Quiz Question

In Planchamp 2022 et al., on imaging-based AAI diagnosis, what was the reported specificity of VCI ≥0.16 in extension for diagnosing AAI?

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Correct. VCI ≥0.16 in extension had 100% sensitivity and 94.54% specificity.
Incorrect. The correct answer is 94.5%.
VCI ≥0.16 in extension had 100% sensitivity and 94.54% specificity.

🔍 Key Findings

  • Ventral Compression Index (VCI) ≥0.16 (extension) or ≥0.2 (flexion) was diagnostic for AAI with 100% sensitivity and >94% specificity
  • VCI had the highest diagnostic accuracy among all measured variables (AUC > 0.99)
  • C1-C2 overlap ≤2.7 mm (extension) or ≤1.8 mm (flexion) also diagnostic for AAI (sensitivity 84–96%, specificity 81–90%)
  • C1-C2 angle ≥176.9° (extension) or ≥187.4° (flexion) had high sensitivity and specificity (~95%)
  • Basion-dens interval ≥5.9 mm (extension) or ≥3.0 mm (flexion) provided moderate diagnostic accuracy
  • Cranial translation ratio (CTR) ≥0.18 classified dogs as potentially unstable (sensitivity 90%, specificity 78%)
  • VCI ≥0.23 reliably differentiated AAI from potentially unstable cases (sensitivity 94%, specificity 94%)
  • DALR ≤0.24 had high specificity (100%) but low sensitivity for AAI diagnosis

Planchamp

Veterinary Surgery

4

2022

Determination of cutoff values on computed tomography and magnetic resonance images for the diagnosis of atlantoaxial instability in small-breed dogs

2022-4-VS-planchamp-5

Article Title: Determination of cutoff values on computed tomography and magnetic resonance images for the diagnosis of atlantoaxial instability in small-breed dogs

Journal: Veterinary Surgery

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In Burton 2025 et al., on antebrachial conformation, what is a proposed biomechanical consequence of increased PRUDA?

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Correct. Increased PRUDA may produce divergent force vectors during weightbearing, stressing the humeral condyle.
Incorrect. The correct answer is Increased distraction at the capitulotrochlear boundary.
Increased PRUDA may produce divergent force vectors during weightbearing, stressing the humeral condyle.

🔍 Key Findings

  • PRUDA (proximal radio-ulnar divergence angle) and UCORA (ulnar center of rotation of angulation) were significantly greater in Cocker Spaniels with HIF vs those without.
  • PRUDA (p < .001): Group 1 (HIF) vs Group 2 & 3.
  • UCORA (p = .036): Group 1 vs Group 3.
  • Other angles (MPRA, LDRA, PCRA, DCRA, torsion) showed no significant differences.
  • Increased PRUDA and UCORA may lead to divergent load vectors across the humeral condyle, potentially predisposing to stress fracture (HIF).
  • Measurement techniques using CT-based 3D reconstructions were reliable (intraobserver ICC > 0.84).

Burton

Veterinary Surgery

4

2025

Antebrachial conformation in Cocker Spaniels with and without humeral intracondylar fissure

2025-4-VS-burton-5

Article Title: Antebrachial conformation in Cocker Spaniels with and without humeral intracondylar fissure

Journal: Veterinary Surgery

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In Planchamp 2022 et al., on imaging-based AAI diagnosis, what was the cutoff value of the VCI in dogs imaged in flexion?

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Correct. VCI ≥0.20 in flexion yielded 100% sensitivity and 96.67% specificity for diagnosing AAI.
Incorrect. The correct answer is ≥0.20.
VCI ≥0.20 in flexion yielded 100% sensitivity and 96.67% specificity for diagnosing AAI.

