Search Results (34)

Background/Objectives: The management of severe anterior dental trauma in growing patients remains a clinical challenge. This case report describes the treatment of a 10-year-old boy presenting with traumatic loss of maxillary anterior teeth following a road traffic accident, including avulsion of two permanent incisors and a primary canine, associated with luxation and intrusion of the contralateral central incisor. Methods: A multidisciplinary approach involving paediatric dentistry, orthodontics, oral surgery, and restorative dentistry was implemented. Treatment aimed to preserve the traumatised incisor and restore the anterior maxillary region through a biological approach combining mandibular first premolar autotransplantation and orthodontic space management. Results: The transplanted first mandibular premolar demonstrated favourable healing, with continued root development and a satisfactory crown-to-root ratio. After orthodontic treatment, the tooth was restored with a composite veneer, achieving good aesthetic and functional outcomes, maintained at the 5-year follow-up. Conclusions: This case highlights that autotransplantation combined with orthodontic space management may represent a viable treatment option in carefully selected growing patients, allowing preservation of alveolar bone, function, and aesthetics. Appropriate surgical, orthodontic, and restorative planning was crucial to the treatment’s success. Full article

Grade IV lateral patellar luxation is an advanced orthopedic condition that may be associated with severe skeletal deformities, chronic soft-tissue contracture, and irreversible loss of normal stifle function. Although reconstructive procedures are considered the treatment of choice in most dogs, some end-stage cases may not be amenable to conventional correction. This report describes the clinical presentation, surgical management, and long-term outcome of a young dog with severe bilateral grade IV lateral patellar luxation treated with single-stage bilateral stifle arthrodesis. A 1-year-old, 42-kg intact female Romanian Shepherd Dog was presented with chronic severe hindlimb dysfunction, crouched posture, and permanent bilateral patellar luxation. Orthopedic and radiographic examination revealed severe femoral valgus, proximal tibial varus, external tibial torsion, absence of a functional trochlear groove, marked caudal thigh muscle contracture, and severely restricted stifle extension. Computed tomography was considered but not performed because of financial limitations. Based on the severity of the deformities and the limited preoperative range of motion, conventional reconstructive procedures were considered unlikely to restore functional joint motion. Bilateral stifle arthrodesis was therefore performed during a single anesthetic event using tibial tuberosity osteotomy, temporary Kirschner-wire fixation, and bilateral 3.5-mm locking compression plates. Due to severe chronic soft-tissue contracture, final arthrodesis angles of 95° and 99° were achieved. Progressive clinical improvement and radiographic bone union were observed throughout follow-up. At 12 months, complete bilateral arthrodesis and implant stability were confirmed radiographically. At 24 months, the dog remained independently ambulatory with a markedly improved quality of life despite persistent mechanical gait abnormalities, including circumduction and intermittent bunny-hopping. This case suggests that bilateral stifle arthrodesis may represent a salvage option in carefully selected dogs with end-stage bilateral grade IV lateral patellar luxation when conventional reconstructive procedures are unlikely to restore useful limb function. Full article

Abnormal tarsal posture in dogs may be associated with structural lesions such as common calcaneal tendon complex rupture, plantar-supporting structure injury, tarsocrural instability, or neurologic dysfunction; however, common calcaneal tendon rupture is typically associated with a plantigrade posture rather than the weight-bearing-dependent tarsal hyperextension pattern described in this case. A 3-year-old intact male Pomeranian developed bilateral weight-bearing-dependent tarsal hyperextension immediately after bilateral medial patellar luxation (MPL) surgery performed at another hospital. At our hospital, complete cranial cruciate ligament rupture of the right stifle and recurrent grade II MPL of the left stifle were identified. Right lateral fabellotibial suture stabilization using a LigaFiba^® 75 lateral suture and crimp system, with supportive reapplication of a 0.8 mm Kirschner wire at the previous tibial tuberosity transposition site, and left trochlear block recession with capsular resection and imbrication were performed. No direct surgical treatment of either tarsus was undertaken. During follow-up after stifle stabilization, bilateral tarsal hyperextension progressively decreased and was no longer clinically observed by 5 months. This case suggests that bilateral weight-bearing-dependent tarsal hyperextension may occur secondary to proximal stifle pathology even in the absence of major structural tarsal instability, and that hyperextension may resolve clinically following stifle stabilization. Full article

