Diretrizes para abordagem minimamente invasiva com haste intramedular em cães
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Data
2020-03-23
Autores
Gonçalves Neto, José Aloizio
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
Objetivou-se descrever detalhadamente os corredores seguros e acessos cirúrgicos para aplicação minimamente invasiva de haste intramedular bloqueada (MINO) em cães. Foram utilizados 14 cadáveres de cães, pesando entre 30 e 40 kg e de raças variadas, sendo 10 deles para estudo anatômico e abordagem do acesso cirúrgico e 4 para planejamento radiográfico e aplicação da técnica MINO com implantação das hastes bloqueadas (ILN) no úmero, fêmur e tíbia. Para tal foram escolhidos aleatoriamente 3 úmeros, 3 fêmures e 3 tíbias desses 4 animais, onde a tíbia utilizada não poderia ser ipsilateral ao fêmur em um mesmo animal. Após a realização da técnica foi feita avaliação das estruturas neurovasculares e musculares de cada abordagem. Em sequência os membros foram radiografados para avaliação da aplicação do implante. Não observou-se lesão macroscópica às grandes estruturas neurovasculares regionais no presente estudo, além disso, lesões leves às musculaturas de cada abordagem foram encontradas. O presente estudo determinou de forma criteriosa e precisa, as referências e interrelações anatômicas dos acessos cirúrgicos para a MINO nas diáfises do úmero, fêmur e tíbia.
The aim of this study was to describe in detail the safe corridors and surgical approaches of minimally invasive interlocking nail (MINO) technique. Forteen cadavers of different dog breeds weighing between 30 and 40 kg were used, 10 of them for anatomical study, and 4 for creation of the MINO portals and dissect to evaluate iatrogenic lesions. A review of the anatomy and surgical approaches of the MINO was performed to establish the landmarks. The first one was a compound of the realisation of portals on the bones and anatomical study. Posteriorly was performed the MINO technic and after this application was to check possible injuries or interferences with noble neurovascular structures. Radiographic evaluation was performed to check the alignment and the position of the implants. The references and anatomical interrelationships of the surgical accesses for the minimally invasive approach of the tibial, femur, and humerus diaphyses were determined in a careful and accurate way. No lesion of important neurovascular structures was observed in any cadaver. The construction of access points for minimally invasive application of the MINO is feasible and safe when using safe corridors.
The aim of this study was to describe in detail the safe corridors and surgical approaches of minimally invasive interlocking nail (MINO) technique. Forteen cadavers of different dog breeds weighing between 30 and 40 kg were used, 10 of them for anatomical study, and 4 for creation of the MINO portals and dissect to evaluate iatrogenic lesions. A review of the anatomy and surgical approaches of the MINO was performed to establish the landmarks. The first one was a compound of the realisation of portals on the bones and anatomical study. Posteriorly was performed the MINO technic and after this application was to check possible injuries or interferences with noble neurovascular structures. Radiographic evaluation was performed to check the alignment and the position of the implants. The references and anatomical interrelationships of the surgical accesses for the minimally invasive approach of the tibial, femur, and humerus diaphyses were determined in a careful and accurate way. No lesion of important neurovascular structures was observed in any cadaver. The construction of access points for minimally invasive application of the MINO is feasible and safe when using safe corridors.
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Palavras-chave
Fraturas, Ortopedia, Fracture, Dog, Cão