Search Results (29)

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

Purpose: We report the successful surgical treatment of a case of spontaneous complete anterior crystalline lens luxation in a patient affected by retinitis pigmentosa (RP), associated with elevated intraocular pressure and pupillary block. Additionally, we review the current literature regarding the association between ectopia lentis and RP. Case description: A 44-year-old female RP patient presented to our emergency department reporting severe ocular pain in her left eye (LE) and sickness. She had no history of ocular trauma and did not report systemic disorders. The best corrected visual acuity at presentation was 1/20 in her LE, the intraocular pressure was 60 mmHg, and slit lamp examination showed in her LE a complete dislocation of the lens in the anterior chamber, with mydriasis, atalamia, and a pupillary block. The patient had been administered intravenous mannitol 18% solution and dorzolamide–timolol eye drops and was hospitalized for urgent lens extraction. Anterior segment optical coherence tomography and ultrasound biomicroscopy were performed before surgery. Decompressive 23-gauge pars plana vitrectomy and phacoemulsification were performed, and the capsular bag was removed due to marked zonular weakness, with deferred intraocular lens implant. Conclusions: Acute angle closure glaucoma in patients with RP may be rarely caused by spontaneous anterior lens dislocation. To our knowledge, this is the first report of spontaneous anterior lens dislocation in an RP patient, documented through photographs, anterior segment optical coherence tomography, and ultrasound biomicroscopy. Full article

In small-breed dogs with concurrent cranial cruciate ligament rupture (CCLR) and medial patellar luxation (MPL), correcting both disorders is are essential for restoring normal gait. However, the previously described surgical treatment, using two osteotomy technique, poses a high risk of fracture and instability. Addressing CCLR and MPL with a single osteotomy and implant was considered superior to the conventional method. Therefore, a pre-contoured modified tibial plateau leveling osteotomy (PCM–TPLO) plate facilitating medial shifting of the proximal tibia was developed. We compared postoperative alignment and strength between this novel plate group and a conventional tibial plateau leveling osteotomy (TPLO) plate group using eight small-breed dog cadavers each. Additionally, we investigated the potential of the novel plate as an alternative to tibial tuberosity transposition. Postoperative alignment and strength were assessed through radiographs and mechanical testing. Measurements including tibial plateau angle, mechanical medial proximal tibial angle, and number of screws within the joint were also analyzed. There were no significant differences in all measured parameters. For the novel plate, the medial displacement ratio of the proximal tibia was confirmed to be approximately 30%, and the result was thought to be appropriate. These findings suggest that the PCM–TPLO plate could be a promising alternative for treating concurrent CCLR and MPL in small-breed dogs. Full article

Background and Objectives: Besides classical stapedotomy, reverse stapedotomy has been used for many years in the management of otosclerosis. Our study aims to investigate whether reversing the surgical steps in stapedotomy impacts vestibular function and hearing improvement. Materials and Methods: A cohort of 123 patients underwent either classic or reverse stapedotomy procedures utilizing a fiber–optic argon laser. Audiological assessments, following the guidelines of the Committee on Hearing and Equilibrium, were conducted, including pure tone average, air–bone (AB) gap, overclosure, and AB gap closure. Vestibular evaluation involved pre- and postoperative comparison of rotatory test parameters, including frequency, amplitude, and slow phase velocity of nystagmus. Results: The study demonstrated an overall median overclosure of 3.3 (3.3, 5.0) dB and a mean AB gap closure of 20.3 ± 8.8 dB. Postoperative median AB gap was 7.5 (7.5, 11.3) dB in the reverse stapedotomy group and 10.0 (10.0, 12.5) dB in the classic stapedotomy group. While overclosure and AB gap closure were marginally superior in the reverse stapedotomy group, these differences did not reach statistical significance. No significant disparities were observed in the frequency, slow phase velocity, or amplitude of nystagmus in the rotational test. Conclusions: Although not always possible, reverse stapedotomy proved to be a safe surgical technique regarding postoperative outcomes. Its adoption may mitigate risks associated with floating footplate, sensorineural hearing loss, and incus luxation/subluxation, while facilitating the learning curve for less experienced ear surgeons. Full article

The current case report describes a successful ultrasound-guided mid-femur sciatic nerve block in an emu. A 2-month-old emu suffering from acute-onset lameness was referred to the University Clinic of Liège, where he was diagnosed with a lateral luxation of the Achilles tendon on both hind limbs. Two surgical procedures were performed for treatment. Both surgical procedures were performed under general anaesthesia with butorphanol, ketamine, midazolam and isoflurane in oxygen. The anaesthesia was continuously monitored. An ultrasound-guided sciatic nerve block was performed to prevent and treat surgically induced nociception. The technique was adapted from what is already described in other species. Levobupivacaine was injected perineurally under ultrasound-guidance. Intraoperative nociception was assessed based on the heart rate and mean arterial pressure changes. The recovery was uneventful and with no clinical signs of postoperative pain. Full article

The aim of this study was to describe the diagnosis and treatment of grade IV lateral patellar luxation (LPL) in two adult large breed dogs with complex femoral deformities using patient-specific three-dimensionally (3D) printed osteotomy guides and implants. Computed tomography (CT) scans were obtained for virtual surgical planning (VSP) using computer-aided design (CAD) software, which allowed for 3D reconstruction and manipulation of the femoral deformities, providing a preoperative view of the correction. Of the two patients, one was affected bilaterally and the other unilaterally, but both dogs were from the same litter. Therefore, the healthy femur of the unilaterally affected patient was used as the physiological reference for the virtual surgical correction. Three distal femoral trapezoid osteotomies (DF-TO) followed by reduction and internal fixation with plates were performed using patient-specific 3D-printed osteotomy guides and implants. This type of osteotomy permitted correction of procurvatum in all the femurs to increase knee extension, raise the dog’s lumbar spine and correct the kyphosis. Preoperative, expected and postoperative femoral angles were compared to evaluate the efficacy of virtual surgical planning and the outcome of surgical correction. Radiographic follow-up, passive range of motion and functional recovery were recorded. There were no major complications requiring revision surgery. Significant clinical improvement was observed in both patients. This study suggests that the treatment used represents a viable surgical alternative to restore limb alignment in patients with complex femoral deformities. Full article