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Background: Wound infusion catheters (WICs) have been used in humans and some veterinary species for post-operative local anesthetic administration following a variety of surgical procedures, aiming to reduce post-operative analgesia requirements and improve patient comfort. Benefit in reduction in pain, post-operative analgesia requirements and length of hospital stay are well documented in humans, but use of WICs may not have been widely adopted in veterinary species due to the concern of increased complications, such as dehiscence or surgical site infection (SSI), creating a barrier to their use. This study aimed to evaluate the use of WICs in horses undergoing standing partial ostectomy surgeries, document complications and investigate if the incidence of SSI was equivalent between those horses that did and did not have a WIC. Methods: Clinical records were searched between January 2010-December 2023 for horses undergoing standing partial ostectomy surgery of thoracolumbar vertebral spinous processes at one institution. Population variables (age, breed, bodyweight), placement of a WIC or not, post-operative complications, analgesia protocols and surgical time were recorded. Horses received up to 0.1 mg kg-1 bupivacaine (0.5 mg mL-1) every 6-8 h via the WIC where one was placed. To compare SSI complication incidence between using or not using a WIC, a proportional independent equivalence test was used. Results: There were 64 horses included in the final analysis with a WIC placed in 29/64 horses (45.3%) and 35/64 (54.7%) having no WIC placed at surgery. Incidence of short-term SSI was 11.4% (no WIC used) and 13.8% (WIC used), respectively. The difference in proportion of SSI between the presence or absence of a WIC was not significant [-0.024 (90% CI -0.181; 0.133); p = 0.94]. Conclusion: The incidence of SSIs was equivalent between groups whether a WIC was used or not. WICs should be considered as part of a multi-modal analgesic approach in the post-operative period. Further research into local anesthetic dosing and its impact on rescue analgesia requirements and painscores is warranted. [ABSTRACT FROM AUTHOR]

Two injured wild Mohave desert tortoises (Gopherus agassizii) presented with hind leg lameness. A contaminated and infected bite wound exposed the coxofemoral joint in one individual. Dorsoventral, lateral, and craniocaudal radiographs produced reduced detail of the affected coxofemoral joint in each tortoise because of superimposition of soft tissue and the bones of the shell, pelvis, and femur. Radiotracking devices that had been epoxied to the shell also complicated diagnosis with traditional radiographic views. Based on a view described in birds, a craniodorsal–caudoventral 45° oblique image offered a superior view of the coxofemoral joint. This image was used to prescribe a femoral head ostectomy and verify successful completion following surgery. [ABSTRACT FROM AUTHOR]

BackgroundWound infusion catheters (WICs) have been used in humans and some veterinary species for post-operative local anesthetic administration following a variety of surgical procedures, aiming to reduce post-operative analgesia requirements and improve patient comfort. Benefit in reduction in pain, post-operative analgesia requirements and length of hospital stay are well documented in humans, but use of WICs may not have been widely adopted in veterinary species due to the concern of increased complications, such as dehiscence or surgical site infection (SSI), creating a barrier to their use. This study aimed to evaluate the use of WICs in horses undergoing standing partial ostectomy surgeries, document complications and investigate if the incidence of SSI was equivalent between those horses that did and did not have a WIC.MethodsClinical records were searched between January 2010–December 2023 for horses undergoing standing partial ostectomy surgery of thoracolumbar vertebral spinous processes at one institution. Population variables (age, breed, bodyweight), placement of a WIC or not, post-operative complications, analgesia protocols and surgical time were recorded. Horses received up to 0.1 mg kg−1 bupivacaine (0.5 mg mL−1) every 6–8 h via the WIC where one was placed. To compare SSI complication incidence between using or not using a WIC, a proportional independent equivalence test was used.ResultsThere were 64 horses included in the final analysis with a WIC placed in 29/64 horses (45.3%) and 35/64 (54.7%) having no WIC placed at surgery. Incidence of short-term SSI was 11.4% (no WIC used) and 13.8% (WIC used), respectively. The difference in proportion of SSI between the presence or absence of a WIC was not significant [−0.024 (90% CI −0.181; 0.133); p = 0.94].ConclusionThe incidence of SSIs was equivalent between groups whether a WIC was used or not. WICs should be considered as part of a multi-modal analgesic approach in the post-operative period. Further research into local anesthetic dosing and its impact on rescue analgesia requirements and pain-scores is warranted.