Congenital atlantoaxial instability (AAI) occurs more often in young, small-breed dogs, usually resulting from malformations in the craniocervical junction. These malformations cause atlantoaxial subluxation or luxation and compression of the cervical spinal cord. As a result, dogs can have varying levels of neurological problems. While surgery is commonly used to realign the vertebrae, outcomes after surgery vary widely, and complications are common. Magnetic resonance imaging (MRI) helps identify abnormalities in the vertebral canal, spinal cord damage, and other brain diseases, which can affect the dog’s prognosis. This retrospective study assessed MRI findings and their association with surgical outcomes in 20 dogs with AAI. Older age and certain MRI results—such as severe ventral spinal cord compression associated with greater preoperative neurological severity and syringomyelia—were associated with less favorable surgical outcomes. Many MRI abnormalities were found, but not all predicted poor outcomes. These results show the importance of thorough MRI before surgery and also suggest that a younger age and not having syringomyelia are good indicators of improved recovery after AAI surgery. Full article

Background: The implantable miniature telescope is used to provide functional vision for patients with advanced AMD. However, despite the considerable cost of the device, there are strict criteria to be met for this procedure, since the patients require challenging neuroadaptation afterward, which sometimes fails and leads to the necessity of device explantation. Visual outcomes also depend on the stability of the microtelescope; tilts cause unwanted optical aberrations and can lead to device luxation, with sight-threatening complications. Case report: This case presents a novel technique for fixing the ophthalmic telescope device SING-IMT™. A 76-year-old female with pre-operative visual acuity of 15 letters on the ETDRS scale underwent surgery on her left eye. The superior haptic was fixed at the 12 o’clock position with a Prolene 5-0 suture, achieving good postoperative stability. The implant was stable throughout the entire observation period. Conclusions: Implant stability is crucial for maximizing visual potential in patients with advanced AMD selected for the procedure, since visual acuity in the peripheral retina, where the perceived image eventually lands, is much lower than the macula. Therefore, there is a need to standardize surgical approaches and use objective follow-up measures to assess long-term patient satisfaction. Full article

A 10-month-old Poodle was presented with intermittent non-weight-bearing lameness of the left thoracic limb. Orthopedic and radiographic examinations revealed medial shoulder luxation and markedly reduced elbow extension. A two-stage surgical approach was performed. In the first stage, selective myotomy of periarticular structures, including the biceps brachii–brachialis complex and the extensor carpi radialis muscle, was conducted via medial and lateral approaches. A trans-articular external skeletal fixator was applied to maintain elbow extension. Elbow extension improved from 105° preoperatively to 142°. After confirming functional recovery of the elbow joint, the second stage involved shoulder arthrodesis using a circular osteotomy technique with a radial saw, which enabled fine-tuned intraoperative adjustment of limb alignment based on the contralateral limb posture. At nine months postoperatively, the patient exhibited a symmetrical gait, full weight-bearing, and no evidence of discomfort on range of motion assessment. This case highlights the clinical relevance of secondary elbow contracture associated with congenital shoulder instability and suggests that a combination of targeted muscle release and adjustable arthrodesis may offer favorable outcomes in managing complex joint dysfunction. Full article

