Long‐term outcomes after pantarsal arthrodesis with medial plate fixation without external coaptation in 30 dogs

Abstract

Objective To report long‐term outcomes of dogs treated with pantarsal arthrodesis (PTA) with medial plate fixation without external coaptation. Study design Retrospective case series. Animals Client‐owned dogs (n = 30). Methods Medical records of dogs that had undergone a PTA with a medially applied plate without adjunctive rigid external coaptation were reviewed. Data collected included signalment, complications, and assessment of function at last physical examination. Follow‐up information was obtained by phone conversations with owners. Complications were classified as minor, major II, major I, and catastrophic. Results Thirty‐six PTA were performed in 30 dogs. Recorded complications included eight (22.2%) minor complications, 11 (30.6%) major II complications and 11 (30.6%) major I complications. One (2.8%) dog required amputation because of catastrophic complication. Owners provided follow‐up for 26 dogs at a median duration of 1215 days (range, 325‐3495) after surgery. The outcome was reported as full function in 12 dogs and acceptable function in 14 dogs, with no owners reporting unacceptable function. The owner of the dog in which amputation was required was not contacted. Incorrect contact details prevented owner follow‐up in the other three dogs, but all had acceptable function at last veterinary follow up. Conclusion Dogs treated with PTA by medially applied plate had a high incidence of complications requiring surgical or medical management, although full or acceptable function was achieved in 29 of 30 dogs. Clinical significance: Pantarsal arthrodesis offers a predictably good medium to long‐term outcome in spite of a high risk of complications.

Acute limb shortening and modified pantarsal arthrodesis for the treatment of a highly comminuted distal tibial articular fracture in a dog

“…The modified PTA described herein healed without complications. CCT thickening was observed postoperatively, as reported after traditional PTA [ 5 ], and was believed to be secondary to the acute tibial shortening.…”

“…The complications encountered herein included CCT thickening and persistent postoperative lameness, some of which may have been mechanical. The reason for the CCT tendinopathy is not entirely understood [ 4 5 ], with some investigators advocating a CCT tenotomy/tenectomy when performing PTA to prevent this complication [ 5 ]. In one study [ 5 ], one case was resolved with medical treatment, while two cases were treated with surgical transection [ 5 ].…”

“…The reason for the CCT tendinopathy is not entirely understood [ 4 5 ], with some investigators advocating a CCT tenotomy/tenectomy when performing PTA to prevent this complication [ 5 ]. In one study [ 5 ], one case was resolved with medical treatment, while two cases were treated with surgical transection [ 5 ]. In the present case, a conservative approach was elected, with improvement after four weeks of anti-inflammatory use.…”

“…In the present case, a conservative approach was elected, with improvement after four weeks of anti-inflammatory use. In the same study, a surgical site infection rate of 30.5% was documented for pantarsal arthrodesis [ 5 ]. Therefore, the authors prescribed postoperative cephalexin for 14 days after surgery.…”

“…Treatment of articular fractures involves anatomic reconstruction, rigid fixation to achieve perfect congruity of the articular surface and early return to function [ 2 3 ]. Arthrodesis is indicated if preserving a functional joint is impossible [ 2 4 5 ].…”