Limb deformity correction aims to improve the patient’s quality of life by restoring normal limb alignment, improving function, alleviating pain, reducing long-term progression of osteoarthritis, and enhancing mobility. The surgeons at Spry Companions utilize innovative techniques and a comprehensive approach to maximize the care of these patients. This involves three basic steps:
Initial Comprehensive Evaluation
Your Spry Companions surgeons will begin by providing a thorough evaluation of your pet’s condition, including a detailed medical history, physical examination, and imaging studies such as X-rays. This aids in understanding the cause, nature and severity of the deformity, resulting in an appropriate treatment approach.
CT Scan and 3-D Pre-Operative Planning
It is likely that a CT Scan will be recommended. While radiographs provide surgeons with initial visualization of the deformity, it is ill-advised to rely on 2D images such as radiographs (x-rays) to quantify accurate measurement of the deformity (2D evaluation of a 3D limb). A CT scan provides surgeons with the ability to evaluate the deformed limb in three dimensions (3D evaluation of a 3D limb). Data from the CT scan is imported into computer software that allows the surgeon to reconstruct the deformed bone in 3D. One or more steps may be needed to complete preoperative planning:
- Segmentation and Limb Alignment Evaluation: This step involves the isolation of the affected bone using software. The isolated bone is then evaluated for the degree of the deformity in each of three planes: frontal, sagittal, and transverse. Those patients who are determined to have a deformity may need additional steps.
- Deformity correction planning: Once the deformity is quantified in the three planes, these numbers allow software to help correct the deformity on the computer model before ever entering the operating room.
- 3D Printing of the affected limb: In some cases, we may choose to print out an exact replica of your patient’s bone using our in-house 3D printing. This allows the surgeons to feel, see and understand the bone deformity before we even anesthetize the patient for correction. We can even perform a “mock surgery” on the bone to ensure that the bone is corrected sufficiently.
- Custom cutting guide or wedge creation: Some cases will require a custom cutting jig/guide that establishes the proper cutting angle in all three planes. This ensures that the surgeon can confidently correct the deformity, removing the guesswork and “eye-balling” of the correction from the operating room.
Surgical Correction
By the time Spry Companion surgeons are anesthetizing your pet for deformity correction, we will have already performed one or more of the above steps to ensure that your pet will have success with the planned intervention. A cut in the bone is made, the deformity is corrected and the bone stabilized. In acute corrections in adult dogs, stabilization is performed with a bone plate. In rare cases in young dogs with substantial limb shortening, a surgeon might utilize an external fixator to provide “distraction osteogenesis” and grow the patient’s bone for them.
Post-Operative Care and Follow-up
Following surgery, proper postoperative care is important for patients receiving corrective osteotomies. Bone healing will be complete at 8 weeks or more. The surgeons and staff at Spry Companions will guide you through postoperative activity restriction. We are also proactive about pain management, infection prevention, and a rehabilitation plan to maximize recovery. Regular follow-up appointments and radiographs are utilized to monitor the progress of bone healing and assess the overall recovery. Adjustments to the original treatment plan may be made based on surgeon follow-up. These patients are never “normal” but we can mitigate the problem well enough to avoid long-term progression of osteoarthritis or pain associated with long-standing deformities.