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Fitzpatrick N, Guthrie JW, Hamilton MH. External skeletal fixation for the treatment of pelvic fractures in cats. Vet Surg 2024. [PMID: 38952025 DOI: 10.1111/vsu.14132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 05/25/2024] [Accepted: 06/08/2024] [Indexed: 07/03/2024]
Abstract
OBJECTIVE To report the technique and the outcome for the repair of pelvic fractures in cats using external skeletal fixation (ESF). STUDY DESIGN Retrospective case series. ANIMALS Client-owned cats (n = 125). METHODS Medical records of cats with pelvic fractures, treated with an ESF between June 2001 and June 2009, were reviewed. Preoperative, immediate postoperative, and more than 4 weeks' postoperative radiographs were compared. Clinical examination was performed 4 to 9 weeks following surgery. Longer term follow up (4 to 80 months) was conducted by client questionnaire. RESULTS No intraoperative complications occurred. There was no change in the pelvic canal width observed on follow-up radiographs (p = .16). Implant loosening was noted on follow-up radiographs in 16/125 (13%) of cases, and 67/803 (8%) pins were palpably loose at the time of frame removal. The mean time to frame removal was 37 ± 9 days. No long-term complications were reported. Long-term mean mobility score was 95 ± 5 and median lameness was 0 (range: 0-2). CONCLUSION An ESF may be successfully applied for the stabilization of various pelvic fractures in cats. CLINICAL SIGNIFICANCE The application of an ESF for the management of pelvic fractures in cats provides good outcomes.
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Jourdain M, Fernandes D, Védrine B, Gauthier O. Fluoroscopically-assisted closed reduction and percutaneous fixation of sacroiliac luxations in cats using 2.4 mm headless cannulated compression screws: Description, evaluation and clinical outcome. Vet Surg 2024; 53:603-612. [PMID: 38240128 DOI: 10.1111/vsu.14070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 11/14/2023] [Accepted: 12/23/2023] [Indexed: 05/12/2024]
Abstract
OBJECTIVE To describe fluoroscopically-assisted closed reduction and percutaneous fixation of sacroiliac-luxation (SIL) in cats and report radiographic results and long-term functional outcomes. STUDY DESIGN Retrospective clinical study. ANIMALS Eleven cats. METHODS Percutaneous fixation of 17 SILs in 11 cats was performed with 2.4 mm headless cannulated compression screws under fluoroscopic guidance. Luxation-reduction, screw placement and purchase within the sacral body, pelvic canal diameter ratio (PCDR) and hemipelvic canal width ratio (HCWR) were assessed on pre- and postoperative radiographs. Radiographic follow-up was performed to assess the same parameters when available. Long-term clinical outcome was evaluated with an owner questionnaire. Wilcoxon paired-test was performed for comparison. RESULTS Mean age and bodyweight of the cats were 3.3 ± 2.6 years and 4.0 ± 0.82 kg, respectively. Nine cats presented with concurrent pelvic injuries. Median luxation-reduction was 94.1% (IQR = 13.9) and median screw-purchase within the sacral body was 73.3% (IQR = 17.0) immediately postoperatively. One screw exited the sacral body caudally. Upon 7-week radiographic follow-up, luxation-reduction (88.3%, IQR = 20.1) and screw-purchase (70.7%, IQR = 12.8) had decreased compared to immediately postoperatively (p = .008 and p = .013 respectively). Screw migration was not observed. PCDR and HCWR measured on postoperative radiographs indicated successful restoration of the pelvic canal width. Owners reported an excellent long-term functional outcome (mean postoperative time: 19 ± 5 months). CONCLUSION Fluoroscopically-assisted closed reduction and fixation of feline SIL using 2.4 mm headless cannulated compression screws allowed good reduction and optimal screw purchase within the sacral body. An excellent functional outcome was reported. CLINICAL SIGNIFICANCE Minimally invasive reduction and fixation with headless compression screws should be considered in cats with SIL.
