Hard tissue surgery | BSAVA Library

Hard tissue surgery

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Raptors, pigeons and passerine birds cover a wide range of body weights from just a few grams in the Canary to >10kg in the Andean Condor. Birds may originate from the wild and from different captive management systems. This chapter covers equipment; perioperative management; common techniques; fractures of the thoracic limb; fractures of the pelvic limb; beak repair techniques; and joint luxation.

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15.1 Red Kite with a highly comminuted diaphyseal ulnar fracture. The sharp edges of the bone may damage the skin and cause an open fracture. Note the soft tissue swelling around the fracture. The radius is intact and such types of fracture may heal with coaptive bandages, as long as there is no major dislocation of fragments.
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15.2 Atraumatic surgery necessitates the use of special surgical equipment such as microsurgical forceps and scissors. Note the large size and curvature of the handles and the counterweight. The blood vessel clamps are very useful in case of haemorrhage.
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15.3 Useful instruments for avian orthopaedics (from left): angled Doolen bone-holding clamp (5½ inches); Verbrugge-Rogalski bone forceps (1.5 mm × 4 inches); a Guelpi-Neroma retractor (3½ inches).
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15.4 Selected pins used in avian medicine (from top): negative profile miniature half-pin with roughened surface; negative profile half-pin with a very small thread width; positive profile (rolled-on) half-pin; positive profile full-pin. Positive profile pins are less likely to break than negative profile pins, which is of importance especially in birds >1 kg.
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15.6 The titanium maxillofacial miniplate, Compact 1.0 (Stratec Medical, Oberdorf, Switzerland) is cuttable and mouldable. The screws are self-tapping.
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15.7 Tie-in external skeletal fixator in a femur. This type of fixator is often the method of choice in femur and humerus fractures. (Drawing by Matthias Haab.)
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15.9 Schematic view of the components of the FESSA external fixator. Tube with (a) gliding and (b) threaded holes, (c) Kirschner pins, (d) screws and (e) allen key. Fixation of pin (c) perpendicular or (f) at 30 degree angle. (Reproduced from , with permission)
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15.10 PMMA being injected into a latex tube (Penrose drain). When hardened this will be the connection bar of a type-1 external skeletal fixator.
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15.12 Figure-of-eight bandage for the immobilization of the wing (A–C). If the fracture involves the elbow or humerus, the bandage is also applied around the body (D). (Drawing by Matthias Haab)
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15.13 Altman splint for the immobilization of a tibiotarsal fracture. Ear-cleaner tips have been integrated into the splint to give additional stability.
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15.15 A tear of the articulation between sternum and right coracoid in a Common Buzzard results in the formation of an asymmetry (line).
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15.16 Tawny Owl with a diaphyseal fracture of the left coracoid with rotation of the proximal fragment, before and after intramedullary pin placement.
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15.17 Tie-in fixator in the humerus of a Kestrel. The fracture has healed without exuberant callus formation.
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15.18 Dorsal view of the humerus in a pigeon after removal of skin for better visualization of anatomical structures, deltoideus major (A), pars propatagialis of the deltoideus muscle (B), dorsal condylus of the humerus (C), radial nerve crossing the humerus (arrow).
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15.19 Dorsal view of the humerus with a tubular external fixator. The distal ends of the pins have not been shortened. The skin has been removed for better visualization. The intramedullary tie-in pin has been marked (X).
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15.20 Plating of the ulna in a pigeon, intraoperative view and radiography after 4 weeks. There is a bridging callus on the ulna; the radius has been fixed with an intramedullary pin for additional stability.
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15.21 Fractures of the trochanter are usually stabilized with two pins and tension-band fixation. Twist knots are formed on both sides of the figure-of-eight tension band to allow symmetrical tightening. (Drawing by Matthias Haab)
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15.22 Fixation of fractures of the distal metaphysis of the femur may be treated with Rush pins or cross-pins. (Drawing by Matthias Haab)
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15.23 Uniplanar type-2 external skeletal fixator in the tibiotarsus of a pigeon. In this small bird Kirschner wires have been used and the connecting bar is made of veterinary thermoplastic.
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15.24 Phalangeal fractures in small birds (generally below 200 g body weight) can be treated with splints. Regular physical therapy is important to minimize the risk of a stiff toe due to adhesions.
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15.25 Radiograph of a fracture of the left mandible of a Tawny Owl. Dental film was used for high resolution.
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15.26 Fracture of the upper beak in a Great Grey Owl immobilized with a cerclage wire.
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15.27 Elbow luxation in a Hobby. In most cases a caudodorsal luxation involving both the radiohumeral and the ulnohumeral joints is present, as in this case (circled).
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