🔍 Key Findings

  • Ventral Compression Index (VCI) ≥0.16 (extension) or ≥0.2 (flexion) was diagnostic for AAI with 100% sensitivity and >94% specificity
  • VCI had the highest diagnostic accuracy among all measured variables (AUC > 0.99)
  • C1-C2 overlap ≤2.7 mm (extension) or ≤1.8 mm (flexion) also diagnostic for AAI (sensitivity 84–96%, specificity 81–90%)
  • C1-C2 angle ≥176.9° (extension) or ≥187.4° (flexion) had high sensitivity and specificity (~95%)
  • Basion-dens interval ≥5.9 mm (extension) or ≥3.0 mm (flexion) provided moderate diagnostic accuracy
  • Cranial translation ratio (CTR) ≥0.18 classified dogs as potentially unstable (sensitivity 90%, specificity 78%)
  • VCI ≥0.23 reliably differentiated AAI from potentially unstable cases (sensitivity 94%, specificity 94%)
  • DALR ≤0.24 had high specificity (100%) but low sensitivity for AAI diagnosis

Planchamp

Veterinary Surgery

4

2022

Determination of cutoff values on computed tomography and magnetic resonance images for the diagnosis of atlantoaxial instability in small-breed dogs

2022-4-VS-planchamp-2

Article Title: Determination of cutoff values on computed tomography and magnetic resonance images for the diagnosis of atlantoaxial instability in small-breed dogs

Journal: Veterinary Surgery

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In Story 2024 et al., on eTPA osteotomy comparison, which technique resulted in the **greatest mechanical axis shift**?

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Correct. Group A (CBLO + CCWO) caused the largest change in mechanical cranial distal tibial angle (mCrDTA), indicating the most mechanical axis shift.
Incorrect. The correct answer is CBLO + CCWO.
Group A (CBLO + CCWO) caused the largest change in mechanical cranial distal tibial angle (mCrDTA), indicating the most mechanical axis shift.

🔍 Key Findings

  • Population: 16 dogs (27 tibias), TPA >34°
  • Techniques analyzed:
    • Group A: CBLO + CCWO
    • Group B: TPLO + CCWO
    • Group C: mCCWO
    • Group D: PTNWO
  • Outcomes:
    • All groups achieved post-correction TPA < 14°.
    • Group A: Slight over-correction (mean TPA 10.47°); greatest mechanical axis shift.
    • Group B: Tibial shortening (~0.58%); least mechanical axis shift.
    • Group C: Lowest post-correction TPA (mean 4.76°); under-correction.
    • Group D: High accuracy, minimal shortening (mean 7.09° post).
  • Statistical Significance:
    • Significant differences in tibial length change and mCrDTA (mechanical axis shift) between groups (p <.05).
    • TPA correction accuracy: Group A (1.02), B (0.95), C (0.89), D (0.98).

Story

Veterinary Surgery

1

2024

Morphologic impact of four surgical techniques to correct excessive tibial plateau angle in dogs: A theoretical radiographic analysis

2024-1-VS-story-1

Article Title: Morphologic impact of four surgical techniques to correct excessive tibial plateau angle in dogs: A theoretical radiographic analysis

Journal: Veterinary Surgery

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In Deprey 2022 et al., on gap fracture implants, which construct demonstrated higher torque to failure during torsional testing?

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Correct. The NAS-ILN resisted significantly more torque before failure than the LCP construct in torsional testing.
Incorrect. The correct answer is NAS-ILN construct.
The NAS-ILN resisted significantly more torque before failure than the LCP construct in torsional testing.

🔍 Key Findings

  • NAS-ILN had significantly greater stiffness in both axial compression and 4-point bending compared to LCP constructs.
  • Ultimate load to failure was significantly higher for NAS-ILN in compression (804 N vs 328 N) and bending (25.7 Nm vs 16.3 Nm).
  • Torsional stiffness and angular deformation were similar, but NAS-ILN resisted higher torque to failure than LCP (22.5 Nm vs 19.1 Nm).
  • No slack was observed with the NAS-ILN construct, unlike older nail designs.
  • Failure modes differed: LCPs failed via plate bending; NAS-ILNs failed at the implant or bone near screw holes.
  • Titanium alloy and curved design of NAS-ILN provides better anatomic fit and more uniform stress distribution.
  • A third, perpendicular locking hole in NAS-ILN may enhance torsional stability but was not utilized in this study.
  • The curved, angle-stable design of NAS-ILN is a novel advancement in veterinary orthopedics.

