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Osteotomia abdutora proximal da ulna (PAUL - Proximal Abducting Ulnar Osteotomy) no maneio da doença do compartimento medial do cotovelo em cães : estudo retrospetivo
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Resumo(s)
A Doença do Compartimento Medial do cotovelo em cães, refere-se ao conjunto de alterações patológicas e degenerativas relacionadas com os diferentes tipos de Fragmentação do Processo Coronóide Medial, bem como às lesões da cartilagem ao nível do epicôndilo umeral medial e do processo coronóide, sem que se verifique a presença de doença ao nível do compartimento lateral do cotovelo. Esta doença pode ser trabalhada cirurgicamente recorrendo à técnica de Osteotomia Abdutora Proximal da Ulna (PAUL – Proximal Abducting Ulnar Osteotomy), tendo sido o presente trabalho desenvolvido com o objetivo de estudar a ocorrência de complicações associadas a esta técnica, bem como avaliar a evolução da claudicação e o nível de conforto dos doentes submetidos a esta cirurgia, contribuindo assim com informação pertinente e atualizada para a literatura existente. O estudo do tipo retrospetivo foi realizado numa amostra de 20 unidades de estudo (cotovelo) (N=20), em cães, submetidos à técnica de PAUL num período de 5 anos. Utilizou-se um inquérito telefónico junto dos tutores, no sentido de avaliar a evolução dos sinais e sintomas dos animais submetidos a cirurgia, inquirindo quanto ao grau de satisfação dos tutores relativamente à técnica PAUL. De acordo com os resultados obtidos, não se registaram complicações intra-cirúrgicas em nenhum dos casos. No período pós-operatório registaram-se 5 casos com complicações, todas de resolução simples e sem sequelas a longo prazo para a recuperação dos doentes. Segundo a opinião dos tutores, todos os animais manifestaram algum grau de melhoria pós-operatoriamente quando comparados com o desconforto exibido inicialmente. 95% dos tutores afirmaram que repetiriam a cirurgia. O presente trabalho permite concluir que a técnica de PAUL surge com um potencial promissor no maneio da Doença do Compartimento Médio do cotovelo, contudo, verifica-se a necessidade de efetuar estudos que avaliem um maior número de casos e durante um período de tempo mais longo, permitindo uma análise mais detalhada dos dados e a obtenção de resultados estatisticamente relevantes.
ABSTRACT - Medial Compartment Disease of the canine elbow refers to the set of pathological and degenerative changes associated with different forms of Fragmentation of the Medial Coronoid Process, as well as to cartilage lesions at the level of the medial humeral epicondyle and the coronoid process, in the absence of pathology in the lateral compartment of the joint. This disease can be surgically worked by using the Proximal Abducting Ulnar Osteotomy (PAUL) technique. The present study was developed to study the occurrence of complications associated with this technique, as well as to evaluate the evolution of lameness and comfort level of the intervention patients, thus contributing relevant and updated information to the existing literature. The retrospective study was performed on a sample of 20 study units (elbow) (N=20) in dogs submitted to PAUL technique over a period of 5 years. A telephone survey with the tutors was used to assess the evolution of signs and symptoms of the intervention animals, inquiring as to the degree of satisfaction of the tutors regarding the PAUL technique. According to the results obtained, there were no intrasurgical complications in any of the cases. In the postoperative period there were 5 cases of complications, all of them with simple resolution and without long-term sequelae for patient recovery. According to the tutors' opinion, all animals showed some degree of improvement postoperatively when compared to the discomfort initially exhibited. 95% of tutors said they would repeat the surgery. The present study allows us to conclude that the PAUL technique shows a promising potential in the management of Medial Compartment Disease of the elbow, however, there is a need for studies to evaluate a larger number of cases over a longer period of time, allowing for a more detailed analysis of the data and for obtaining statistically relevant results.
ABSTRACT - Medial Compartment Disease of the canine elbow refers to the set of pathological and degenerative changes associated with different forms of Fragmentation of the Medial Coronoid Process, as well as to cartilage lesions at the level of the medial humeral epicondyle and the coronoid process, in the absence of pathology in the lateral compartment of the joint. This disease can be surgically worked by using the Proximal Abducting Ulnar Osteotomy (PAUL) technique. The present study was developed to study the occurrence of complications associated with this technique, as well as to evaluate the evolution of lameness and comfort level of the intervention patients, thus contributing relevant and updated information to the existing literature. The retrospective study was performed on a sample of 20 study units (elbow) (N=20) in dogs submitted to PAUL technique over a period of 5 years. A telephone survey with the tutors was used to assess the evolution of signs and symptoms of the intervention animals, inquiring as to the degree of satisfaction of the tutors regarding the PAUL technique. According to the results obtained, there were no intrasurgical complications in any of the cases. In the postoperative period there were 5 cases of complications, all of them with simple resolution and without long-term sequelae for patient recovery. According to the tutors' opinion, all animals showed some degree of improvement postoperatively when compared to the discomfort initially exhibited. 95% of tutors said they would repeat the surgery. The present study allows us to conclude that the PAUL technique shows a promising potential in the management of Medial Compartment Disease of the elbow, however, there is a need for studies to evaluate a larger number of cases over a longer period of time, allowing for a more detailed analysis of the data and for obtaining statistically relevant results.
Descrição
Dissertação de Mestrado Integrado em Medicina Veterinária
Palavras-chave
Cão Cotovelo Doença do Compartimento Medial Cirurgia Osteotomia Abdutora Proximal da Ulna Dog Elbow Medial Compartment Disease Surgery Proximal Abducting Ulnar Osteotomy
Contexto Educativo
Citação
Santos MCA 2020. Osteotomia abdutora proximal da ulna (PAUL - Proximal Abducting Ulnar Osteotomy) no maneio da doença do compartimento medial do cotovelo em cães : estudo retrospetivo [dissertação de mestrado]. Lisboa: FMV-Universidade de Lisboa.
Editora
Universidade de Lisboa, Faculdade de Medicina Veterinária