Management and treatment of feline tarsal injuries

Kulendra, Elvin; Arthurs, Gareth

doi:10.1136/inp.g1434

Cited by 10 publications

(15 citation statements)

References 14 publications

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“…It performed favourable when considering necessary implant stability while being less bulky in our reported light-weight fashion than other previously published configurations and systems, and therefore offered an improved comfort to the patient. 1,7 Primary internal repair was used for three purposes: first, to re-establish the congruency and stability of the joint; second, to maintain good articular reduction before TESF placement; and third, to mitigate the need for heavy and bulky TESF frames. Internal repair of the TCI may be particularly challenging due to the complex anatomy of this region, the small bone sizes and the difficulties to achieve an isometrically placed prosthesis.…”

Section: Discussionmentioning

confidence: 99%

“…Tarsocrural joint instabilities (TCI) involve malleolar fractures, collateral ligament ruptures and shearing injuries. [1][2][3] Reconstruction of the articular surface, restoration of anatomic joint alignment and joint stabilization are paramount to optimize outcome and limit the development of osteoarthritis. 4 Reduction of malleolar fractures is typically achieved by open reduction and internal fixation (ORIF) using pins and a tension band wire or a small lag screw.…”

Section: Introductionmentioning

confidence: 99%

“…4,5 Treatment modalities for collateral ligament ruptures include open reduction and internal stabilization using primary ligament suture and/or prosthetic ligament reconstruction, external coaptation, transarticular external skeletal fixation (TESF) or a combination of these. [1][2][3][6][7][8] Primary ligament suture should be attempted whenever possible. 9 Unfortunately, primary repair is not always feasible particularly when there is significant soft tissue damage.…”

Section: Introductionmentioning

confidence: 99%

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Tarsocrural Instability in Cats: Combined Internal Repair and Transarticular External Skeletal Fixation

2020

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Objective The aim of this study was to report outcomes after combined internal repair and transarticular external skeletal fixation (TESF) for the treatment of tarsocrural joint instabilities (TCI) in cats. Materials and Methods Open reduction of the tarsal joint was performed followed by combined (1) internal repair (tibial/ fibular malleolar osteosynthesis or primary ligament suture and/or prosthetic ligament repair) and (2) temporary TESF. Stability of the tarsus was determined at short-term follow-up (4–8 weeks postoperatively). Short-term complications were evaluated and midterm outcome assessed by an owner telephone questionnaire. Results Fourteen cats were included of which nine had open TCI. Median time for frame removal was 47 days. Eleven patients had satisfactory stability of the tarsus at short-term follow-up. Catastrophic complications occurred in three cats consisting of extensive skin necrosis of the paw with subsequent hindlimb amputation in two and multiple digit amputations in one cat. Major complications occurred in one cat with persistent TCI requiring pantarsal arthrodesis. Nine cat owners indicated a ‘full or acceptable’ outcome at midterm (median, 1.5 years). Conclusion Close monitoring in the postoperative period until TESF removal is important for early identification of complications. Despite good joint stability at short-term, persistent or recurrent lameness at midterm can occur.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Tarsocrural Instability in Cats: Combined Internal Repair and Transarticular External Skeletal Fixation

2020

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“…The straight branch of the medial collateral ligament is the tibiocentral ligament and inserts on the dorsomedial process of the central tarsal bone. 37 The lack of soft tissue in this area predisposes the joint to open fractures and luxations, and the tarsus is particularly prone to shearing injury. For these cats wound management is the immediate priority once the cat is stable.…”