Objective: This article presents technical guidelines for perio‐restorative esthetic crown lengthening, along with a discussion of the biologic rationale. A classification system is proposed to assist in treatment planning and sequencing the surgical and restorative phases. Clinical Considerations: When esthetic crown lengthening is performed as an adjunct to restorative therapy, the surgical approach must be determined by the anticipated position of the restorative margins. The removal of sufficient bone to achieve the desired clinical crown length and preserve the supracrestal gingival tissue dimensions is facilitated by the use of a surgical guide fabricated according to the design of the restorations. A staged approach allows sequencing the provisional restoration to minimize unesthetic sequelae during the healing period. Inadequate bone resection and/or alteration of the soft tissue dimensions results in delayed healing, leading to coronal gingival rebound and biologic width impingement. Conclusion: The identification and preservation of appropriate restorative and biologic landmarks is essential for success in pre‐prosthetic esthetic crown lengthening treatment. A staged approach improves the esthetic management during the postsurgical healing and maturation period. Clinical Significance: A restorative driven classification system for sequencing and staging adjunctive esthetic crown lengthening procedures is presented. Technical guidelines to enhance gingival margin predictability are suggested, accompanied by relevant evidence. In addition, wound healing timelines following gingival and osseous resection are provided. [ABSTRACT FROM AUTHOR]

The reshaping of the nasal pyramid has evolved significantly over the past 20 years. Mechanical instruments have been refined to minimize the bone trauma of osteotomies. However, these instruments can inadvertently cause radiated fractures and comminuted fractures, which compromise bone stability and can create surface defects. Electric and piezoelectric instruments (PEI) have been developed to address these issues. PEI instruments are selective unlike electric instruments. These instruments allow for precise rhinosculpture and osteotomies under direct visual control. The article reviews the advantages and disadvantages of each method by comparing them for the most frequently performed procedures on the nasal bone pyramid in rhinoplasty., Competing Interests: Disclosures Consultant for Acteon., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Objectives: Crooked noses pose significant challenges in rhinoplasty due to their complex anatomy, particularly in the bony vault. Traditional methods focus on osteotomies but often do not equalize the lengths of the nasal bones. This study introduces a novel technique using otologic drills to address this problem by shortening the longer nasal bone and aligning the nasion-rhinion line at the midline. Methods: A Goodman incision was made to access the nasal bones under general anesthesia. Otologic drills were used for lateral and transverse ostectomies to shorten the longer nasal bone and reposition the nasal bone vault. Follow-ups were conducted 3, 6, and 12 months after surgery. Results: Of 48 cases (22 men and 26 women), 47 achieved satisfactory results with a straightened nose. One case showed a slight deviation after surgery, which did not require revision. Discussion : The technique effectively addresses the issue of asymmetric nasal bone lengths, which traditional methods often overlook. Using otologic drills allows precise bone cutting, contributing to long-lasting outcomes. Conclusions: Otologic drill-assisted ostectomies effectively equalize nasal bone lengths, improving nasal symmetry. More research with larger case series and long-term follow-up is needed to confirm the efficacy and safety of this technique, including potential applications in closed rhinoplasty., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: All authors contributed at every stage of the manuscript. The authors declared that they had no potential conflicts of interest regarding this article’s research, authorship, and publication.

Case Summary: An 8-year-old male neutered domestic shorthair cat was presented with an acute onset of left thoracic limb lameness and a firm swelling on the lateral aspect of the left distal antebrachium. A CT scan of the left thoracic limb revealed an expansile osteolytic cystic bone lesion centred at the distal left ulnar metaphysis. Cytology from fine-needle aspiration was not consistent with neoplasia. The CT features and the cytology results were suggestive of a bone cyst. A distal partial ulnectomy with ulnar styloid process excision was performed as the biopsy method and as the treatment approach. Histopathology results were consistent with an aneurysmal bone cyst (ABC). Carpal instability was not detected after distal partial ulnectomy; therefore, a stabilisation method was not required. Limb function was excellent after surgery, with no lameness and no recurrence detected by the owner at 2, 6 and 24 weeks postoperatively. The veterinary examination at 12 weeks postoperatively confirmed the owner's outcome assessment., Relevance and Novel Information: To the authors' knowledge, this is the first report describing a distal partial ulnectomy with ulnar styloid process excision in a cat. Despite disrupting the short ulnar collateral ligament, this technique provided excellent short-term limb function with no need for carpal joint stabilisation. This technique allowed for the complete excision of a distal ulnar ABC and avoided cyst debridement, which could be associated with haemorrhage, recurrence and malignant transformation. Distal partial ulnectomy should be considered for distal ulnar bone lesions in cats., Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)

