33rd Annual Scientific Meeting proceedings

Introduction:

Malunion of pelvic fractures can lead to pelvic canal narrowing resulting in obstipation and megacolon. If clinical signs have been present for less than 6 months, pelvic widening procedure can be considered. Pelvic symphyseal distraction osteotomy has been described as a successful method to widen the pelvic canal in cats, but never in dogs.

Case description:

A 5-month-old dog was presented for obstipation and megacolon secondary to malunion of pelvic fractures. Given the chronicity of fractures, symphyseal distraction osteotomy was the preferred option. An anvil-shaped methylmethacrylate spacer for embedding without additional fixation was used. Cement size and shape was defined according to the maximum distraction obtained intraoperatively. A cystopexy was performed in order to avoid a pelvic bladder. A local rotation flap using the external rectus fascia was required to achieve closure of the caudal abdominal wall.

Results:

The dog recovered uneventfully from the surgery. The dog was fully weight bearing and had no issue defecating.

Discussion :

Revision of fracture malunion via corrective osteotomy or ostectomy are surgical options but with a substantial major risk of complications. Symphyseal distraction is a safer option. Several types of spacer have been described. Readily available and easily shaped in situ are the major advantages of the methylmethacrylate. Moreover, the anvil shape permits to match the edges of the symphysis allowing intrinsic stability and therefore does not require additional fixation. Therefore symphyseal distraction osteotomy may be successful for the treatment of pelvic canal stenosis in dogs.