Section: Hindlimb Joint Luxationsmentioning

confidence: 99%

Traumatic joint luxations in cats: Reduce, repair, replace, remove

Meeson¹,

Strickland

2021

Journal of Feline Medicine and Surgery

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Practical relevance: Traumatic joint luxations are usually associated with significant trauma and there may be concomitant systemic injury. Joints are unstable as a result of injury to one or more supporting structures and the clinician should aim to determine which structures are damaged with physical examination, diagnostic imaging and careful assessment under sedation/anaesthesia. The aim is to reduce the joint back to its anatomical position, and then to maintain this through repair of damaged structures. However, where this is not possible, replacement or removal (arthrodesis/excision arthroplasty) of the joint remain viable options. Clinical challenges: Owing to the small size of feline joints and the severity of damage often seen, surgical management of these cases can be challenging. The first priority is to ensure the patient is systemically well before embarking on any specific surgical treatment of a luxated joint. Cats also present challenges in the postoperative period and a lack of patient and owner compliance can be detrimental to postoperative outcomes. Aims: This article aims to help the reader diagnose joint luxations and to assist decision-making with an overview of the management and treatment options available. Evidence base: There are a number of original articles and textbook chapters in the literature covering aspects of different joint luxations, particularly for the more common luxations. This article draws on information from key feline research and, where necessary, extrapolates from relevant canine research. The authors also offer practical guidance based on their own clinical experience.

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“…The tarsal joint of these species is considerably complex, as it is constituted by the tibia, fibula, tarsal bones, metatarsal bones and the ligaments and fibrocartilage that maintain the bones attached together. Nevertheless, no thorough CT or MRI anatomic tarsal joint studies of non-domestic felines have been carried out so far, and that is why performing an adequate CT and MRI anatomical identification could prove extremely useful for the understanding of injuries depicted in felines [20–23]. This research has as principal objective the execution of a detailed anatomical description of a Bengal tiger’s tarsal joint by CT, MRI and anatomical dissections.…”

Section: Introductionmentioning

confidence: 99%

Computed tomography and magnetic resonance imaging study of a normal tarsal joint in a Bengal tiger (Panthera tigris)

Arencibia

Matos

Encinoso³

et al. 2019

BMC Vet Res

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Background In this research, using computed tomography (CT) and magnetic resonance imaging (MRI), we provide a thorough description of the standard appearance of a right tarsal joint in a Bengal tiger ( Panthera tigris ). CT scans were performed using a bone and soft tissue window setting, and three-dimensional surface reconstructed CT images were obtained. The MRI protocol was based on the use of Spin-echo (SE) T1-weighted and Gradient-echo (GE) STIR T2-weighted pulse sequences. Magnetic resonance (MR) images were taken in the transverse, sagittal and dorsal planes. We also performed anatomical dissections to facilitate the interpretation of the different structures of the tarsus joint and allow comparisons with CT and MRI images. Results The CT images allowed us to observe differences between the bones and soft tissues of the tarsal joint. When applying the bone window setting, the obtained footage showed the anatomy between the medulla and cortex. Additionally, the trabecular bone was delineated. By contrast, the soft tissue window allowed the main soft tissue structures of the tarsal joint, including ligaments, muscles and tendons, to be differentiated. Footage of the main anatomical structures of the standard tiger tarsus was obtained through MRI. The SE T1-weighted images showed the best evaluation of the cortical, subchondral and trabecular bone of the tibia, fibula, tarsus and metatarsus bones. Nonetheless, the GE STIR T2-weighted images allowed us to better visualize the articular cartilage and synovial fluid. In both MRI pulse sequences, the ligaments and tendons appeared with low signal intensity compared with muscles that were visible with intermediate signal intensity. Conclusions The results of this CT and MRI study of the Bengal tiger tarsal joint provide some valuable anatomical information and may be useful for diagnosing disorders in this large non-domestic cat.

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Management and treatment of feline tarsal injuries

Cited by 10 publications

References 14 publications

Tarsocrural Instability in Cats: Combined Internal Repair and Transarticular External Skeletal Fixation

Tarsocrural Instability in Cats: Combined Internal Repair and Transarticular External Skeletal Fixation

Traumatic joint luxations in cats: Reduce, repair, replace, remove

Computed tomography and magnetic resonance imaging study of a normal tarsal joint in a Bengal tiger (Panthera tigris)

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