Page 588 - ONLINE PROCEEDING BOOK WSAVA 2017
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An Urban Experience
transmits load bearing forces directly to the appendicular skeleton, by-passing the pads and other soft tissues of the paw.
A similar but distinct type of walking frame involves bridging the tarsus or carpus using an external bilateral linear frame. The side-bars of the frame are bent distally to provide a platform on which the patient can walk. Within the frame distal tibial or radial physeal fractures
in juveniles or metacarpal/metatarsal or phalangeal fractures in small dogs or cats can be re-aligned by tensioning a length of plastic drip tube which is looped over the distal walking bars and sutured proximally to the skin of the antebrachium.
Distraction-Compression Osteo-Integration (DCOI)
Non-union following fracture repair or primary loss
of signi cant MT or MC bone stock due to trauma
is uncommon but may be associated with infection, inadequate blood supply and shearing injuries. Revision surgical procedures can compound the underlying reason for suboptimal bone healing by further compromising the biologic envelope. The author has operated a number of cases of fracture non-union or massive traumatic bone loss of the canine manus/
pes using a biologic stimulation technique featuring sequential distraction and compression in order to stimulate incorporation of large cortico-cancellous autogenous bone graft blocks. This technique was developed from reports of cyclical distraction and compression in humans for successful treatment of non-unions of femoral fractures. The technique is termed distraction-compression osteo-integration, DCOI
The bone blocks used are generally autogenous coccygeal vertebrae (or less commonly blocks from the iliac crest and wing). These are incorporated into the defect by being “skewered” onto kirschner wires which themselves are placed as intramedullary pins across
the fracture defect. The fractures and bone defects
are stabilized using modi ed hybrid circular pin-arch external skeletal  xator constructs. Dynamic phases
of distraction and compression are performed daily for several weeks to enhance bone regeneration and to promote incorporation of the autogenous cortical bone blocks into the defects. The majority of the cases that we have treated had undergone multiple previous surgical procedures, with many associated complications prior to presentation and the DCOI technique was employed as a last resort before considering amputation.
42ND WORLD SMALL ANIMAL VETERINARY ASSOCIATION CONGRESS AND FECAVA 23RD EUROCONGRESS


































































































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