Use of circular external skeletal fixator constructs to stabilize tarsometatarsal arthrodeses in three dogs

Abstract

SummaryThis report describes the use of circular external skeletal fixator (CESF) constructs for the stabilization of unilateral tarsometatarsal arthrodeses in three dogs with traumatic intertarsal or tarsometatarsal fracture/luxation injuries. The application of the CESF was performed following a limited approach to the intertarsal and tarsometatarsal joints. All three of the dogs developed post-operative wire tract inflammation with drainage and two dogs developed osteomyelitis. These complications resolved with systemic antibiotic administration, debridement, and/or wire removal, after which all of the dogs tolerated the CESF well and resumed weight-bearing on the affected limb. The mean time to CESF removal was 16 weeks. The CESF construct provided sufficient stabilization for progressive union of the tarsometatarsal arthrodeses with a good long-term functional outcome in all three of the dogs.

Postoperative complications associated with external skeletal fixators in cats

“…[9][10][11] Implant failures include pin loosening, breakage or bending; clamp loosening; and connecting bar breakage. FAC rates in dogs of up to 100% have previously been reported; 8,12 more recent studies in cats have reported lower complication rates, ranging from 26-65%. 4,5,13,14 While individual studies have evaluated different ESF types at specific anatomical locations in defined groups of animals, it remains difficult to compare overall ESF complication rates.…”

“…9–11 Implant failures include pin loosening, breakage or bending; clamp loosening; and connecting bar breakage. FAC rates in dogs of up to 100% have previously been reported; 8,12 more recent studies in cats have reported lower complication rates, ranging from 26–65%. 4,5,13,14…”

“…other studies have also shown the tarsus to be a common region for the development of FACs. 2,12,18 Tarsal ESFs are mechanically vulnerable, being subject to significant transarticular bending forces as they cross the flexed tarsocrural joint. Also, relatively small pins may have to be placed in the metatarsal bones, further increasing the construct's vulnerability to mechanical failure.…”

Short-term outcome after treatment of talocrural instability in cats using modified type II transarticular external skeletal fixation

“…It has been recommended that primary ligament repair should be accomplished as the treatment of choice whenever possible. Otherwise, prosthetic ligament reconstruction may mimic the ligament's action and ensure joint stability while allowing a suitable range of motion 2 , 10 , 18 , 36 . In this study, TESF was combined with primary ligament repair in 18 cats and with ligament prostheses in one cat.…”