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Affiliation(s)
- Mathieu Jourdain
- Small Animal Surgery Department, Veterinary Hospital, Oniris College of Veterinary Medicine Food Science and Engineering, Nantes, France
| | | | | | - Olivier Gauthier
- Small Animal Surgery Department, Veterinary Hospital, Oniris College of Veterinary Medicine Food Science and Engineering, Nantes, France
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Dell'Apa D, Auletta L, Okonji S, Cauduro A, Dondi M, Opreni M, Gandini G, Bianchi E. Traumatic and iatrogenic sciatic nerve injury in 38 dogs and 10 cats: Clinical and electrodiagnostic findings. J Vet Intern Med 2024; 38:1626-1638. [PMID: 38634245 PMCID: PMC11099794 DOI: 10.1111/jvim.17076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 04/01/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Reports describing sciatic nerve injuries (SNI) and their outcome are scarce in veterinary medicine. HYPOTHESIS Describe the causes of traumatic and iatrogenic SNI and evaluate which clinical and electrodiagnostic findings predict outcome. ANIMALS Thirty-eight dogs and 10 cats with confirmed SNI referred for neurologic and electrodiagnostic evaluation. METHODS Clinical and electrodiagnostic examination results, including electromyography (EMG), motor nerve conduction studies, muscle-evoked potential (MEP), F-waves, sensory nerve conduction studies, and cord dorsum potential (CDP), were retrospectively evaluated. Quality of life (QoL) was assessed based on owner interviews. RESULTS Surgery (42%) and trauma (33%) were the most common causes of SNI; in dogs, 24% were caused by bites from wild boars. Ability to flex and extend the tarsus was significantly associated with positive outcome in dogs. Mean time from onset of clinical signs until electrodiagnostic evaluation was 67 ± 65 (range, 7-300) days and 65 ± 108 (range, 7-365) days for dogs and cats, respectively. A cut-off amplitude of 1.45 mV for compound motor action potentials (CMAP) was predictive of positive outcome in dogs (P = .01), with sensitivity of 58% and specificity of 100%. CONCLUSIONS AND CLINICAL IMPORTANCE Clinical motor function predicts recovery better than sensory function. Electrodiagnostic findings also may play a role in predicting the outcome of SNI. Application of the proposed CMAP cut-off amplitude may assist clinicians in shortening the time to reassessment or for earlier suggestion of salvage procedures. Owners perceived a good quality of life (QoL), even in cases of hindlimb amputation.
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Affiliation(s)
| | - Luigi Auletta
- Department of Veterinary Medicine and Animal Sciences (DIVAS)University of MilanMilanItaly
| | - Samuel Okonji
- Department of Veterinary Medical ScienceUniversity of BolognaBolognaItaly
| | | | - Maurizio Dondi
- Department of Veterinary ScienceUniversity of ParmaParmaItaly
| | | | - Gualtiero Gandini
- Department of Veterinary Medical ScienceUniversity of BolognaBolognaItaly
| | - Ezio Bianchi
- Department of Veterinary ScienceUniversity of ParmaParmaItaly
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Flores JA, Rovesti GL, Rodriguez-Quiros J. A Bilateral Acetabular Physeal Fracture Treated with External Fixation in an Immature Cat. Animals (Basel) 2024; 14:379. [PMID: 38338023 PMCID: PMC10854531 DOI: 10.3390/ani14030379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 01/14/2024] [Accepted: 01/23/2024] [Indexed: 02/12/2024] Open
Abstract
This study aimed to assess the outcome of a bilateral acetabular physeal fracture treated with external fixation in an immature cat, a surgical technique not usually employed in immature patients. The fixator took 40 days, and it was removed after radiographic bone healing was achieved. No significant complications related to the technique were identified, and the outcome was classified as good based on the functional assessment and pain scales employed. The use of external fixation for stabilising acetabular fractures in immature cats should be considered a viable technical option, especially for minimally invasive stabilisation.
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Affiliation(s)
- Jose Antonio Flores
- Hospital Veterinario IVC Evidensia Prïvet, Calle Duero 37, Villaviciosa de Odón, 28670 Madrid, Spain
| | - Gian Luca Rovesti
- Clinica Veterinaria M. E. Miller, Via della Costituzione 10, 42025 Cavriago, Italy
| | - Jesus Rodriguez-Quiros
- Departamento de Medicina y Cirugía Animal, Facultad de Veterinaria, Universidad Complutense de Madrid, Avda. Puerta de Hierro s/n, 28040 Madrid, Spain
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Emilian Adrian D, Genoni S, Morrison S, Whitelock R. Use of Locking Plates Fixed with Cortical Screws for Pelvic Fracture Repair in 20 Cats. Vet Comp Orthop Traumatol 2024; 37:50-56. [PMID: 37696299 DOI: 10.1055/s-0043-1771190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/13/2023]
Abstract
OBJECTIVE The aim of this study is to describe the use of String of Pearls (SOP) plates for the surgical management of feline pelvic fractures, including surgical technique, proposed indications, complications, and outcomes in a cohort of cats. STUDY DESIGN This study is a single-center retrospective clinical case series. METHODS Medical records (2015-2019) of cats presenting for pelvic fractures (n = 33) were reviewed. Type of fracture, preoperative and postoperative imaging, and complications were retrospectively retrieved. Owners were contacted via questionnaire for medium- and long-term follow-up. RESULTS A total of 20 cats met the inclusion criteria. Minor intraoperative complications were encountered in three patients. One patient suffered a major intraoperative complication. Five major complications were encountered postoperatively. These included two greater trochanter osteotomy fixation implant removal and three SOP plate removal. Full function was recovered in all patients according to the owners' assessment. CLINICAL SIGNIFICANCE The use of SOP plates in feline pelvic fractures appears to yield a consistently good outcome with a very low incidence of canal narrowing and screw loosening. SOP plates are easy to contour and to apply along the entire pelvic length.
