Dual Energy X-Ray Absorptiometry (DEXA) in Evaluation of the Proximal Femur after Repair of Proximal Femoral Physeal Fractures in Immature Dogs

D. M. Tillson; J. K. Roush; R. M. McLaughlin Jr.; Ph. W. Toll; D. C. Richardson

doi:10.1055/s-0038-1632447

Veterinary and Comparative Orthopaedics and Traumatology, Table of Contents

Vet Comp Orthop Traumatol 1995; 08(03): 153-158
DOI: 10.1055/s-0038-1632447

Original Research

Schattauer GmbH

Dual Energy X-Ray Absorptiometry (DEXA) in Evaluation of the Proximal Femur after Repair of Proximal Femoral Physeal Fractures in Immature Dogs

D. M. Tillson

¹From the Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS

,

J. K. Roush

¹From the Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS

,

R. M. McLaughlin Jr.

¹From the Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS

,

Ph. W. Toll

²Mark Morris Associates, Topeka, KS, USA

,

D. C. Richardson

²Mark Morris Associates, Topeka, KS, USA

› Author Affiliations

Abstract

Summary

Thin slices of the proximal femora of twelve immature dogs were examined with dual energy x-ray absorptiometry, after surgical creation and repair of proximal femoral physeal fractures. A protocol for the subtraction of microvascular barium sulphate was used to eliminate interference from the barium with the determination of bone mineral content (BMC), bone mineral density (BMD) and volumetric bone mineral density (VBMD). The results showed there was a significant decrease in the BMC (four and eight weeks) and BMD (eight weeks) for the entire proximal femora of the operated side when compared to the non-operated side. Significant decreases were also seen for the BMC of the physeal region at week eight and the VBMD of the metaphyseal area in the two week femora. The findings with DEXA support the clinical findings of femoral neck thinning in proximal femoral physeal fractures that are surgically repaired. The DEXA findings suggest that the quality of the bone of the femoral neck is less as shown by the decreased BMC, BMD and VBMD. Postoperative complications may occur at a higher frequency when such quality changes occur.

Dog proximal femora were examined with DEXA after surgical creation and repair of proximal femoral physeal fractures. DEXA findings support clinical findings of femoral neck thining after fracture repair.

Keywords

DEXA - bone densitometry - microangiography - proximal femur fracture

Full Text

References

REFERENCES
1 Johnston CC, Slemenda CW, Melton LJ. Clinical use of bone densitometry. NEJM 1991; 324: 1105-9.
2 Sartoris DJ, Resnick D. Current and innovative methods for noninvasive bone densitometry. Radiol Clin N Am 1990; 28: 257-78.
3 Markel MD, Wikenheiser MA, Morin RL. Quantification of bone healing: Comparison of QCT, SPA, MRI and DEXA in dog osteotomies. Acta Orthop Scand 1990; 61: 487-98.
4 Sartoris DJ, Resnick D. Noninvasive bone densitometry. Radiol 1989; 1: 2-19.
5 Gibson KL, vanEe RT, Pechman RD. Femoral capital physeal fractures in dogs: 34 cases (1979–1989). J Am Vet Med Assoc 1991; 198: 886-90.
6 Piermattei DL, Greeley RG. An Atlas of Surgical Approaches to the Bones of the Dog and Cat. 2nd edn. Philadelphia: Saunders; 1979
7 Hulse DH, Wilson JW, Abdelbaki YZ. Revascularization of femoral capital physeal fractures following surgical fixation. J Vet Orthop 1981; 2: 50-7.
8 Kuzma A, Sumner-Smith G, Miller C, McLaughlin R. A technique of repair of femoral capital epiphyseal fractures in the dog. J Smal Anim Pract 1989; 30: 444-8.
9 Anson LW, DeYoung DJ, Richardson DC, Betts CW. Clinical evaluation of canine acetabular fractures stabilized with an acetabular plate. Vet Surg 1988; 17: 220-5.
10 Roush JK, Wilson JW. Effects of plate luting on cortical vascularity and the development of cortical porosity in canine femurs. Vet Surg 1990; 19: 208-14.
11 Brain IB. The preparation of decalcified sections. Chicago, IL: Charles C. Thomas Publishing; 1966: 69-133.
12 Tillson DM, McLaughlin RM, Roush JK. Evaluation of experimental proximal femoral physeal fracture repair using two cortical screws placed from the articular surface. VCOT 1994; 7: 140-7.
13 Ammann P, Rizzoli R, Slosman D, Bonjour JP. Sequential and precise in vivo measurement of bone mineral density in rats using dual-energy x-ray absorptiometry. J Bone Min Res 1992; 7: 311-6.
14 Eyres KS, Bell MJ, Kanis JA. New bone formation during leg lengthening evaluated by dual energy x-ray absorptiometry. J Bone Joint Surg 1993; 75 B 96-106.
15 Glastre C, Braillon P, David L. et al Measurement of bone mineral content of the lumber spine by dual energy x-ray absorptiometry in normal children: Correlation with growth parameters. J Clin Endocrinol Metab 1993; 70: 1330-3.
16 Qurales LD. Prednisone-induced osteopenia in Beagles: variable effects mediated by differential suppression of bone formation. Am J Physiol 1992; 263 E 136-41.
17 Markel MD, Chao EYS. Noninvasive monitoring techniques for quantitative description of callus mineral content and mechanical properties. Clin Orthop 1993; 293: 37-45.
18 Henderson RC. Assessment of bone mineral content in children. J Pediatr Orthop 1991; 11: 314-7.
19 Rhinelander FW, Stewart CL, Wilson JW. Bone vascular supply. In: Skeletal Research. Simmons DJ, Kunin AS. (eds) New York: Academic Press; 1979: 367-95.
20 DeCamp CE, Probst CW, Thomas MW. Internal fixation of femoral capital physeal injuries in dogs: 40 cases (1979–1987). J Am Vet Med Assoc 1989; 194: 1750-4.
21 Springer ER, Lachiewicz PF, Gilbert J A. Internal fixation of femoral neck fractures: a comparison biomechanical study of Knowles pins and 6.5 mm cancellous screws. Clin Orthop 1991; 267: 85-92.
22 Janes GC, Collopy DM, Price R, Sikorski JM. Bone density after rigid plate fixation of tibial fractures. J Bone Joint Surg 1993; 75 B 914-7.
23 Daly WR. Femoral head and neck fractures in the dog and cat: a review of 115 cases. Vet Surg 1978; 2: 29-38.