Técnica de sutura ílio-femoral com fio de polidioxanona para estabilização da articulação coxofemoral em cão com luxação coxofemoral traumática

Background: The hip dislocation is the most common traumatic dislocation in dogs. Surgical treatment has better results, but there is still no consensus on the best technique. This study aims to report a case of traumatic hip dislocation in a dog, in which case it was decided by extra-articular stabilization, using absorbable monofilament wire of Polydioxanone, through implementing the Ilium-Femoral Suture Technique. This surgical thread is composed of a poly dioxanone polymer and differs from polyglycolic acid and polyglactin 910 by being a monofilament. The surgical technique consists of making a tunnel in the ileum body, in dorsolateral-ventromedial direction and another in the greater trochanter, in the caudally skull. The stabilization is achieved using one or more sutures standard “8”, passing through the two tunnels. The vast majority of published works on the subject, reports the use of non-absorbable wires, such as surgical nylon or polyamide in the making of this type of suture, justifying the relevance of this report. Case: A Belgian Malinois breed dog of 2.5-year-old, female, was treated at a private clinic in the city of Porto Alegre, RS, Brazil, with trauma history by trampling. The patient had lack of member support and maintenance of the same in external rotation. General anesthesia of the patient, with 5 mg.kg-1 of Propofol (Propovan®), preceded by the application of preanesthetic medication with 0.05 mg.kg-1 of acepromazine 0.2% (Acepran®), 0.2 mg.kg-1 of Methadone Hydrochloride 5% (Mytedom®) and 3 mg.kg-1 of Ketamine hydrochloride 10% (Quetamina®), allowed the detailed clinical examination and proper positioning of the patient to perform the radiographic examination. The same show total loss of contact between the articular surface of the acetabulum and the femoral head rights, this being displaced skull-dorsally in relation to the acetabulum. Radiographs were compatible with dislocated hip-skull right dorsal. As an alternative to immediate treatment, we opted for the closed reduction of dislocation and making a Ehmer sling for emergency stabilization and, about 24 h after, extra-articular surgical stabilization by implementing the Ilium-Femoral suture technique. According to the patient’s author reports, the support of the member took place on the 3rd day after surgery. An X-ray control, performed 12 weeks after the procedure, showed moderate atrophy of the muscles of the right hind limb and mild periosteal reaction in the ipsilateral ileum body region. Discussion: The diagnosis of hip traumatic cranio-dorsal dislocation is based on patient history, clinical signs, full orthopedic examination and radiographic findings. The present patient case was an automobile trampling victim, however, the clinical signs presented as lack of support from the member and lack of external rotation may be associated with other disorders or diseases affecting the musculoskeletal system. The ease of palpation and the elevation of the greater trochanter, in relation to the ischial tuberosity and coxal and radiographs in the medial-lateral and ventral-dorsal projections made it possible to confirm the diagnosis. To prevent further tissue damage, it was held closed reduction with the patient under general anesthesia and using an Ehmer sling. Due to the size and the dog’s degree of activity, we opted for the surgical stabilization. Conventional cranio-lateral approach was sufficient to expose the structures without the need for magnification to display the ileum body. The surgical technique was simple and easy to perform and the patient remained without a sling or other type of bandage for immobilization in the postoperative, an advantage of using this technique.