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Danielski et al: Complications after proximal abducting ulnar osteotomy and prognostic factors in 66 dogs
Veterinary Surgery 1, 2022

🔍 Key Findings

  • Major complications occurred in 25.6% of limbs treated with PAUL, including non-union, implant failure, and infection requiring revision surgery.
  • Increased body weight was significantly associated with a higher risk of complications (7% increased risk per additional kg; p = .04).
  • Post-operative radiographic assessment was unreliable in predicting complications; inter-observer agreement was poor (kappa ≤ 0.12).
  • Expert evaluation of implant or reduction errors had low predictive value (k < 0.2) for postoperative complications.
  • Common major complications included non-union (6 limbs), screw breakage, and surgical site infections.
  • Implant removal was required in 11.5% of limbs, mostly due to non-union or infection.
  • Being a Labrador appeared protective on univariate analysis, but not on multivariate analysis after adjusting for weight.
  • Radiographs showing suboptimal plate placement or osteotomy reduction did not reliably correlate with actual complication occurrence.

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← Articles

Danielski et al: Complications after proximal abducting ulnar osteotomy and prognostic factors in 66 dogs
Veterinary Surgery 1, 2022

🔍 Key Findings

  • Major complications occurred in 25.6% of limbs treated with PAUL, including non-union, implant failure, and infection requiring revision surgery.
  • Increased body weight was significantly associated with a higher risk of complications (7% increased risk per additional kg; p = .04).
  • Post-operative radiographic assessment was unreliable in predicting complications; inter-observer agreement was poor (kappa ≤ 0.12).
  • Expert evaluation of implant or reduction errors had low predictive value (k < 0.2) for postoperative complications.
  • Common major complications included non-union (6 limbs), screw breakage, and surgical site infections.
  • Implant removal was required in 11.5% of limbs, mostly due to non-union or infection.
  • Being a Labrador appeared protective on univariate analysis, but not on multivariate analysis after adjusting for weight.
  • Radiographs showing suboptimal plate placement or osteotomy reduction did not reliably correlate with actual complication occurrence.

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Multiple Choice Questions on this study

In Danielski 2022 et al., on PAUL complications, what percentage of limbs experienced major complications?

A. 5%
B. 12%
C. 18%
D. 25%
E. 35%

Answer: 25%

Explanation: Major complications occurred in ~25.6% of treated limbs.
In Danielski 2022 et al., on PAUL complications, which factor was significantly associated with increased risk of post-operative complications?

A. Use of post-op bandaging
B. Sex of the dog
C. Age at surgery
D. Body weight
E. Implant size

Answer: Body weight

Explanation: Heavier dogs had a 7% increased risk of complications per kg.
In Danielski 2022 et al., on PAUL complications, what was the most commonly observed major complication?

A. Delayed union
B. Ulnar fracture at plate end
C. Screw loosening
D. Non-union
E. Surgical site seroma

Answer: Non-union

Explanation: Non-union occurred in 6 limbs and was the most common major complication.
In Danielski 2022 et al., on PAUL complications, what did the study reveal about expert prediction of complications based on post-op radiographs?

A. Experts could predict complications with high accuracy
B. Experts agreed in most assessments
C. Inter-observer agreement was moderate
D. Post-op radiographs were poorly predictive
E. Plate placement was a reliable predictor

Answer: Post-op radiographs were poorly predictive

Explanation: Experts had poor agreement (k ≤ 0.12) and low predictive ability.
In Danielski 2022 et al., on PAUL complications, what was the inter-observer agreement (kappa) for predicting complications from radiographs?

A. 0.65
B. 0.45
C. 0.23
D. 0.11
E. 0.00

Answer: 0.11

Explanation: Kappa values were as low as 0.11, indicating poor agreement between experts.

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