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Thought I'd share a case from work...

Hurley

Registered
We've got a fun one to work on today and I'd thought I'd share some pictures for anyone interested in seeing them.

This is a Great Dane youngster who suffered a fracture through part of the growth plate and was not treated, but left out in the yard to heal. The fracture ended up partially closing the distal growth plate of the radius, which stopped growth in part of the bone while the other part of the radius and the ulna continued to grow. This resulted in a pretty dramatic angular limb deformity in this young dog. The dog was rescued by Great Dane Rescue and we're working on her today to try and give her a more normal limb to stand on and try to save her elbow. Her affected leg is 5 1/2 centimeters shorter than the normal limb, which forces him to walk with his elbow completely extended at all times. This puts tremendous strain on the ligaments.

What we are going to do today is cut both the radius and ulna and rotate the radius to bring the limb back closer to alignment. It is impossible to completely straighten this leg, especially in just one surgery, but we can certainly improve her. By putting her into a circular fixator, we're going to lengthen her limb as much as her tendons will allow. (When the leg is shortened as tendons are developing, they don't reach their normal length. If you stretch the bone out the full 5.5 centimeters, the tendons won't be long enough and you'll end up with a contracted foot...one the dog couldn't extend to walk on.)

Here she is. :D

LimbDeformity4.jpg


And a closeup of her normal leg (on the right) compared to her deformed leg (on the left):

LimbDeformity1.jpg



And here are the radiographs, where you can see how twisted and thickened this old fracture has made this leg. Left side (L) is the normal limb, compared to Right side (R). Radiographs are taken from the side and from the front.

RadsCombo.jpg



I'll see if I can get some pics later of the post-operative views.
 
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Sad

How unfortunate. I am a huge dog lover. I am glad to hear that she is getting the help she needs. I had a great dane/black lab mix who portrayed more of the dane qualities and I no longer have her ( :cry: ) she was my baby, but this youngster you have here looks just like her. Makes me sad yet happy that she will hopefully be much better after surgery. Let us know how it goes and good luck with that.
 
Poor critter. I'm glad she's in better hands now.

I may be way off but I'll ask all the same...

Could amputation be an option? I've seen 3 legged dogs and even a 2 legged cat (fortunately had a diagonal pair!) get along just fine! -or is it that such a massive dog needs that 4th leg more than a 3 legged kelpie or jack russell?
 
princess said:
Could amputation be an option? I've seen 3 legged dogs and even a 2 legged cat (fortunately had a diagonal pair!) get along just fine! -or is it that such a massive dog needs that 4th leg more than a 3 legged kelpie or jack russell?

Boy, we're on the same wavelength today. I was wondering about this myself, but hesitated to ask.
 
Amputation is always an option as a salvage procedure, but in this case she uses the leg already. We're trying to help her use it better and to prevent the breakdown she's facing later in life walking in such an abnormal manner.

With amputation there's no going back. If anything happens to her good leg, then she would really have a problem. I hate to have to amputate large dog front limbs if I don't have to, but if it's required it's certainly an option. They carry so much of their weight on their front end that I try to preserve both limbs as often as I can. And I agree, many dogs are three-legged animals with a spare, especially something like a terrier. If you didn't count, you'd never notice a missing limb. ;) They have the great advantage of never knowing life wasn't supposed to be this way and they just adjust and go on about life (unlike some humans that give up the will to do anything or go into depression fretting how unfortunate they are to now be missing a limb).

So, could we amputate, absolutely, but what do you do when she gets an OCD or elbow dysplasia or a bone tumor or fracture in the good leg. ;)
 
Hey Dean...


Bzzzzzzzz




-that was the sound of my brain after this much coffee!!!



Thanks for clearing that up Connie. I thought it might be as much. Mum was given the option of a 6 month old 3 legged JR terrier when she addopted her lovely Malti-****zu mop head from the lost dogs home and she said it looked like it never had that leg to begin with.
 
princess said:
OH, now that's pathetic!!! :rolleyes:


I can't even write shi-tzu without getting edited!

