Use of Autogenous Fascia Lata Graft in the Treatment of Chronic Segmental Defect of the Common Calcaneus Tendon in Domestic Feline
AbstractBackground: The common calcaneus tendon is formed by the common tendon of the femoral biceps muscle, tendon of the superficial digital flexor muscle and gastrocnemius muscle tendon, and its rupture is related to acute traumas in small animals. Among some applications described, surgical repair can be adopted in the correction of tendon ruptures and the
use of grafts may be indicated in some severe lesions, where it is not possible to perform tenorrhaphy. This study aims to report the case of a feline with rupture of the common calcaneus tendon in which the tenorrafia associated with the autogenous fascia lata graft was performed as adjuvant to the cicatrization of the same.
Case: A 24-month-old, undefined male feline with approximately 3 kg was treated at the FCAV Veterinary Hospital, UNESP Jaboticabal, State of São Paulo, Brazil, with a history of falling, for approximately two weeks, and has since plantigrade posture. Upon physical examination, it was possible to identify a discontinuity of the common calcaneus tendon. The radiographs were performed, which did not show any bone changes. A hemogram and biochemical profile were performed, which were within normal limits. The patient underwent surgery, and a complete lesion of the common calcaneus tendon was identified, with a chronic aspect. Approximation of the stumps was impossible, so a flap of fascia lata, about two centimeters long and one centimeter wide, was removed, which was used as a bed and tendon support for tendon growth. After removal all of the present fibrosis, the tendon stumps were approximated by means of modified Kessler suture with mononylon thread, and fascia lata flap of the ipsilateral limb was sutured with separate single points in both tendon ends
and in their lateral and medial portion. In the tibiotarsic joint, the external skeletal fixator type II was used for immobilization, during a period of 30 days. In the immediate postoperative period the patient was already able to support the member on the floor, with progressive improvement, and after 60 days of surgery the animal presented complete support of the
limb, without pain or any other alteration coming from the surgery. The animal presented a rapid recovery after surgical treatment with the autogenous fascia lata flap.
Discussion: The rupture of the common calcaneus tendon is not commonly reported in felines and its occurrence is related to acute trauma, where the animals will present lameness and plantigrade posture. Depending on the degree of tendon involvement, there are different procedures that may be indicated, such as tenorrhaphy, reimplantation for avulsion cases, and transplantation with grafts when there is segment loss. In the present study, the use of tenorrhaphy associated with the implantation of autogenous lata-fascia graft was chosen, since the grafts generally provide the framework for healing due to its replacement by collagen tissue in the recipient, in addition to providing mechanical protection initially. Fascia lata, due to its antigenic character as being autogenous, has been shown to be a viable and easily obtained surgical option. The use of the fascia lata graft associated with external immobilization with external fixator type II in the tibiotarsal joint allowed an excellent result and is therefore a recommended treatment for cases of rupture of the common calcaneus tendon in felines.
Keywords: cats, lameness, plantigrade stance.
Bloomberg M. 1993. Muscles and tendons. In: Slatter D.H. (Ed). Textbook of small animal surgery. (Eds). 2nd edn. Philadelphia: Saunders, pp.1996-2020.
Butler H.C. 1974. Tendon, muscle, and fascia. In: Archibald J. (Ed). Canine surgery. 2nd edn. Santa Barbara: American Veterinary Publications, pp.933-947.
Cordrey L.J., McCorkle H. & Hilton E. 1963. A comparative study of fresh autogenous and preserved homogenous tend o grafts in rabbits. Journal of Bone and Joint Surgery. 45B (1):182-195.
Dal-Bó I.S., Ferrigno C.R.A., Macedo A.S., Paes F., Santos J.F., Marinho P.V.T., Bregadioli T. & Galeazzi V.S. 2016. Tenorrhaphy of the Common Calcaneal Tendon in Dogs and Cats. Acta Scientiae Veterinariae. 44 (Suppl 1):144.
Dyce K.M., Sack W.O. & Wensing C.J.G. 1997. O aparelho locomotor. In: Tratado de anatomia veterinária. 2.ed. Rio de Janeiro: Guanabara Koogan, pp.25-78.
Schmitt B. 2013. Ruptura do tendão calcâneo comum em cão: relato de caso. Porto Alegre, RS. Dissertação (Especialização em Clínica Médica e Cirúrgica de Pequenos Animais) - Programa de Pós-graduação em Clínica Médica e Cirúrgica de Pequenos Animais, Centro de Estudos Superiores de Maceió da Fundação Educacional Jayme de Altavila.
Edshage S., Goldie I. & Niebauer J.J. 1970. Tissue surrounding grafted tendons in dogs. Acta Orthopaedica Scandinavica. 41(3): 292-306.
Haddad J.L., Chavez-abraham V., Carrera J., Vilchis J. & Sastre N. 1997. Microsurgical reconstruction of the Achilles tendon with a fascia lata flap. Journal Reconstructive Microsurgery. 13(5): 309-312.
Khan K., Riaz M., Murison M.S. & Brennen M.D. 1997. Early active mobilization after second stage flexor tendon grafts. Journal of Hand Surgery. 22(3): 372-374.
King M. & Jerram R. 2003. Achilles tendon rupture in dogs. Compendium On Continuing Education For The Practicing Veterinarian. 25(8): 613-620.
Muir P. & Dueland R.T. 1994. Avulsion of the origin of the medial head of the gastrocnemius muscle in a dog. Veterinary Record. 135: 359-360.
Raiser A.G. 2000. Homoimplante ortotópico de tendão calcâneo comum, preservado em glicerina a 98%, e tratado com radiação laser Arseneto de Gálio, sob dois métodos de imobilização em cães. 88f. Santa Maria, RS. Tese (Doutorado em Cirurgia) - Programa de Pós-graduação em Medicina Veterinária, Universidade Federal de Santa Maria.
Ridge P.A. & Owen M.R. 2005. Unusual presentation of avulsion of the lateral head of the gastrocnemius muscle in a dog. Journal of Small Animal Practice. 46: 196-198.
Stahl C., Wacker C., Weber U., Forterre F., Hecht P., Lang J. & Gorgas D. 2010. MRI features of gastrocnemius musculotendinopathy in herding dogs. Veterinary Radiology & Ultrasound. 51: 380-385.
Swiderski J., Fitch A., Staatz A. & Lowery J. 2005. Sonographic assisted diagnosis and treatment of bilateral gastrocnemius tendon rupture in a Labrador retriever repaired with fascia lata and polypropylene mesh. Veterinary and Comparative Orthopaedics and Traumatology.18: 258-263.
Virchenko O. & Aspenberg P. 2006. How can one platelet injection after tendon injury lead to a stronger tendon after4 weeks? Acta Orthopaedica.77: 806-812.
How to Cite
This journal provides open access to all of its content on the principle that making research freely available to the public supports a greater global exchange of knowledge. Such access is associated with increased readership and increased citation of an author's work. For more information on this approach, see the Public Knowledge Project and Directory of Open Access Journals.
We define open access journals as journals that use a funding model that does not charge readers or their institutions for access. From the BOAI definition of "open access" we take the right of users to "read, download, copy, distribute, print, search, or link to the full texts of these articles" as mandatory for a journal to be included in the directory.
La Red y Portal Iberoamericano de Revistas Científicas de Veterinaria de Libre Acceso reúne a las principales publicaciones científicas editadas en España, Portugal, Latino América y otros países del ámbito latino