Avian Surgical Techniques - BSAVA2012 - VIN https://www.vin.com/apputil/content/defaultadv1.aspx?pId=11349&catI...

WSAVA/FECAVA/BSAVA W C 2012
Neil A. Forbes, BVetMed, DECZM(Avian), FRCVS, RCVS & European Recognised Specialist Avian Medicine
Great Western Exotic Vets, Vets Now Referrals Hospital, County Park Estate, Swindon

As this is an advanced lecture, the author will take correct equipment and surgical
handling techniques as read, e.g., use of magnification, illumination, sitting position
with forearm support and instrument actions by finger rolling rather than forearm
movements.
Avian Orthopaedic Surgery

Triage is the starting point of any potential avian orthopaedic surgery. Decision
making is based on species, lifestyle and degree of perfection required in respect of
the patients needs, bearing in mind the prognosis. The main deciding factors are:
normal eyesight, compound or closed fracture, and proximity to the joint. Techniques
must achieve longitudinal, lateral and rotational stability, whilst causing the minimal
amount of collateral damage. If a fracture can be stabilised without even opening the
fracture site, so much the better. The simplest and least invasive technique is likely
to be optimal. Timing is important, and whilst stabilisation (to minimise pain, prevent
further trauma occurring etc.) is vital, it is also important to consider the stress the
patient has already undergone and not to do too much too soon. The vast majority
of avian fracture cases will have a better outcome if surgery is delayed for 24 hours
whilst stabilisation is achieved, taking into account the management of pain,
infection and stress.
There is no one 'right way to tackle each case'; the avian surgeon must be
prepared to adapt and modify well tried and tested techniques, in order to develop
the best fix for each case, i.e., on a case-by-case basis. A technique should be used
which will allow normal movement of the affected limb within 48 hours of surgery. In a
well aligned and immobilised avian fracture, healing is by endosteal callous and
should be complete in 3–4 weeks.
The author's preferred technique is the tie-in or hybrid fixator, which can be
modified to include a pin and tension wire, or cross-pin technique (for fractures close
to the joint), or as required in other bones and situations. In essence a surgical
approach is made to the fracture site, an intramedullary pin (no greater in diameter
than one-third of the medulla) is inserted and advanced normo- or retrograde to exit
the bone, with the most minimal risk of causing iatrogenic joint damage. The fracture
is reduced and the pin passed back into the opposite medulla. The skin is closed.
External fixator pins are then placed in the most appropriate position, with at least
two pins either side of the fracture. The exposed end of the intramedullary pin is bent
through 90 degrees and joined with all external fixator pins using an external fixator
bar. In many cases the intramedullary pin can be removed after 10 days, and all
metalwork 18 days later.
Developmental Skeletal Problems

These should, in general terms, be corrected as early as possible, before long bone
abnormalities lead to joint changes or complications. Developmental problems may
be caused by metabolic bone disease, abnormal positions in the egg during

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Avian Surgical Techniques - BSAVA2012 - VIN https://www.vin.com/apputil/content/defaultadv1.aspx?pId=11349&catI...

incubation, trauma, abnormal nest substrate, excessive rates of growth or excessive

weightbearing at too early an age. Scissor beak and bragnathism also require
correction whilst the chick is still young and the beak is soft. The aim in all such
cases is to create dental acrylic ramps or beak extensions to force the beak to be
used in the normal position. So long as this is achieved, then natural correction is
likely to occur within 10 days.
Soft Tissue

As in all species, a good anatomical knowledge and good planning and preparation
are essential. Prognosis is improved greatly by use of magnification, illumination,
efficient retractors (e.g., Lone Star), haemoclips, radiosurgery and suction. Standard
soft tissue surgical procedures include: ingluviotomy, laparotomy for
proventriculotomy, salpingohysterectomy, orchidectomy, enterotomy, liver biopsy,
lung biopsy or caesarean section. Whilst cloacal surgeries such as cloacopexi,
cloacoplasty and cloacotomy are still on occasions indicated, the underlying cause
is typically behavioural, which must be addressed as a priority. Other common
surgical techniques include the management of bumblefoot, feather cyst removal,
preen gland surgery and skin wounds, defects or neoplasia.

S I
(click the speaker's name to view other papers and abstracts submitted by this speaker)

Neil A. Forbes, BVetMed, DECZM(Avian), FRCVS, RCVS, European Recognised

Specialist Avian Medicine (/apputil/content/defaultadv1.aspx?pId=11349&
authorId=50639)
Great Western Exotic Vets
Vets Now Referrals Hospital
Swindon, UK

URL: https://www.vin.com/doc/?id=5328310 (https://www.vin.com/doc/?id=5328310)

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