Practical relevance: The femur is the most commonly fractured bone in cats. Femoral fractures usually result from high-velocity trauma such as a road traffic accident or fall from a height and, as such, are associated with a wide variety of concurrent injuries. The initial focus of treatment should always be on assessment and stabilisation of the major body systems. Once any concurrent injuries have been addressed, all femoral fractures need surgical stabilisation, with the notable exception of greenstick fractures in very young cats, which can heal with cage rest alone. A number of different surgical options are available depending on the fracture type, location, equipment, surgeon experience and owner finances. Clinical challenges: Femoral fractures can vary hugely in complexity and the small size of feline bones can limit the choice of implants. Furthermore, cats can present unique challenges in the postoperative period due to their active nature and the limited means to control their exercise level. Audience: This review is aimed at general and feline-specific practitioners who have some experience of feline orthopaedics, as well as those simply wishing to expand their knowledge. Aims: The aim of this review is to help clinicians assess, plan and manage feline femoral fractures. It provides an overview of diagnostic imaging and a discussion of a range of suitable surgical options, including the principles of different types of fixation. It also highlights cat-specific issues, approaches and implants pertinent to the management of these cases. Evidence base: A number of original articles and textbook chapters covering many aspects of femoral fractures in cats and dogs have been published. Where possible, this review draws on information from key feline research and, where necessary, extrapolates from relevant canine literature. The authors also offer practical guidance based on their own clinical experience.
This study describes the surgical management of a traumatic scapular avulsion including complications and clinical outcome in a 3-year-old Maine Coon cat. Traumatic scapular avulsion was diagnosed clinically and confirmed on a computed tomography scan, alongside severe scapula displacement. The scapula was stabilized surgically by the placement of two circumcostal sutures, through paired bone tunnels drilled both cranial and caudal to the base of the scapular spine, and two sutures passing through bone tunnels in the dorsal border of the scapula bone secured to the serratus ventralis muscle. The cat was able to bear weight on the affected limb within 48 hours of surgery; however, limb function subsequently deteriorated at home. Revision surgery was required 14 days postoperatively to replace failed polydioxanone suture with ultra-high molecular weight polyethylene suture (Fiberwire). Following revision surgery, the cat had a very acceptable functional outcome, with scapular stability and only intermittent lameness/stiffness noted in the medium-term follow-up. The present case report demonstrates that the described modified surgical technique may be used successfully in the treatment of scapular avulsion in cats and restores acceptable function to the affected limb.
Objective The aim of this study was to categorize the presentation, management, complications and long-term outcome of canine acetabular fractures, and to determine the factors affecting outcome. Materials and Methods Case records and imaging for dogs with acetabular fractures were reviewed with long-term follow-up via canine brief pain inventory (CBPI) and owner questionnaires. Results The majority of fractures were in the mid-third (36/52) and caudal-third (13/52) with few in the cranial-third of the acetabulum (3/52). Concurrent injuries were diagnosed in 47/49 dogs; 10/34 dogs had neurological deficits on presentation. Forty-seven fractures received treatment: 25/47 had direct surgical repair (DSR), 10/47 had salvage surgery (SS) and 12/47 had conservative management (CM). Fracture location significantly affected treatment group (p = 0.001). New neurological deficits were documented after DSR in 5/24 dogs and SS in 2/10 dogs. Short-term complications occurred after DSR in 10/18 dogs (five minor, five major) and CM in 1/8 dogs (major). Long-term complications occurred after DSR in 2/15 dogs (major) and CM in 2/7 dogs (catastrophic). Conservative management dogs had worse average owner-reported CBPI scores than DSR or SS dogs. Clinical Significance Acetabular fractures predominate in the mid and caudal acetabulum, with high levels of concurrent injuries. Fracture location significantly influenced the treatment approach taken. Postoperative neurological deficits are common following SS and DSR.
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