Background and Clinical Significance: Tooth impaction is a developmental anomaly characterized by the inability of a tooth to emerge into its predetermined anatomical position within the oral cavity during the normal eruption period. Impaction of the mandibular second premolar is an uncommon condition and poses a heightened risk of neurosensory injury when the tooth is adjacent to the mental foramen. Early diagnosis and precise planning are therefore essential. Case Presentation: This case report presents a rare instance of an asymptomatic impacted mandibular second premolar located in close proximity to the mental foramen in a 44-year-old female patient. The impaction was discovered incidentally on an orthopantomogram, and Cone-Beam Computed Tomography (CBCT) confirmed intimate contact between the root of the impacted second premolar and the mental nerve. Surgical removal was performed under local anesthesia via a conservative triangular flap and a corticotomy window. Platelet-Rich Fibrin (PRF) generated from autologous blood was placed in the socket to foster healing. The proximity of the mental foramen dictated minimal bone removal and atraumatic luxation to avoid nerve stretch or compression. PRF was selected as an effective biomaterial shown to accelerate soft tissue healing and moderate postoperative discomfort, potentially reducing the likelihood of neurosensory disturbance. The socket presented satisfactory healing, and neurosensory function was normal at the first week follow-up and remained normal at 7 months postoperatively (longest follow-up), and no complications were reported by the patient. Conclusions: CBCT-guided planning, meticulous surgical techniques, and adjunctive PRF allowed for safe extraction without post-operative paraesthesia. Timely identification of such rare impactions broadens treatment options and minimizes complications. Full article

A water deer (Hydropotes inermis argyropus) was rescued following a vehicle collision and presented with suspected hip injury. Radiographic examination confirmed coxofemoral luxation, and a femoral head ostectomy (FHO) was performed to restore functional mobility. Postoperatively, the water deer underwent intensive rehabilitation, including controlled movement and physical therapy, to enhance limb function. Following successful recovery, the water deer was equipped with a GPS collar and released into its natural habitat. GPS tracking data were collected to evaluate the water deer’s post-release adaptation and movement patterns. The Minimum Convex Polygon (MCP) method was used to determine the home range, showing an overall home range (MCP 95%) of 8.03 km² and a core habitat (MCP 50%) of 6.967 km². These results indicate a successful post-surgery outcome, with the water deer demonstrating mobility comparable to healthy individuals. This case demonstrates the clinical feasibility of an FHO in managing hip luxation in water deer and underscores the critical role of post-release monitoring in evaluating functional rehabilitation success in wildlife medicine. This study underscores the importance of integrating surgical intervention, structured rehabilitation, and post-release monitoring to ensure the successful reintroduction of injured wildlife. GPS tracking provides valuable insights into long-term adaptation and mobility, contributing to evidence-based conservation medicine. Full article

Objective: The aim of this study was to evaluate the clinical outcomes of sutureless scleral-fixated (SSF) Soleko Fil Carlevale intraocular lens (SC-IOL) implants associated with pars plana vitrectomy (PPV) in patients with aphakia secondary to complicated cataract surgery or IOL luxation nationwide. Methods: A multicenter, national, retrospective study of 268 eyes (268 patients) which underwent simultaneous PPV and SC-IOL implantation was conducted. Demographics; ocular data; pre-surgical, surgical and post-surgical details; and refractive results were collected. Intra- and postoperative complications and management details were described. Best-corrected visual acuity (BCVA), intraocular pressure (IOP) and central retinal thickness (CRT) were collected at 1 week and at 1, 3, 6 and 12 months post-surgery. Kaplan–Meier curves were constructed to assess the cumulative probability of postoperative BCVA, IOP levels, macular edema (ME) and corneal decompensation. Results: The cumulative probability of final VA ≤ 0.3 logMAR was 64.4% at 12 months follow-up. The probability of IOP > 21, ≥25 and ≥30 mmHg was 29.8%, 16.9% and 10.1%, respectively, and the cumulative probability of IOP-lowering treatment was 42.3% at 12 months. Glaucoma surgery was required in 3.7% of the eyes (10/268). The cumulative probability of postoperative ME development was 26.6% at 12 months, managed with topical treatment alone (73.5%) and intravitreal injections (26.5%). Corneal transplantation was required in 3.7% of the eyes (10/268). Conclusions: Sutureless scleral-fixated SC-IOL is an adequate therapeutic alternative in the management of aphakia with good visual results and an acceptable safety profile in routine clinical care. Longer-term studies are needed to evaluate its results and complications compared to other therapeutic alternatives. Full article

