Treatment of quadriceps contracture with femoral shortening ostectomy, rectus femoris muscle transposition and dynamic stifle flexion apparatus in a dog

Abstract

A 13-month-old, 3.3 kg castrated male Shih-tzu presented with right hindlimb lameness. The physical examination revealed atrophy of the right thigh muscles, hyperextension of the stifle joint and external torsion of the tibia. On the radiographic examination, patella alta and genu recurvatum were observed. A biapical deformity of the tibia and external torsion of the distal tibia were detected by computed tomography (CT). A three-dimensional (3D) printed bone model was designed and constructed for the preoperative plan prior to surgery. Rectus femoris muscle transposition, femoral shortening ostectomy and open wedge osteotomy of the distal tibia were performed using hybrid external skele/t0al fixation (hybrid-ESF). A dynamic stifle flexion apparatus was used to prevent recurrence of a quadriceps contracture (QC). Intense physiotherapy was administered postoperatively. The dog began to use the affected limb one week after surgery. Functional improvement in the affected limb was observed, and full weight-bearing was possible at 3 months after surgery. Union of the osteotomy lines was observed at 3 months, and the stifle joint was fully movable at 7 months after surgery. Regarding the treatments for QC, these methods may be excellent candidates, as they do not lead to severe damage to the limb or amputation.