Quiz Question
In Raleigh 2022 et al., on pericardiectomy complications, which surgical tool was most frequently associated with the onset of ventricular fibrillation?
🔍 Key Findings
- Ventricular fibrillation (VF) occurred in 3% of pericardiectomy cases across reporting institutions.
- 14 of 16 dogs (88%) that developed intraoperative VF died, indicating high mortality.
- Electrosurgical devices were used in 15/16 dogs; VF onset coincided with their use in 8 dogs, suggesting a potential but unproven association.
- Preoperative arrhythmias were seen in 7 dogs (e.g., VPCs, VT, bradycardia), possibly serving as early warning signs.
- Thoracoscopic approach was used in 75% of cases; however, conversion to open surgery was required in 9/13 thoracoscopic procedures after VF onset.
- Defibrillation was attempted in 13 dogs, but only 3 converted to sinus rhythm, and only 2 survived postoperatively.
- VF may result from stray current or cardiac manipulation; bipolar energy devices were implicated despite lower theoretical risk.
- Preventative strategies include judicious electrosurgery use, close ECG monitoring, rapid CPR preparedness, and preop cardiac risk assessment.
Veterinary Surgery
4
2022
The development of ventricular fibrillation as a complication of pericardiectomy in 16 dogs
2022-4-VS-raleigh-3
In Sisk 2024 et al., on intramedullary nails, what biomechanical property is most affected by increasing nail diameter?
🔍 Key Findings Summary
- IMN provides relative stability, resists bending/torsion due to central axis alignment
- Larger diameter nails = exponentially greater stiffness (∝ D⁴)
- Trade-off: Larger interlocking holes weaken fatigue strength of the nail
- Reaming increases contact/stability but has pros/cons:
- Improves outcomes in closed fractures
- May reduce endosteal blood flow in thin-walled bones (e.g., cats)
- Design advances:
- Angle-stable IMN reduce rotational slack
- Expandable nails simplify insertion but may compromise removal or compressive load resistance
- Precontoured nails match bone curvature but lack consistent clinical superiority
- Material debates continue (e.g., titanium vs. stainless steel vs. magnesium)
Veterinary and Comparative Orthopedics and Traumatology
6
2024
Biomechanical Principles of Intramedullary Nails in Veterinary and Human Medicine
2024-6-VCOT-sisk-1
In Meltzer 2022 et al., on femoral implant selection, which factor most consistently predicted the use of a cemented femoral stem?
🔍 Key Findings
- Hybrid implants were used in older, heavier dogs with lower canal flare index (CFI) compared to cementless types.
- CFI <1.8 was associated with higher risk of femoral fracture or stem subsidence with cementless implants.
- Total complication rate was 14%, with catastrophic complications in only 1.5%—lower than reported in other studies.
- No significant difference in complication rates across implant types (BFX, BFX-C, hybrid).
- Femur fractures were rare (2.9%), lower than in prior studies, and successfully managed with cerclage/plate fixation.
- Coxofemoral luxation was the most common complication (8 cases); all occurred within 62 days post-op, mostly resolved with revision.
- Collared BFX stems did not significantly reduce complications, though they may limit stem subsidence.
- An implant selection algorithm was proposed, using age ≥7 years, weight ≥45 kg, and CFI <1.8 to guide cemented vs. cementless stem use.
Veterinary Surgery
2
2022
Case factors for selection of femoral component type in canine hip arthroplasty using a modular system
2022-2-VS-meltzer-1
In Deprey 2022 et al., on gap fracture implants, what was the failure mode of the LCP constructs under axial compression?
🔍 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.
Veterinary Surgery
8
2022
Mechanical evaluation of a novel angle‐stable interlocking nail in a gap fracture model
2022-8-VS-deprey-2
In Trefny 2025 et al., on locking plate biomechanics, which configuration showed higher construct stiffness in compression bending?
🔍 Key Findings
- Short working length constructs had significantly higher stiffness and lower strain than long constructs in compression bending (p = 0.0172).
- In tension bending, short constructs also had higher precontact stiffness and lower strain, but this reversed after transcortical contact (~150 N).
- Transcortical contact increased stiffness only in long constructs, producing a bilinear load-displacement curve.
- Postcontact stiffness was higher in long constructs, but this may not reflect clinical benefit due to risks of high interfragmentary strain.
- Short working length reduced strain at multiple ROIs under both loading conditions, including over fracture gap (Tables 1–3).
- Increased working length promoted stress concentration and deformation, especially in compression bending.
- In vitro benefits of long constructs (via contact stability) may not translate to healing, as repetitive loading could increase plate strain and bone resorption.
- Plate strain was effectively mapped using 3D digital image correlation, confirming regional strain differences between configurations.