Introduction Ultrasonic bone surgery, or piezosurgery, is a novel technique utilizing ultrasonic vibrations to cut bone while minimizing damage to adjacent soft tissues. This study aims to evaluate the knowledge and awareness of ultrasonic bone surgery among periodontology and oral surgery postgraduate students in Maharashtra, India. Methods A cross-sectional, questionnaire-based study was conducted among 180 postgraduate students (84 in periodontology and 96 in oral surgery). A Google Form questionnaire (Google LLC, Mountain View, CA, United States) with 15 close-ended questions was distributed via email. Data were analyzed using SPSS Statistics version 25 (IBM Corp. Released 2017. IBM SPSS Statistics for Windows, Version 25.0. Armonk, NY: IBM Corp.) employing frequency percentages and Pearson Chi-square tests for intergroup comparisons. Results Of the participants, 80 (95.3%) of periodontology and 91 (94.7%) of oral surgery postgraduates were aware of ultrasonic bone surgery. Significant differences were found in the knowledge of critical bone damage temperature (p=0.009) and postoperative complications (p=0.037), with periodontology postgraduates showing higher awareness. Both groups recognized ultrasonic bone surgery's precision, safety, and reduced trauma advantages. Overall knowledge and awareness were higher among periodontology postgraduates (n=84, 87.5%) than oral surgery postgraduates (n=96, 78.3%). Conclusion Both groups demonstrated a good understanding of ultrasonic bone surgery, with periodontology postgraduates showing notably higher awareness. These findings underscore the importance of integrating ultrasonic bone surgical techniques into dental education to enhance patient care and keep pace with technological advancements. Further studies with larger sample sizes across India are recommended., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Ethics Review Committee of Krishna Vishwa Vidyapeeth issued approval 201/2022-202. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Dongare et al.)

Background: Surgical treatment options for horses with overriding dorsal spinous processes include interspinous ligament desmotomy and partial spinous process ostectomy. The impact of spinal surgery on the three-dimensional biomechanics of the equine thoracolumbar spine and the epaxial musculature is unclear., Objectives: To investigate the influence of interspinous ligament desmotomy and cranial wedge ostectomy on the biomechanics of the equine thoracolumbar spine and the paraspinal Musculi multifidi., Study Design: Ex-vivo experiments., Methods: Twelve equine thoracolumbar spine specimens were mounted in a custom-made mechanical test rig. Based on computed tomographic imaging, distances between dorsal spinous processes and the spinal range of motion (lateral bending, axial rotation, flexion, extension) were compared before and after desmotomy and cranial wedge ostectomy performed at two or five surgical sites. Anatomical dissection was subsequently conducted to document surgical trauma to the Musculi multifidi following desmotomy., Results: The distance between spinous processes in neutral position did not increase significantly after desmotomy (median preoperative = 7.2 mm, interquartile range [IQR] = 3.6 mm; median postoperative = 7.4 mm, IQR = 3.7 mm; p = 0.09), but increased significantly after ostectomy (median preoperative = 8.8 mm, IQR = 4.2 mm; median postoperative = 13 mm, IQR = 6.1 mm; p < 0.001). Both surgical procedures significantly increased the rotational spinal range of motion (p = 0.001), particularly at the level T14/T15 (median preoperative = 6.4°, IQR = 3.2°; median postoperative = 8.2°, IQR = 3.5°; increase = 28.1%; p = 0.02). Musculi multifidi injury was evident at all desmotomy sites., Main Limitations: Ex-vivo study with limited sample size., Conclusions: Neither interspinous ligament desmotomy nor cranial wedge ostectomy resulted in an increased range of motion during flexion, extension or lateral bending but both procedures influenced the rotational component of the equine thoracolumbar spinal mobility., (© 2024 The Author(s). Equine Veterinary Journal published by John Wiley & Sons Ltd on behalf of EVJ Ltd.)