DI Dismukes, DB Fox, JL Tomlinson.
University of Missouri - Columbia, Comparative Orthopaedics Laboratory, Columbia, MO, United States

ACVS Abstract 2007 

All existing reports of antebrachial ALD correction are based on measurements made from orthogonal view radiography. We utilized a novel orthogonal ‘segmental’ radiographic technique, 3-dimensional computed tomography reconstruction, and stereolithography to aide in the diagnosis, quantification, planning, and surgical correction of a severe biapical antebrachial deformity which possessed excessive procurvatum, varus and valgus deviations and marked external rotation.

A 1-year-old castrated 7.4Kg Mixed-Breed dog was evaluated and treated for a severe antebrachial deformity. Measurements of medial proximal radial angle (MPRA) and lateral distal radial angle (LDRA) were made from orthogonal radiographs completed for the proximal and distal segments of the radius separately. Deformities were localized and quantified by the center of rotation of angulation (CORA) methodology. Computed tomography (CT) and 3-D reconstruction were performed of the entire antebrachium and carpus to create three truesized stereolithographic (SLA) models.

Two models were used for confirmation of measurements and rehearsal surgery prior to definitive surgical treatment.  Both were sterilized and used intraoperatively for comparison. Two closing wedge osteotomies were performed at the level of the CORAs on the radius and stabilized with bone plates and screws. Radiographic and gross
evaluation revealed successful improvement of MPRA, LDRA, as well as the rotational component. Surgical time was 195minutes. No surgical complications were encountered. This combined novel technique can provide additional information for diagnosing and surgical planning of severe antebrachial angular limb deformities. The use of such additional modalities may increase surgical efficiency and decrease surgical time and thus, morbidity.