Deprey

Veterinary Surgery

8

2022

Mechanical evaluation of a novel angle‐stable interlocking nail in a gap fracture model

2022-8-VS-deprey-3

Article Title: Mechanical evaluation of a novel angle‐stable interlocking nail in a gap fracture model

Journal: Veterinary Surgery

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In Caldeira 2025 et al., on femoral neck fixation, how did displacement values compare among groups?

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Correct. There was no statistically significant difference in displacement between the groups
Incorrect. The correct answer is No significant difference among groups.
There was no statistically significant difference in displacement between the groups

🔍 Key Findings

Design: In vitro study on cadaveric femurs (n=21) with basilar femoral neck fractures stabilized using 2 vs 3 titanium cannulated screws.

Stiffness: Control > 3-screw > 2-screw (674 > 120 > 90 N/mm).

Yield Load: 3-screw (586 N) > 2-screw (303 N); both < intact femur (2692 N).

Displacement: No difference across groups.

Complication: 3-screw technique more demanding; higher risk of cortical perforation, especially with narrow femoral necks.

Failure Mode: Dislodgement of femoral head + screw shaft bending.

Conclusion: 3 screws = stronger construct than 2 screws. Clinical implications need further study.

Caldeira

Veterinary and Comparative Orthopedics and Traumatology

1

2025

In Vitro Biomechanical Study of Femoral Neck Fracture Fixation with Two or Three Cannulated Screws in Dogs

2025-1-VC-Caldeira-5

Article Title: In Vitro Biomechanical Study of Femoral Neck Fracture Fixation with Two or Three Cannulated Screws in Dogs

Journal: Veterinary and Comparative Orthopedics and Traumatology

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In Danielski 2022 et al., on PAUL complications, what was the most commonly observed major complication?

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Correct. Non-union occurred in 6 limbs and was the most common major complication.
Incorrect. The correct answer is Non-union.
Non-union occurred in 6 limbs and was the most common major complication.

🔍 Key Findings

  • Major complications occurred in 25.6% of limbs treated with PAUL, including non-union, implant failure, and infection requiring revision surgery.
  • Increased body weight was significantly associated with a higher risk of complications (7% increased risk per additional kg; p = .04).
  • Post-operative radiographic assessment was unreliable in predicting complications; inter-observer agreement was poor (kappa ≤ 0.12).
  • Expert evaluation of implant or reduction errors had low predictive value (k < 0.2) for postoperative complications.
  • Common major complications included non-union (6 limbs), screw breakage, and surgical site infections.
  • Implant removal was required in 11.5% of limbs, mostly due to non-union or infection.
  • Being a Labrador appeared protective on univariate analysis, but not on multivariate analysis after adjusting for weight.
  • Radiographs showing suboptimal plate placement or osteotomy reduction did not reliably correlate with actual complication occurrence.

Danielski

Veterinary Surgery

1

2022

Complications after proximal abducting ulnar osteotomy and prognostic factors in 66 dogs

2022-1-VS-danielski-2

Article Title: Complications after proximal abducting ulnar osteotomy and prognostic factors in 66 dogs

Journal: Veterinary Surgery

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In Von Pfeil 2024 et al., on acute ulnar shortening in dogs, what was the median time to radiographic bone healing?

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Correct. Median bone healing time was 8 weeks, with a range of 4–14 weeks.
Incorrect. The correct answer is 8 weeks.
Median bone healing time was 8 weeks, with a range of 4–14 weeks.

🔍 Key Findings

  • All dogs (11/11) showed improved radiohumeral articulation postoperatively, confirmed arthroscopically.
  • Median shortening: radioulnar (3.2 mm), humeroradial (1.8 mm), humeroulnar (1.2 mm).
  • Median lameness score improved from 2/4 to 1/4 by final follow-up.
  • Bone healing achieved in a median of 8 weeks (range: 4–14 weeks).
  • No major complications; minor issues included 1 screw loosening and 1 superficial infection.
  • Subjective function was graded full in 4 dogs, acceptable in 7.
  • Arthroscopy enabled accurate dynamic joint assessment, preferred over static radiographs.
  • Use of both orthopedic wire and plating provided secure fixation and improved outcomes.