Patellar luxation is common in small breed dogs and is often treated surgically. This study compares the long-term outcomes of two surgical techniques, trochlear wedge recession (TWR) and trochlear block recession (TBR), for medial patellar luxation (MPL) with regard to osteoarthritis (OA) progression. High inter-observer agreement was hypothesized for the use of a modified OA scoring system and fewer OA changes in the TBR group. This study included 25 dogs (<15 kg) with grade-2 or -3 MPLs treated at the University of Veterinary Medicine Vienna (2016–2021). A total of 32 stifle joints (TWR Group n = 11, TBR Group n = 21) were evaluated pre-operatively and at least one year post-operatively using a modified OA scoring system. A statistical analysis was conducted to compare OA progression between the techniques. The inter-observer agreement was high. The OA scores increased in both groups post-operatively, with TBR demonstrating a greater progression at specific points. Overall, no significant differences were found between the techniques. These findings suggest that OA progression does not significantly differ between TWR and TBR. The modified OA scoring system has shown to be reliable for assessing OA progression after treatment. Further prospective studies with larger study populations incorporating clinical assessments are needed for a better understanding of the surgical impacts on OA development. Full article

Background: Traumatic injuries to the alveolar process and primary teeth in early childhood can have long-term consequences on the development of permanent dentition and eruption pathways. Objective: This case report aims to illustrate the impact of early orofacial trauma on the eruption and development of permanent maxillary incisors and to emphasize the importance of timely interdisciplinary management. Case Presentation: An 8-year-old female patient presented to a pediatric dentistry clinic with delayed eruption of the maxillary anterior permanent teeth. In contrast, her monozygotic twin sister exhibited complete eruption of all permanent anterior teeth, raising parental concern regarding a possible pathological delay. Her medical history revealed orofacial trauma at the age of two, resulting in an alveolar process fracture, avulsion of the primary maxillary left central incisor (tooth 61), and luxation of the primary maxillary right central incisor (tooth 51). A clinical examination demonstrated sufficient arch space without signs of eruption and enamel defects on tooth 52. Radiographic evaluations, including panoramic imaging and cone beam computed tomography (CBCT), confirmed the presence of impacted permanent teeth with structural anomalies suggestive of trauma-related developmental disturbances. Results: The patient underwent a multidisciplinary treatment over a three-year period involving pediatric dentistry, oral surgery, and orthodontics. Management included surgical exposure of the impacted teeth followed by orthodontic traction to guide the eruption and treatment of enamel hypoplasia. Conclusions: This case highlights the long-term consequences of early traumatic dental injuries on permanent dentition development. It underscores the necessity of early diagnosis and a coordinated interdisciplinary approach to optimize outcomes and enhance the long-term oral health and quality of life of affected individuals. Full article

This report examines the successful recovery of a feline that presented with multiple complex fractures and dislocations involving the facial and cranial structures resulting from a traffic accident. Diagnostic CT imaging identified significant injuries, including luxation of the left temporomandibular joint (TMJ), a mandibular symphyseal fracture, a hard palate fracture, and a left orbital fracture accompanied by severe exudate within the nasal cavity, compressing the left orbit and nasal passages. Importantly, no additional injuries were detected in the thoracic or abdominal regions, facilitating a more targeted treatment plan. The management of this case required extensive surgical intervention, including open reduction of the TMJ, stabilization of the mandibular symphysis, repair of the bony palate, and partial maxillectomy. After 20 days of ICU hospitalization, the feline fully recovered. This outcome is particularly noteworthy as the combination of severe injuries observed in this case is unprecedented in the veterinary literature. Consequently, it offers critical insights into both surgical techniques and postoperative management strategies applicable to similarly complex trauma cases. The feline’s full recovery, characterized by the restoration of normal daily functions, highlights the clinical significance of pursuing multiple, complex surgical procedures in cases of severe trauma. It serves as a valuable reference for advancing the understanding and management of severe facial trauma in veterinary practice. Full article

