Osnove hirurškog pristupa prelomu dugih cevastih kostiju pasa

Abstract

Prelomi dugih cevastih kostiju kod pasa najčešće nastaju usled trauma, padova i drugih povreda. Osnovni principi pristupa sanacije preloma primarno podrazumevaju adekvatnu stabilizaciju opšteg stanja životinje i saniranje potencijalnih, po život ugrožavajućih povreda. Upotreba adekvatnog protokola analgezije perioperativno, kao i nakon završene sanacije preloma dugih cevastih kostiju može doprineti bržem oporavku psa. Nakon stabilizacije pacijenta pristupa se odabiru anesteziološkog protokola u zavisnosti od težine povrede i dužine trajanja same intervencije. Monitoring vitalnih funkcija i monitoring bola se vrše preoperativno, intraoperativno i nekoliko dana postoperativno. Hirurški pristup prelomu dugih cevastih kostiju kod pasa u praksi podrazumeva upotrebu adekvatnih hirurških procedura u cilju stabilizacije fragmenata preloma. U tu svrhu se koriste različite ortopedske procedure uz adekvatnu upotrebu implanta (alanteza). Najčešće se koriste, u zavisnosti od tipa preloma intramedularni pinovi, žica, pločice i šrafovi. Pre početka svake ortopedske procedure neophodno je napraviti plan. U zavisnosti od starosne kategorije, težine povrede, potencijalno prisutnih primarnih oboljenja, načina držanja životinje, rase i drugo neophodno je odabrati najadekvatniji hirurški pristup. To podrazumeva pravilan odabir implanta i načina hirurške sanacije. Posebnu pažnju treba obratiti na kose i transverzalne prelome humerusa, radiusa, femura i tibije. Sve ortopedske intervencije se moraju obaviti u što sterilnijim uslovima uz poštovanje svih principa asepse i antisepse kako bi se rizik od potencijalnih komplikacija sveo na minimum.

Fractures of long tubular bones in dogs are most often caused by trauma, falls and other injuries. The basic principles of the fracture remediation approach primarily the use of adequate stabilization of the general condition of the animal and remediation of potential, life-threatening injuries. The use of an adequate analgesia protocol perioperatively, as well as after the completion of the repair of a fracture of long tubular bones, can contribute to faster recovery of the dog. After stabilization of the patient, the choice of anesthesia protocol is chosen depending on the severity of the injury and the duration of the intervention itself. Monitoring of vital functions and monitoring of pain are carried-out preoperatively, intraoperatively and for several days postoperatively. The surgical approach to fractures of long tubular bones in dogs in practice involves the use of adequate surgical procedures in order to stabilize fracture fragments. For this purpose, various orthopedic procedures are used with adequate use of implants. Depending on the type of fracture, intramedullary pins, wires, plates and screws are most often used. Before starting any orthopedic procedure, it is necessary to make a plan. Depending on the breed, age category, severity of the injury, potential presece of primary diseases, the way the animal is kept, etc., it is necessary to choose the most appropriate surgical approach. This means the correct choice of implant and the method of surgical repair. Special attention should be paid to oblique and transverse fractures of the humerus, radius, femur and tibia. All orthopedic interventions must be performed in the most sterile conditions, respecting all the principles of asepsis and antisepsis in order to minimize the risk of potential complications.