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Use of a Four Pin and Methylmethacrylate Fixation in L7 and the Iliac Body to Stabilize Lumbosacral Fracture-Luxations: A Clinical and Anatomic Study

Author:
WEH, J. MICHEAL, KRAUS, KARL H.
Source:
Veterinary surgery 2007 v.36 no.8 pp. 775-782
ISSN:
0161-3499
Subject:
cement, clinical trials, dogs, fracture fixation, guidelines, radiography, retrospective studies, vertebrae
Abstract:
To describe the clinical outcome of a 4 pin lumbosacral fixation technique for lumbosacral fracture-luxations, and to refine placement technique for iliac pins based on canine cadaver studies. Retrospective and anatomic study. Dogs (n=5) with lumbosacral fracture-luxations and 8 cadaveric canine pelvi. Lumbosacral fracture-luxations were stabilized with a 4 pin (positive-profile threaded) and bone cement fixation. Caudal pins were inserted in the iliac body and cranial pins were inserted into the L7 or L6 pedicle and body. Follow-up examinations and radiographs were performed to assess patient outcome. Intramedullary pins were inserted into the iliac bodies of 8 cadaver pelvi. Radiographs were taken to measure pin insertion angles and define ideal insertion angles that would maximize pin purchase in the ilium. Follow-up neurologic examination was normal in 4 dogs. Radiographic healing of the fracture was evident in 5 dogs. One implant failure occurred but did not require re-operation. For cadaver iliac pins, mean craniocaudal insertion angle was 29° and mean lateromedial insertion angle was 20°. Four pin and bone cement fixation effectively stabilizes lumbosacral fracture luxations. The iliac body provides ample bone stock, which can be maximized using an average craniocaudal pin trajectory of 29° and an average lateromedial pin trajectory of 20°. Lumbosacral fracture-luxations can be stabilized with 4 pin and bone cement fixation in the lumbar vertebrae and iliac body, using 29 and 20° as guidelines for the craniocaudal and lateromedial pin insertion angles in the ilium.
Agid:
424376