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Affiliation(s)
| | - Stefano Genoni
- The Ralph Veterinary Referral Centre, Marlow, United Kingdom
| | - Shane Morrison
- Advanced Practitioner in Small Animal Surgery - Christchurch Veterinary Referrals, Ipswich, United Kingdom
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Englar RE. Recasting the gold standard - part I of II: delineating healthcare options across a continuum of care. J Feline Med Surg 2023; 25:1098612X231209855. [PMID: 38131211 PMCID: PMC10811762 DOI: 10.1177/1098612x231209855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
AIM This is the first part of a two-part series on spectrum of care that encourages practitioners to embrace a non-binary approach to healthcare delivery. When care is not framed as all-or-none, either/or or best versus lesser, the provider and client can agree to diagnostic and/or treatment plans that individualize the practice of veterinary medicine. Care is tailored to the patient along a continuum of acceptable options. Care may also be intentionally incremental, with plans to reassess the patient and revise case management as needed. RELEVANCE Acknowledgment and ultimately acceptance that patient care journeys can be distinct, yet equitably appropriate, offers providers the flexibility to adapt case management competently and confidently to the patient based upon contextualized circumstances including client needs, wants and expectations for healthcare outcomes. Thinking outside the box to recast the historic gold standard with a continuum of care strategically offers feline practitioners a means by which they can overcome barriers to healthcare delivery. SERIES OUTLINE This first article introduces spectrum of care as an appropriate approach to case management and broadens its definition beyond cost of care. Part II explores communication strategies that enhance veterinary professionals' delivery of spectrum of care through open exchange of relationship-centered dialogue.
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Affiliation(s)
- Ryane E Englar
- University of Arizona College of Veterinary Medicine, Oro Valley, AZ, USA
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Flores JA, Rovesti GL, Gimenez-Ortiz L, Rodriguez-Quiros J. Retrospective Assessment of Thirty-Two Cases of Pelvic Fractures Stabilized by External Fixation in Dogs and Classification Proposal. Vet Sci 2023; 10:656. [PMID: 37999479 PMCID: PMC10675007 DOI: 10.3390/vetsci10110656] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 11/03/2023] [Accepted: 11/13/2023] [Indexed: 11/25/2023] Open
Abstract
The goals of this study were to evaluate the outcomes of bone healing, patient comfort during the treatment, functional results, and complications in pelvic fractures treated with external fixation, as well as to propose a classification system for the applied external frames. A total of thirty-two canine patients with pelvic fractures of different origins were treated. To provide a better reference for the frames used, an alphanumeric classification system was developed, detailing the frame structure and the number and location of the pins used. In this study, eighty-six fractures were treated in the 32 patients of this work, with an average fixation time of 9.88 ± 4.15 weeks. No major complications were detected in this case cohort, and the outcomes were rated at 9.46 based on a visual assessment scale for the patient's comfort during treatment. Outcomes graded as excellent and good were 96%. The use of external fixation for stabilization of pelvic fractures should be considered as a technical option, especially for minimally invasive stabilization of complex fractures, either as a primary or secondary stabilization.
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Affiliation(s)
- Jose Antonio Flores
- Hospital Veterinario IVC Evidensia Prïvet, Calle Duero 37, Villaviciosa de Odón, 28670 Madrid, Spain
| | - Gian Luca Rovesti
- Clinica Veterinaria M. E. Miller, Via della Costituzione 10, 42025 Cavriago, Italy;
| | - Lucia Gimenez-Ortiz
- Clínico Veterinario Val de Iglesias, Calle de la Corredera Alta 30, San Martín de Valdeiglesias, 28680 Madrid, Spain;
| | - Jesus Rodriguez-Quiros
- Departamento de Medicina y Cirugía Animal, Facultad de Veterinaria, Universidad Complutense de Madrid, Avda. Puerta de Hierro s/n, 28040 Madrid, Spain;
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Murugarren M, Piana F, Kalff S, Solano M. Locking Compression Plate Fixation of Feline Acetabular Fractures: Application, Complications and Perioperative Outcome. Vet Comp Orthop Traumatol 2023; 36:93-98. [PMID: 36577445 DOI: 10.1055/s-0042-1750402] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
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.
