Download PDF
Vet Comp Orthop Traumatol 2021; 34(02): 079-084
DOI: 10.1055/s-0040-1716434
Original Research

The Use of Intraoperative Skeletal Traction for the Repair of Pelvic Fractures: An Experimental Cadaveric Study

Alexandros Bourbos 
1   Surgical Department, Centro Veterinario Luni Mare, Ortonovo, Italy
,
Filippo Cinti 
1   Surgical Department, Centro Veterinario Luni Mare, Ortonovo, Italy
2   Eastocott Referrals, Swindon, United Kingdom of Great Britain and Northern Ireland
,
Fabiana Sergiampietri
1   Surgical Department, Centro Veterinario Luni Mare, Ortonovo, Italy
,
Guido Pisani
1   Surgical Department, Centro Veterinario Luni Mare, Ortonovo, Italy
› Author Affiliations
› Further Information
Also available at
    Permissions and Reprints

Abstract

Objective The purpose of this study was to evaluate the use of intraoperative skeletal traction for the surgical repair of pelvic fractures. Opposition and anchorage points for the application of traction were the same in all cadavers.

Materials and Methods Cadavers from 10 adult dogs with a median body weight of 31.9 kg (range: 20–38 kg) were used. The fractures were experimentally created in all dogs to produce an oblique iliac fracture on the left side and a transverse fracture on the right (total of 20 fractures) at the same time. Dogs were positioned on an operating table in lateral recumbency and traction was applied first on the left side and then on the right after changing the position of the animal. Increasing amounts of traction were applied to each fracture and recorded until a distraction length of 2 cm was created between the bone fragments. The Kolmogorov–Smirnov test confirmed normality of the data, and a paired t-test was used to compare traction of the two fracture types.

Results The measurement of traction and distraction of the bone fragments was possible in all fractures. A distraction of at least 2 cm was obtained with a mean peak traction force of 15.4 kg for transverse fractures and 18.6 kg for oblique fractures.

Conclusion Intraoperative skeletal traction provides a useful and reliable tool for the reduction in experimental oblique and transverse iliac fractures in dogs. There were strong correlations between body weight and the force required to obtain a distraction length of 2 cm in the fracture line; for oblique fractures, traction was related to the square of body weight, and for transverse fractures, the relationship between weight and required traction was near linear.

Keywords

intraoperative skeletal traction - pelvic fracture - repair - cadaveric study

Authors’ Contributions

All the authors conceptualized and designed the study. They acquired, analysed and interpreted the data, and drafted and approved the submitted manuscript. A.B. is accountable for content of the manuscript.


