PMC6005288_01
Subluxation of the left intertarsal joint with dynamic varus deviation of the distal limb in an adult male bateleur eagle (Terathopius ecaudatus).
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Physical examination revealed firm periarticular enlargement, reduced range of motion, subluxation, and dynamic varus deviation at the left intertarsal joint (Figure 1).
Sequential radiographs of an adult male bateleur eagle (Terathopius ecaudatus) with chronic left intertarsal joint instability performed prior to and following unsuccessful and successful surgical stabilization procedures using a novel application of a braided suture and titanium button system (Arthrex, Inc., Naples, USA). (a-c) Presurgical radiographs demonstrating subluxation of the left intertarsal joint, varus deviation of the distal limb, and associated degenerative joint disease at the left intertarsal joint using (a) standard dorsoplantar view, (b) stress dorsoplantar view (b), and standard lateral view. (d-f) Radiographs performed 7 weeks following unsuccessful surgical stabilization of the left intertarsal joint revealing suboptimal positioning of the stabilization implants and persistent subluxation of the left intertarsal joint using (d) standard dorsoplantar view, (e) stress dorsoplantar view, and (f) standard lateral view. (g and h) Postoperative radiographs following successful surgical stabilization of the left intertarsal joint showing resolution of subluxation and appropriate positioning of stabilization implants using (g) standard dorsoplantar view and (h) standard lateral view.
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Orthogonal view radiographs of the pelvic limbs revealed muscle atrophy of the left hindlimb, moderate soft-tissue expansion around the left intertarsal joint with an uneven joint space that was widened at its lateral and narrowed at its medial aspects on the dorsoplantar radiographic view, and evidence of degenerative joint disease at this joint (Figure 2). Stress radiographs of the distal limbs were performed, confirming subluxation at the left intertarsal joint (Figure 2). Radiographs confirmed suboptimal positioning of the previously placed joint stabilization implants, and persistent subluxation of the left intertarsal joint was demonstrated in stress radiographic views (Figure 2). Postoperative radiographs indicated appropriate positioning of the stabilization implants (Figure 2).
Illustration of the dorsal (anterior) aspect of the left intertarsal joint depicting novel application of a braided suture and titanium button system for surgical stabilization of left intertarsal joint instability in an adult male bateleur eagle (Terathopius ecaudatus). The braided suture was passed from the lateral aspect of the intertarsal joint through two intraosseous tunnels created at the distal tibiotarsus and proximal tarsometatarsus. Each end of the suture was threaded through both holes of a 2-hole titanium button and passed back through each respective intraosseous tunnel. The suture was then tightened to an appropriate tension and secured using a surgeon's knot.
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A 30 ga. needle was placed into the intertarsal joint space to confirm its location, and a 2 mm drill bit was used to make an intraosseous tunnel through both cortices of the distal tibiotarsus extending proximomedially from the distolateral aspect of the metaphysis (Figure 3). A flexible suture passer was used to shuttle a single strand of braided suture material (#2 Arthrex FiberWire , Arthrex, Inc., Naples, USA) from the lateral entry points of both intraosseous tunnels to the medial exit points at both bones (Figure 3).