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Incongruência do Cotovelo e a sua correção cirúrgica
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Abstract(s)
A incongruência do cotovelo é um termo que descreve o mau alinhamento das superfícies
articulares. Esta é considerada uma das alterações, onde se englobam o grupo da displasia do
cotovelo. A incongruência pode ocorrer por duas razões principais: por má conformação da
incisura troclear da ulna com a tróclea do úmero, ou por crescimento desigual entre o rádio e a
ulna, resultando numa ulna mais curta em relação ao rádio ou um rádio mais curto em relação
à ulna. Podendo surgir associada a outros tipos de lesões também descritas como displasia do
cotovelo tais como a fragmentação do processo coronoide medial, a não união do processo
ancóneo da ulna ou a osteocondrite dissecante da porção medial do côndilo do úmero. No caso
clínico apresentado, compara-se a sensibilidade de diagnóstico desta patologia entre a
radiografia e a tomografia axial computadorizada. A lesão observada neste animal é muito
extensa, apresenta lesão do processo coronoide medial e osteoartrite associadas a
incongruência do cotovelo. Estas características apenas são observadas devido a sensibilidade
e as características da tomografia axial computadorizada, esta permite fazer um estudo completo
da lesão e delinear o curso da cirurgia tal como, prever o prognóstico deste animal. A cirurgia
realizada para correção desta lesão foi uma coronoidectomia subtotal e uma osteotomia
perpendicular proximal da ulna. Esta solução cirúrgica pode ser condicionada por outras
comorbilidades ortopédicas presentes neste animal, como a displasia da anca que necessita de
controlo de dor. Por um lado foi atingida congruência articular após a cirurgia efetuada, por outro
haverá problemas mesmo após cirurgia corretiva, já que a incongruência e osteoartrite são tão
severas.
An elbow incongruency is a term that describes the misalignment of the joint surfaces. It is considered one of the pathologies that are included in the elbow dysplasia group. Incongruence can occur for two reasons: a malformation in the trochlear incision of the ulna with the humerus trochlea, or by uneven growth between the radio and the ulna, resulting in an ulna that is shorter in relation to the radius or a radius that is shorter than the ulna. It may arise associated with other types of injuries also described as elbow dysplasia. In the clinical case presented, the diagnostic sensitivity of this pathology is compared between radiography and computed axial tomography. The lesions observed in this animal are very extensive with the presence of the medial coronoid process lesion and osteoarthritis associated with elbow incongruity. These characteristics are only observed with the sensitivity and characteristics of computed axial tomography, which allow a complete study of the lesion and outline the course of surgery as well as predicting, in a certain way, the prognosis of this animal. The surgery used to resolve this incongruency was a subchondral coronoidectomy and a perpendicular proximal osteotomy of the ulna. This surgical solution can be conditioned by other orthopedic comorbidities present in this animal, such as hip dysplasia that requires pain control. On one hand it was reached joint congruence after the surgery was performed, on the other there will be problems even after corrective surgery, since incongruence and osteoarthritis are so severe.
An elbow incongruency is a term that describes the misalignment of the joint surfaces. It is considered one of the pathologies that are included in the elbow dysplasia group. Incongruence can occur for two reasons: a malformation in the trochlear incision of the ulna with the humerus trochlea, or by uneven growth between the radio and the ulna, resulting in an ulna that is shorter in relation to the radius or a radius that is shorter than the ulna. It may arise associated with other types of injuries also described as elbow dysplasia. In the clinical case presented, the diagnostic sensitivity of this pathology is compared between radiography and computed axial tomography. The lesions observed in this animal are very extensive with the presence of the medial coronoid process lesion and osteoarthritis associated with elbow incongruity. These characteristics are only observed with the sensitivity and characteristics of computed axial tomography, which allow a complete study of the lesion and outline the course of surgery as well as predicting, in a certain way, the prognosis of this animal. The surgery used to resolve this incongruency was a subchondral coronoidectomy and a perpendicular proximal osteotomy of the ulna. This surgical solution can be conditioned by other orthopedic comorbidities present in this animal, such as hip dysplasia that requires pain control. On one hand it was reached joint congruence after the surgery was performed, on the other there will be problems even after corrective surgery, since incongruence and osteoarthritis are so severe.
Description
Keywords
Cartilagem Cotovelo Osteoartrite Incongruência Patologia da articulação Tomografia axial computadorizada Cartilage Computerized axial tomography Osteoarthritis Elbow Incongruity Pathology of the joints