The double-arch modified type-1b external skeletal fixator: Technique description and functional outcome for surgical management of canine antebrachial limb deformities

Publication date 1st August 2011
Authors Noel Fitzpatrick, Christos Nikolaou, Mike Farrell, K. Perry, Sarah Girling, T. J. Smith, Russell Yeadon


To describe acute correction of antebrachial angular and rotational limb de- formities (ARLD) using a new external skeletal fixator (ESF).


Dogs that were presented with lameness caused by ARLD were treated by radial and ulnar osteotomies and acute real- ignment. A modified type-1b ESF incorporat- ing double arches (DA-ESF) and a novel con- necting configuration facilitated alignment with six degrees of freedom. Bilateral deform- ities were corrected surgically in the same session. Aseptic preparation of both antebra- chii allowed comparison of limb alignment. Radiographic evaluation was performed using centre of rotation of angulation (CORA) methodology.


Thirty-five antebrachii (22 dogs) underwent surgery. Postoperative limb func- tion was graded as good (n = 31), fair (n = 2), or poor (n = 2). Persistent medial carpal insta- bility was associated with a suboptimal out- come. Postoperative radiographic images of the frontal and sagittal plane joint angles and elbow-to-carpus translation were compared with values that were reported in previous studies, and were within published reference ranges in most cases. Complications included delayed radial osteotomy union (n = 5), de- layed ulnar osteotomy union (n = 2) and im- plant-associated morbidity (n = 3).

Clinical relevance

A practical technique for acute correction of complex antebrachial ARLD is suggested, incorporating a new con- figurationofESF.Putativelimitationsofradio- graphic planning using CORA may be com- pensated by careful attention to intra-oper- ative visual an