:roflmao: lol....thats too funny!


But about the puppy. . . .I think that it is wonderful what you do and I hope that the surgery goes well. I am a huge dog lover as well and it is great that you are going to try to save her leg first!

Actually, my cousin in Minnesota had a three legged dog named Buck and he did quite well, but he was about half the size of a Great Dane.
GOOD LUCK!!!
 
Awww, that is so sad! I love Danes, they are so forgiving! Her face looks like she's saying "I love you".
 
Aww...what a wonderful story. That really made my day, as crappy as it started out. What a sweet dog to get a wonderful second chance. =)

Was this an injury-injury or a growth abnormality, that was never treated?

The procedure you describe reminds me of a kid at school a year younger than me. One of his legs stopped growing longer, and they had to pin that circular thing on him for months and slowly stretched his leg bone out. By the time he got it off his Junior year you could barely tell there was a problem, just a slight limp as the one leg was a half inch shorter than the other.

But it sure made getting on the school bus a chore. The bus eventually had to pick everyone up before him a bit earlier so he could be helped on board and off once we got to school, without everyone being late. =P
 
Anyone not wishing to see a little blood and bone, don't scroll past the next 4 pictures. Just a warning. :D

Well, it took a good 3 1/2 hours of surgery, but we're happy with the results we've achieved. The elbow, carpus (wrist), and paw are all in alignment now. She still has a cranial bow the the radius, which we didn't try to correct and really couldn't have without messing up her carpus, and she'll always have a thickened leg, but functionally she should be much better off.

Below are some pre-operative and post-operative photos of her leg from 3 different views. The bow is most visible from the front view, but as you can see from the side and behind views, the limb is now straight.

We've placed a circular external skeletal fixator on the limb to hold the radius steady for osteotomy (bone cut) healing and the black and silver posts between the ring and set of 2 rings are linear motors to allow us to lengthen her bone a mm a day as far as her tendons will allow. We won't make up the entire 5.5 cm shortness, but we'll definitely improve the length.

ViewSide.jpg


ViewBehind.jpg


ViewFront.jpg
 
And here are the postoperative radiographs showing the osteotomies (cuts) in the radius and ulna and how we've opened the gap and rotated the bone.

RadsPostOp.jpg
 
And now the gore. ;) Note that most of the "blood" is blood-tinged saline used to flush the wound and keep the bone cool while cutting.

Here's a photo from intraop showing the curvilinear osteotomy in the radius that allows us to rotate the bone to straighten the limb. The ulna was also cut from the side to free up the bone segments and allow rotation.

Intraop1.jpg



And here's the finished product with ring fixator in place.

Intraop2.jpg
 
To answer a couple questions, her original problem was a fractured radius. Her compounding problem was being owned by uncaring idiots that just chained her in the back yard to a doghouse rather than get her medical help. This led to an angular limb deformity over months since the fracture closed the growth plate on one side of the radius.

As for how long will the pins stay in, the answer is until the fracture that we just created heals. We will be expanding the fracture over the next couple of weeks, then the bone will fill in the gap. I would bet the ring fixator will be on a good 3 months, give or take. Average fracture healing takes 8 weeks, but we have to create a gap and then let the body catch up, so it'll take a bit longer.
 
As for how long will the pins stay in, the answer is until the fracture that we just created heals. We will be expanding the fracture over the next couple of weeks, then the bone will fill in the gap. I would bet the ring fixator will be on a good 3 months, give or take. Average fracture healing takes 8 weeks, but we have to create a gap and then let the body catch up, so it'll take a bit longer.[/QUOTE]

Sounds like she will be well taken care of. Keep us updated on her recovery it's always a good feeling to hear the rescue stories that turn out positive! Will she be adopted out after her full recovery?
 
She is currently with a foster owner through the rescue. Sometimes foster owners end up keeping the dogs, other times homes are found for them.
 
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