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Affiliation(s)
- Maider Murugarren
- Fitzpatrick Referrals Orthopaedics and Neurology, Eashing, Godalming, United Kingdom
| | - Francesco Piana
- Fitzpatrick Referrals Orthopaedics and Neurology, Eashing, Godalming, United Kingdom.,Langford Veterinary Services, University of Bristol, Langford, Bristol, United Kingdom
| | - Stephen Kalff
- Fitzpatrick Referrals Orthopaedics and Neurology, Eashing, Godalming, United Kingdom.,Pacific and Santa Cruz Veterinary Specialists, Santa Cruz, California, United States
| | - Miguel Solano
- Fitzpatrick Referrals Orthopaedics and Neurology, Eashing, Godalming, United Kingdom.,The Ralph Veterinary Referral Centre, Fourth Avenue, Globe Business Park, Marlow, Buckinghamshire, United Kingdom
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Moi TSM, Minto BW, Macedo AP, Lucena DVF, Malta CAS, Dias LGGG. Preliminary study on a novel dedicated plate for iliac fractures in dogs. PLoS One 2022; 17:e0269313. [PMID: 36018880 PMCID: PMC9416997 DOI: 10.1371/journal.pone.0269313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 05/18/2022] [Indexed: 11/19/2022] Open
Abstract
Introduction The aim of this study was to describe and evaluate a novel plate designed specifically for the canine ilium using finite element methods. The cranial portion of the plate had an elliptical shape and contained nine screw holes. The caudal portion of the plate was triangular with three screw holes. Four and three screws were used at the cranial (screw 1 to 4) and caudal (screw 5 to 7) segment of the plate. Finite element models of the plate and canine pelvis were created. A load of 300 N was applied on the femur-hip joint contact area. Values of Von Mises Stress on the plate, screws and the maximum and minimum main stresses in the bone were used to capture the mechanical factors in this study. Results The novel implant had a plate stress of 51.9 megapascals (MPa) with higher stress in the dorsal part of the plate. Screws 2 and 4 showed similar stress values of 17.3 MPa. Screws 1 and 3 were the most loaded (51.9 MPa and 75 MPa, respectively). Screws 5, 6, and 7 showed similar dissipation and stress values (21.55 MPa). There was traction force in the dorsal region of the pubis and compression in the ventral part, with dissipation and values of 15.4 MPa and 23.9 MPa, respectively, acquiring balance between them. Conclusion The novel plate is potentially applicable and specifically suitable for iliac fractures in dogs. The screws distribution modeled proved itself strategical since the simulated stresses were evenly distributed throughout the implant construct.
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Affiliation(s)
- Tryssia S. M. Moi
- Department of Veterinary Clinic and Surgery, Faculty of Agrarian and Veterinary Sciences, São Paulo State University (UNESP), Jaboticabal, São Paulo, Brazil
- * E-mail:
| | - Bruno W. Minto
- Department of Veterinary Clinic and Surgery, Faculty of Agrarian and Veterinary Sciences, São Paulo State University (UNESP), Jaboticabal, São Paulo, Brazil
| | - Ana P. Macedo
- Department of Dentistry, Faculty of Dentistry, University of São Paulo (USP), Ribeirão Preto, Brazil
| | - Dayvid V. F. Lucena
- Department of Veterinary Clinic and Surgery, Faculty of Agrarian and Veterinary Sciences, São Paulo State University (UNESP), Jaboticabal, São Paulo, Brazil
| | - Caio A. S. Malta
- Department of Veterinary Clinic and Surgery, Faculty of Agrarian and Veterinary Sciences, São Paulo State University (UNESP), Jaboticabal, São Paulo, Brazil
| | - Luis G. G. G. Dias
- Department of Veterinary Clinic and Surgery, Faculty of Agrarian and Veterinary Sciences, São Paulo State University (UNESP), Jaboticabal, São Paulo, Brazil
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Abstract
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.