Von Pfeil

Veterinary Surgery

3

2024

Outcomes of 11 dogs with short radius syndrome treated with acute arthroscopically assisted ulnar shortening

2024-3-VS-pfeil-1

Article Title: Outcomes of 11 dogs with short radius syndrome treated with acute arthroscopically assisted ulnar shortening

Journal: Veterinary Surgery

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In Deprey 2022 et al., on gap fracture implants, what was the failure mode of the LCP constructs under axial compression?

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Correct. The LCP constructs failed by plate bending at the screw holes in compression testing.
Incorrect. The correct answer is Plate bending at open screw holes.
The LCP constructs failed by plate bending at the screw holes in compression testing.

🔍 Key Findings

  • NAS-ILN had significantly greater stiffness in both axial compression and 4-point bending compared to LCP constructs.
  • Ultimate load to failure was significantly higher for NAS-ILN in compression (804 N vs 328 N) and bending (25.7 Nm vs 16.3 Nm).
  • Torsional stiffness and angular deformation were similar, but NAS-ILN resisted higher torque to failure than LCP (22.5 Nm vs 19.1 Nm).
  • No slack was observed with the NAS-ILN construct, unlike older nail designs.
  • Failure modes differed: LCPs failed via plate bending; NAS-ILNs failed at the implant or bone near screw holes.
  • Titanium alloy and curved design of NAS-ILN provides better anatomic fit and more uniform stress distribution.
  • A third, perpendicular locking hole in NAS-ILN may enhance torsional stability but was not utilized in this study.
  • The curved, angle-stable design of NAS-ILN is a novel advancement in veterinary orthopedics.

Deprey

Veterinary Surgery

8

2022

Mechanical evaluation of a novel angle‐stable interlocking nail in a gap fracture model

2022-8-VS-deprey-2

Article Title: Mechanical evaluation of a novel angle‐stable interlocking nail in a gap fracture model

Journal: Veterinary Surgery

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In Lomas 2025 et al., on DPO and dorsolateral subluxation, what plate angle resulted in the greatest increase in DLS score postoperatively?

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Correct. The 30° plate yielded the highest mean DLS increase (39.8%) compared to other plate angles.
Incorrect. The correct answer is 30°.
The 30° plate yielded the highest mean DLS increase (39.8%) compared to other plate angles.

🔍 Key Findings

  • DPO significantly improved femoral head coverage, increasing mean DLS from 36.1% to 71.4% postoperatively (p < 0.001).
  • No significant change in DLS between immediate postoperative and follow-up scans, suggesting stable surgical outcomes over time.
  • Greater plate angle (30°) yielded larger DLS improvement (mean increase: 39.8%) compared to 25° and 20° plates.
  • Only 3 hips had post-op DLS scores <55%, indicating most patients had lower risk of osteoarthritis progression.
  • No correlation found between DLS improvement and age, body weight, or side of surgery, suggesting broad applicability.
  • CT was used for DLS measurement in simulated weight-bearing, improving precision over radiographic methods.
  • Major limitations included small sample size, multiple surgeons, and variable sedation vs anesthesia during imaging.
  • DPO confirmed as effective for reducing dorsolateral subluxation, improving coxofemoral joint congruency in dysplastic dogs.

Lomas

Veterinary and Comparative Orthopaedics and Traumatology

2

2025

The Impact of Double Pelvic Osteotomy on Dorsolateral Subluxation in 24 Dogs

2025-2-VCOT-lomas-3

Article Title: The Impact of Double Pelvic Osteotomy on Dorsolateral Subluxation in 24 Dogs

Journal: Veterinary and Comparative Orthopaedics and Traumatology

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Quiz Results

Topic: Fracture Management
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