Objectives The objective was to assess the medium- and long-term outcomes (radiographic and owner questionnaire) of feline tibial diaphyseal fractures with orthogonal plate fixation via a minimally invasive plate osteosynthesis (MIPO) approach. Methods Medical records and radiographs of cats that had tibial diaphyseal fractures stabilised with orthogonal plates were obtained (2012-2016). Immediate postoperative radiographs were reviewed to assess the construct configuration and follow-up radiographs (where available) were used to assess bone healing and implant-related complications. An owner-completed questionnaire (feline musculoskeletal pain index [FMPI]) was used at a minimum of 6 months following surgery to assess the cats' ability to perform normal activities. Results Eight feline tibial diaphyseal fractures met the inclusion criteria. One major complication was observed, most likely due to an operative technical error. There were no further complications following revision surgery. Six of the eight cases that had radiographic follow-up either had clinical bone union or showed evidence of bone healing. All cases were classified as successful according to FMPI. Conclusions and relevance Orthogonal plating of feline tibial diaphyseal fractures via an MIPO approach resulted in successful outcomes and a lower complication rate compared with previously reported techniques.

To assess screw loosening and pelvic narrowing following the use of locking implants to stabilise ilial body fractures in cats and small dogs. Review of clinical records and post operative and follow up radiography of 12 cats and five small dogs to evaluate accuracy of fracture reduction, screw purchase and subsequent screw loosening and reduction in pelvic diameter. No screw loosening or reduction in pelvic diameter was observed at follow up. Locking T-plates may prevent complications reported following the use of conventional implant systems for the repair of ilial fractures in cats and small dogs.

Practical relevance: Cats frequently present with diaphyseal fractures, which require treatment in order to achieve a good return to function. These fractures often occur due to significant trauma; for example, as a result of road traffic accidents, high-rise syndrome and dog bite wounds. The first priority is to ensure the patient is systemically well before embarking on any specific surgical treatment of a fracture. Clinical challenges: Surgical management of diaphyseal fractures can be challenging due to the surgical approach for some bones being technically demanding, for example because of the presence of important neurovascular structures, and the small size of feline bones, which limits the choice of implant size and strength. Further, it may be difficult to visualise fracture alignment when using minimally invasive techniques, although the use of intraoperative fluoroscopy can aid with this, and malalignment can be common for some fracture repairs, particularly in cases where anatomical reconstruction is not possible. Aims: This review focuses on diaphyseal long bone fractures and aims to assist decision-making, with an overview of the management and treatment options available. Evidence base: Many textbooks and original articles have been published on aspects of managing fractures in small animals. The authors also provide recommendations based upon their own clinical experience.

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such complicating factors as variable absorption or distribution.Two important features emerge from this study. Firstly, our findings confirm observations'0"1 of an age-related decline in microsomal oxidation rates in man. Secondly, they show that in a population exhibiting this decline acetylation does not change with age. Thus, there are pharmokinetic grounds in the elderly for reducing the dose of drugs that are metabolised by oxidation, but this does not seem to apply to drugs metabolised by acetylation. Indeed, in so far as the latter pathway is concerned, not only was there no observed difference in acetylator phenotype in the two groups but there was also no apparent difference within the phenotypes, or in antimodes between the populations. These findings do not therefore support the hypothesis that heterozygotes for acetylation have a survival advantage to old age. Nor do they support the hypothesis that there is a general decline of liver function with advancing age in man.'We thank Mrs L Pulmann and Mr D B Henderson for technical help; Dr A J Cassells-Smith and the department of clinical biochemistry, Newcastle General Hospital, for undertaking the routine laboratory investigations; colleagues in the department of geriatric medicine, Newcastle General Hospital; and the Newcastle Area Health Authority (Teaching) for financial support.