including hospital management for changing dressings and non-compliance with performing physiotherapy and massages to reduce edema.