Use of the Modified Toggle Pin Technique for Management of Coxofemoral Luxation in Dogs: a Review of Literature and a Report of Two Cases

Use of the modified toggle pin technique for management of coxofemoral luxation in dogs: A review of literature and a report of two cases. The surgical technique described in this paper is a modification of toggle pin stabilization, which is an intracapsular reduction technique for displaced hip. The modification involves a different prosthesis to replace the ligament of the head of femur (LHF), which was made by braiding together 4 strands of lavzane – a non-absorbable, polyester, multifilamentous suture material. The braiding makes the prosthesis extra stretchable and elastic, which makes it more resistant to tension. At the same time it allows articular mobility and good healing of the joint. The surgical approach and technique for use of toggle pin for LHF were similar to those that have been described. In both clinical cases, no bandage was used postoperatively, and the patients started to use the affected limbs immediately after surgery. No postoperative complications associated with the surgical technique or the material occured. Both dogs were fully recovered by 30 days, one of the dogs had no lameness at 10 days already. Radiographic images at 6–7 months revealed moderate degenerative changes in one case, that showed no progression in 3 years. No radiographic abnormalities were observed in the other dog. The modified toggle pin technique can maintain coxofemoral reduction and allow early weight-bearing. As it requires no postoperative immobilization of the coxofemoral joint, it is a particular advantage in those animals with multiple orthopedic injuries (especially of the contralateral limb). According to the literature, the failure of the toggle pin technique occurs mostly due to the breakage of the suture. This modification might thus decrease the percentage of reluxation. Further studies are in progress to investigate the long-term efficacy of braided toggle material and the application of this method in different clinical cases.