This study explored the complications and prognosis of modified tibial plateau leveling osteotomy with tibial tuberosity transposition (mTPLO-TTT) for simultaneously correcting high-grade medial patellar luxation (MPL) and cranial cruciate ligament disease (CCLD) in small-breed dogs. This retrospective study evaluated patient data, lameness scores, radiographic outcomes, and complications over a median follow-up period of 10 weeks. Additionally, an owner interview was conducted 6 months postoperatively. Nine stifles from seven dogs were included in this study. All cases showed satisfactory patellar alignment and stability after surgery, with no major complications or reluxations. The lameness scores improved, and radiographic assessments confirmed implant stability and appropriate bone healing. Owner-reported outcomes at 6 months were also favorable. These findings suggest that simultaneous mTPLO-TTT is an effective surgical option for small-breed dogs with concurrent CCLD and Grade IV MPL. Full article

Background: The aim of this retrospective study was to compare the surgical and refractive outcomes using the Carlevale IOL (FIL SSF; SOLEKO) with those of the retropupillary-fixated Artisan IOL (Aphakia Model 205; OPHTEC), implanted through a 6 mm sclerocorneal tunnel incision in both groups. Methods: This study included 51 consecutive eyes (25 Carlevale and 26 Artisan IOLs). Due to complex preoperative conditions (e.g., dislocated polymethylmethacrylat IOL, luxated Cataracta rubra), all patients underwent lens explantation using a standardized 6 mm sclerocorneal tunnel incision and a 23 G or 25 G pars plana vitrectomy. Visual acuity (VA), spherical equivalent, refractive prediction error (PE), incision-suture time, and complication rates were recorded preoperatively and during the follow-up period. Results: The average follow-up period was 40.9 ± 5.7 days. VA improved by 0.28 ± 0.39 logMAR (p < 0.0001) in the Carlevale group and by 0.36 ± 0.47 logMAR (p < 0.0001) in the Artisan group. The improvement was comparable between both groups (p = 0.921). The deviation of the PE was −0.67 ± 0.56 in the Carlevale group and 0.34 ± 0.71 in the Artisan group (p < 0.0001). The mean incision-suture time was 42.5 ± 5.8 min in the Carlevale group and 28.2 ± 6.4 min in the Artisan group. Anterior chamber and vitreous hemorrhages were the most common complications, occurring in 12% in the Carlevale group and 17.2% in the Artisan group. Conclusions: The use of the Carlevale IOL, implanted using a sclerocorneal tunnel technique, presents a valid option for treating complex lens dislocations. The scleral fixation of the Carlevale IOL minimizes risks associated with iris fixation, such as chronic inflammation and pupil distortion, making it particularly suitable for patients with damaged irises. Full article

A non-reducible tibial tuberosity fracture is a rare complication of tibial tuberosity transposition performed during correcting of medial patella luxation (MPL) in dogs. This condition severely disrupts the quadriceps extensor mechanism, leading to significant pelvic limb lameness. An 11-year-old, 1.8 kg spayed female Yorkshire Terrier sustained a comminuted left tibial tuberosity fracture during surgical correction of an MPL. Six months after surgery, the dog was markedly lame and unable to extend the left stifle. Radiographs revealed patella alta and resorption of the fragmented tibial tuberosity. A composite frozen allogeneic calcaneal tendon–bone block was utilized to reconstruct the tibial tuberosity and reattach the patellar ligament. Initial postoperative radiographs confirmed restoration of a normal patellar ligament to patella length ratio (1.42). Both the allogeneic bone used for tibial tuberosity reconstruction and the tendon used to reattach the patellar ligament were successfully integrated. The dog regained satisfactory limb function without recurrence of patella luxation, as reported by the owners 29 months postoperatively. The use of a calcaneal tendon–bone allograft effectively restored the functional integrity of the quadriceps extensor mechanism, providing a viable option for addressing quadriceps insufficiency resulting from the loss of the osseous tibial insertion. Full article