Veterinary and Comparative Orthopaedics and Traumatology
3
2025
Effect of Plate Screw Configuration on Construct Stiffness and Plate Strain in a Synthetic Short Fragment Small Gap Fracture Model Stabilized with a 12-Hole 3.5-mm Locking Compression Plate
2025-3-VCOT-trefny-1
In Muroi 2025 et al., on refracture risk, all refractures in the **plate removal group** occurred at which location?
🔍 Key Findings
- Refracture occurred in 5.5% of limbs, with higher incidence in the plate removal group (12.5%) vs. non-removal (3.5%).
- In the non-plate removal group, refractures occurred at the most distal screw site, linked to greater screw position change during growth (OR 1.79, p=0.04).
- Screw-to-bone diameter ratio (SBDR) >0.4 was a significant risk factor for refracture in the plate retention group.
- In the plate removal group, refractures occurred at the original fracture site, associated with lower pixel value ratio (bone mineral density) and reduced radial thickness.
- Implant-induced osteoporosis (IIO) beneath the plate likely contributed to refracture risk after plate removal.
- Younger age at fracture (<6 months) was associated with higher refracture risk due to ongoing radial growth and shifting screw position.
- No significant association was found between refracture and plate type (locking vs conventional), fixation method, or ulnar union.
- Recommendations include careful SBDR sizing, motion restriction, and cautious plate removal decisions in growing dogs.
Veterinary and Comparative Orthopaedics and Traumatology
2
2025
A Retrospective Study of Risk Factors Associated with Refracture after Repair of Radial–Ulnar Fractures in Small-Breed Dogs
2025-2-VCOT-muroi-3
In Deprey 2022 et al., on gap fracture implants, which material was the NAS-ILN made of?
🔍 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.
Veterinary Surgery
8
2022
Mechanical evaluation of a novel angle‐stable interlocking nail in a gap fracture model
2022-8-VS-deprey-4
In Sisk 2024 et al., which IMN design improvement addresses rotational slack?
🔍 Key Findings Summary
- IMN provides relative stability, resists bending/torsion due to central axis alignment
- Larger diameter nails = exponentially greater stiffness (∝ D⁴)
- Trade-off: Larger interlocking holes weaken fatigue strength of the nail
- Reaming increases contact/stability but has pros/cons:
- Improves outcomes in closed fractures
- May reduce endosteal blood flow in thin-walled bones (e.g., cats)
- Design advances:
- Angle-stable IMN reduce rotational slack
- Expandable nails simplify insertion but may compromise removal or compressive load resistance
- Precontoured nails match bone curvature but lack consistent clinical superiority
- Material debates continue (e.g., titanium vs. stainless steel vs. magnesium)
Veterinary and Comparative Orthopedics and Traumatology
6
2024
Biomechanical Principles of Intramedullary Nails in Veterinary and Human Medicine
2024-6-VCOT-sisk-4
In Trefny 2025 et al., on plate length and stiffness, what was the measured effect of plate length on plate strain?
🔍 Key Findings
- 12-hole LCPs (80% plate–bone ratio) showed significantly higher construct stiffness than 6-, 8-, or 10-hole plates in both compression and tension bending.
- Strain on the plate was significantly lower in 12-hole vs 6-hole plates at all regions of interest (ROIs), especially around the fracture gap.
- No incremental increases in stiffness or decreases in strain were observed between 6-, 8-, and 10-hole plates—only when comparing to 12-hole plates.
- Bone model strain adjacent to the plate end was significantly lower for 10- and 12-hole plates vs 6-hole plates under both loading conditions.
- The threshold effect suggests biomechanical benefits only emerge beyond a plate–bone ratio of ~80%.
- Working length increased from 9.4 mm (6-hole) to 13 mm (others), potentially influencing strain/stiffness differences.
- Four-point bending was used, as it replicates the most biomechanically relevant force on plated long bones.
- Clinical implication: Longer plates may reduce plate strain and peri-implant bone strain, potentially lowering risk of fatigue failure or stress risers.
Veterinary and Comparative Orthopaedics and Traumatology
2
2025
Effect of Plate Length on Construct Stiffness and Strain in a Synthetic Short-Fragment Fracture Gap Model Stabilized with a 3.5-mm Locking Compression Plate
2025-2-VCOT-trefny-2
In Deprey 2022 et al., on gap fracture implants, which construct demonstrated higher torque to failure during 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.
Veterinary Surgery
8
2022
Mechanical evaluation of a novel angle‐stable interlocking nail in a gap fracture model
2022-8-VS-deprey-3
Quiz Results
You answered 7 out of 10 questions correctly
Key Findings