Intraoperative radiation for limb sparing of the distal aspect of the radius without transcarpal plating in five dogs.
OBJECTIVE
To evaluate intraoperative irradiation (IORT) as a method of limb spare with preservation of the radiocarpal joint.


METHODS
Prospective case series.


METHODS
Dogs (n=5) with stage II sarcoma of the distal aspect of the radius.


METHODS
A bone segment containing the tumor was isolated surgically, treated by IORT, reimplanted, and secured by internal fixation. In 1 dog, the postradiation tumor bed was curetted and filled with bone cement. Dogs were administered alternating adriamycin and carboplatin starting 2 weeks after IORT and monitored at regular intervals.


RESULTS
Four dogs had osteosarcoma and 1 had undifferentiated sarcoma. Implant failure (n=3), deep tissue infection (3), and pathologic fracture (3) resulted in amputation (3) or pancarpal plating (2). The dog with undifferentiated sarcoma was euthanatized because of suspected tumor recurrence 4 months postoperatively. Osteotomy healing was documented by radiography (1), histopathology (2), or by direct observation (2).


CONCLUSIONS
A technique for limb-sparing surgery of the distal portion of the radius in dogs using IORT had advantages include healing of the autograft and a source for a perfectly fitting autograft but did not appear to offer any advantage with respect to infection rate. Long-term preservation of the radiocarpal joint was not successful.


CONCLUSIONS
It was not possible to preserve the function of the radiocarpal joint and so this technique cannot be recommended currently. Further study is needed to evaluate whether or not IORT can be considered in combination with pancarpal plating and possibly curettage and cementation of the tumor to prevent subchondral bone collapse.
Boston
Sarah Elizabeth
SE
Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA. bostonianonthemove@hotmail.com
Duerr
Felix
F
Bacon
Nick
N
Larue
Susan
S
Ehrhart
Eugene J
EJ
Withrow
Steve
S
D000818:Animals; D001843:Bone Cements / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000532:radiotherapy / Q000601:surgery / Q000662:veterinary*; D016190:Carboplatin / Q000627:therapeutic use; D003131:Combined Modality Therapy; D004283:Dog Diseases / Q000532:radiotherapy* / Q000601:surgery*; D004285:Dogs; D004317:Doxorubicin / Q000627:therapeutic use; D005260:Female; D005593:Fracture Fixation, Internal / Q000662:veterinary; D007430:Intraoperative Care / Q000379:methods / Q000662:veterinary*; D023821:Limb Salvage / Q000662:veterinary; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology / Q000662:veterinary; D011446:Prospective Studies; D011839:Radiation, Ionizing; D012509:Sarcoma / Q000532:radiotherapy / Q000601:surgery / Q000662:veterinary*; D016896:Treatment Outcome
D001843:Bone Cements; D004317:Doxorubicin; D016190:Carboplatin