Multi-centre retrospective study of the long-term outcome following suspected traumatic elbow luxation in 32 cats

Locking Compression Plate Fixation of Feline Acetabular Fractures: Application, Complications and Perioperative Outcome

OBJECTIVES

 The aim of this study was to report the use, complications and perioperative outcome of locking compression plates (LCP) for acetabular fracture fixation in feline patients.

STUDY DESIGN

 Medical records were reviewed for cats presented with acetabular fractures between 2011 and 2019. Only cases that involved open reduction and internal fixation with at least one LCP and had a minimum of 5-week postoperative follow-up were included. Long-term follow-up was based on the Feline Musculoskeletal Pain Index.

RESULTS

 Fifteen cats with 15 acetabular fractures met the inclusion criteria. Locking compression plates were used as a sole method of fixation in 11/15 cases, while with other ancillary implants in 4/15 cases. There were two minor complications related to the LCP consisting of a single screw backing out. Two major perioperative complications not related to the locking implants were described and required further surgical treatment. At the last clinical follow-up (median 46 days: 38-88 days), function was described as full for 7/15 cats, and acceptable for 8/15 cats. The Feline Musculoskeletal Pain Index questionnaire was completed by 9/15 owners at a median of 2,332 days; all owners reported their cats had minimal impairment.

CLINICAL SIGNIFICANCE

 Based on our results, LCP is a suitable implant for acetabular fracture fixation in cats, associated with a satisfactory outcome. Complications were similar to previously reported with other methods.

Surgical stabilization of traumatic elbow joint luxation and proximal ulnar fracture in a silvery langur (Trachypithecus cristatus)

CASE DESCRIPTION

A 3-year-old 5-kg sexually intact female silvery langur housed in a single-species group at a zoological institution was presented because of acute trauma to the left forelimb.

CLINICAL FINDINGS

Radiography of the left forelimb revealed a type II Monteggia fracture (proximal ulnar fracture with cranial displacement and caudal luxation of the radial head). During surgery, disruption of the annular ligament and rupture of the lateral collateral ligament were noted.

TREATMENT AND OUTCOME

The langur underwent open reduction and internal fixation of the ulnar fracture and placement of a radioulnar positional screw, a prosthetic lateral collateral ligament, and a temporary hinged type 1A external skeletal fixator. The langur was returned to group housing, underwent behavioral training, and was periodically anesthetized for physical therapy sessions to improve range of motion of the left elbow joint. The external skeletal fixator was removed 4 weeks after surgery, and the radioulnar positional screw was removed 6 weeks after surgery. Three months after surgery, the range of motion of the langur's left elbow joint was considered normal, and the animal returned to normal activity.

CLINICAL RELEVANCE

For the captive silvery langur of the present report, surgical stabilization and postoperative management of a type II Monteggia fracture of the left forelimb were successful with recovery of elbow joint function. These techniques may be applied to other captive nonhuman primates, including those that brachiate or are members of social species that must be housed with conspecifics in the postoperative period to maintain group dynamics.

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

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.