Supplementary Material



Publication History

Received: 18 February 2020

Accepted: 24 July 2020

Article published online:
07 October 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Phillips IR. A survey of bone fractures in the dog and cat. J Small Anim Pract 1979; 20 (11) 661-674
    CrossrefPubMedGoogle Scholar
  • 2 Newton CD. Fractures of the pelvis. In: Newton CD, Nunamaker DM. eds. Textbook of Small Animal Orthopaedics. Philadelphia: JB Lippincott Company; 1985: 1-11
    Google Scholar
  • 3 Schwarz PD. Fracture biomechanics of the appendicular skeleton. Causes and assessment. In: Bojrab MJ, Smeak DD, Bloomberg MS. eds. Disease Mechanism in Small Animal Surgery. Philadelphia: Lea & Febiger; 1993: 1009-1026
    Google Scholar
  • 4 Brinker, Piermattei, and Flo's Handbook of Small Animal Orthopedics and Fracture Repair. 5th ed. St Louis, Missouri: Elsevier Inc; 2016: 433
    Google Scholar
  • 5 Moens N, DeCamp CE. Fractures of the pelvis. In: Johnston SA, Tobias KM. eds. Veterinary Surgery Small Animal, Expert Consults. 2nd ed. Canada: Elsevier Saunders; 2018: 938-956
    Google Scholar
  • 6 Denny HR, Butterworth SJ. A Guide to Canine and Feline Orthopaedic surgery. Oxford: Blackwell Science; 2000: 441-454
    CrossrefGoogle Scholar
  • 7 Messmer M, Montavon PM. Pelvic fractures in the dog and cat: a classification system and review of 556 cases. Vet Comp Orthop Traumatol 2004; 17: 167-183
    Article in Thieme ConnectPubMedGoogle Scholar
  • 8 Matta JM, Merritt PO. Displaced acetabular fractures. Clin Orthop Relat Res 1988; (230) 83-97
    PubMedGoogle Scholar
  • 9 Lewis DD, Stubbs WP, Neuwirth L. et al. Results of screw/wire/polymethacrylate for acetabular fracture repair in 14 dogs. Vet Surg 1997; 26: 223-234
    CrossrefPubMedGoogle Scholar
  • 10 Denny HR. Pelvic fractures in the dog: a review of 123 cases. J Small Anim Pract 1978; 19 (03) 151-166
    CrossrefPubMedGoogle Scholar
  • 11 DeCamp CE, Braden TD. Sacroiliac fracture-separation in the dog: a study of 92 cases. Vet Surg 1985; 14: 127-130
    CrossrefPubMedGoogle Scholar
  • 12 Lanz OI, Lewis DD, Madison JB, Miller GJ, Martin DE. A biomechanical comparison of screw and wire fixation with and without polymethylmethacrylate re-enforcement for acetabular osteotomy stabilization in dogs. Vet Surg 1999; 28 (03) 161-170
    CrossrefPubMedGoogle Scholar
  • 13 Tomlinson JL. Fractures of the pelvis. In: Slatter DH. ed. Textbook of Small Animal Surgery. 3rd ed. Saunders: Elsevier Philadelphia; 2003: 1989-2001
    Google Scholar
  • 14 Rovesti GL, Margini A, Cappellari F, Peirone B. Intraoperative skeletal traction in the dog: a cadaveric study. Vet Comp Orthop Traumatol 2006; 19 (01) 9-13
    Article in Thieme ConnectPubMedGoogle Scholar
  • 15 Peirone B, Rovesti GL, Baroncelli AB, Piras L. Minimally invasive plate osteosynthesis fracture reduction techniques in small animals. Vet Clin North Am Small Anim Pract 2012; 42 (05) 873-895 , v
    CrossrefPubMedGoogle Scholar
  • 16 Piermattei's Atlas of Surgical Approaches to the Bones and Joints of the Dog and Cat. 5th ed. Missouri: Elsevier Saunders; 2014: 317-319
    Google Scholar
  • 17 Buxton RA. The use of Perkins' traction in the treatment of femoral shaft fractures. J Bone Joint Surg Br 1981; 63-B (03) 362-366
    CrossrefPubMedGoogle Scholar
  • 18 Browner B, Jupiter J, Krettek C. Skeletal Trauma: Basic Science, Management, and Reconstruction. 5th ed. Philadelphia: Elsevier Sanders; 2015: 1565-2387
    Google Scholar
  • 19 Byrd JW. Hip arthroscopy. J Am Acad Orthop Surg 2006; 14 (07) 433-444
    CrossrefPubMedGoogle Scholar
  • 20 Benoit B, Gofton W, Beaulé PE. Hueter anterior approach for hip resurfacing: assessment of the learning curve. Orthop Clin North Am 2009; 40 (03) 357-363
    CrossrefPubMedGoogle Scholar
  • 21 Woolson ST, Pouliot MA, Huddleston JI. Primary total hip arthroplasty using an anterior approach and a fracture table: short-term results from a community hospital. J Arthroplasty 2009; 24 (07) 999-1005
    CrossrefPubMedGoogle Scholar
  • 22 Flierl MA, Stahel PF, Hak DJ, Morgan SJ, Smith WR. Traction table-related complications in orthopaedic surgery. J Am Acad Orthop Surg 2010; 18 (11) 668-675
    CrossrefPubMedGoogle Scholar
  • 23 Albracht BG, Jenkins MD. Sciatic nerve palsy after distal femoral traction for vertically unstable pelvic fracture in a neurologically intact patient. J Am Acad Orthop Surg Glob Res Rev 2019; 3 (09) e045
    PubMedGoogle Scholar
  • 24 Peterson NE. Genitoperineal injury induced by orthopedic fracture table. J Urol 1985; 134 (04) 760-761
    CrossrefPubMedGoogle Scholar
  • 25 Topliss CJ, Webb JM. Interface pressure produced by the traction post on a standard orthopaedic table. Injury 2001; 32 (09) 689-691
    CrossrefPubMedGoogle Scholar
  • 26 Bourbos A, Cinti F, Sergiampietri F, Pisani G. The use of an intraoperative skeletal traction device for delayed reduction in pelvic fractures in two dogs. Veterinary and Comparative Orthopaedics and Traumatology Open 2020; 03 (01) e40-e45
    PubMedGoogle Scholar