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Affiliation(s)
| | - Richard L Meeson
- Department of Clinical Science and Services, Queen Mother Hospital for Animals, Royal Veterinary College, University of London, London, UK
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Li W, Du S, Guo H, Han X, Huang T. To Summarize and Analyze the Epidemiological Characteristics and Prognostic Risk Factors of Patients with Pelvic Fracture Complicated with Perineal Injury. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:4831330. [PMID: 35399837 PMCID: PMC8986410 DOI: 10.1155/2022/4831330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 01/28/2022] [Indexed: 11/24/2022]
Abstract
This study is aimed at summarizing and analyzing the epidemiological characteristics and prognostic risk factors of patients with a pelvic fracture with perineal injury. The clinical data of 153 patients with pelvic fracture with perineal injury treated in our hospital from January 2012 to June 2021 were analyzed retrospectively. The data of sex, age, injury mechanism, pelvic fracture type, shock index (SI), perineal wound depth, concomitant injury, total hospital stay, and death were collected by the electronic medical record system. Among the 153 patients, there were 94 males and 59 females, with an average age of (43.2 ± 16.8) years. The cases were mainly concentrated into two age groups: 20-29 years old and 50-59 years old. In a year, pelvic fractures were mainly concentrated in 1-2 months and 11-12 months. In terms of injury time, there were mainly two periods of time in a day: 10 : 00~12 : 00 and 15 : 00~18 : 00. The MOTS-RTS scores of the patients in the undead group and the dead group were (7.12 ± 1.52), (2.69 ± 0.96), ISS scores were (27.36 ± 15.84), (61.32 ± 7.08), GCS scores were (12.84 ± 3.69), (4.13 ± 1.25), APACH II scores were (12.87 ± 8.84), (32.41 ± 6.98), and SOFA scores were (6.68 ± 5.87), (17.12 ± 3.12). The MOTS-RTS and GCS scores of the nondeath group were significantly higher, while the ISS score, APACH II score, SOFA score, and shock index were significantly lower. The overall mortality rate of 153 patients was 13.7%. The average area of perineal trauma in undead and dead patients was (54.5 ± 113.52) cm2 and (262.63 ± 300.84) cm2, respectively. The average depth of perineal trauma was (9.63 ± 7.22) cm and (16.23 ± 10.13) cm, respectively. The larger the area of perineal injury and the deeper the depth of perineal trauma, the worse their prognosis. Cox multivariate analysis showed that complications, MOTS-RTS score, ISS score, GCS score, perineal trauma area, and perineal trauma depth were independent risk factors affecting the prognosis of patients with pelvic fracture with perineal injury. Most of the patients with pelvic fracture complicated with perineal injury are 20-29 years old and 50-59 years old. The more serious the perineal injury is, the higher the mortality is. The main causes of death are refractory hemorrhagic shock and infection.
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Affiliation(s)
- Wen Li
- General Hospital of Central Theater Command, No. 627 Wuluo Road, Wuhan, Hubei Province 430070, China
| | - Shasha Du
- Daye City People's Hospital, No. 25 Dongfeng Road Chengbei Development Zone, Daye, Hubei Province 435100, China
| | - Houcai Guo
- General Hospital of Central Theater Command, No. 627 Wuluo Road, Wuhan, Hubei Province 430070, China
| | - Xuan Han
- General Hospital of Central Theater Command, No. 627 Wuluo Road, Wuhan, Hubei Province 430070, China
| | - Tao Huang
- Daye City People's Hospital, No. 25 Dongfeng Road Chengbei Development Zone, Daye, Hubei Province 435100, China
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Wills DJ, Neville-Towle J, Podadera J, Johnson KA. Computed Tomographic Evaluation of the Accuracy of Minimally Invasive Sacroiliac Screw Fixation in Cats. Vet Comp Orthop Traumatol 2021; 35:119-127. [PMID: 34847579 DOI: 10.1055/s-0041-1736648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES The aim of this study was to report the use of computed tomography (CT) for postoperative evaluation of the accuracy of sacroiliac reduction and minimally invasive screw fixation in a series of five cats. MATERIALS AND METHODS Medical records between January 2016 and March 2017 of cats presenting to the author's institution were reviewed. Included were cats that had undergone minimally invasive sacroiliac screw fixation with a complete medical record and pre- and postoperative radiographs. Screw size was obtained from the medical records. CT images were acquired prospectively and evaluated to assess joint reduction, relative screw size and screw positioning. RESULTS Six sacroiliac luxations and 6 screws were available. Fixation was achieved with either a 2.4 (n = 1) or 2.7 mm (n = 5), 316L stainless steel, cortical bone screw. Mean screw size as a proportion of sacral diameter was 47.7%. Sacroiliac reduction >90% in the craniocaudal plane and sacral screw purchase >60% of the sacral width were achieved in 3/5 cases. Mean dorsoventral screw angulation was 1.6 degrees (range: -9.7 to 11.7 degrees) and craniocaudal angulation was -4.5 degrees (range: -16.6 to 6.6 degrees). Complications included screw loosening in the one case of bilateral repair and penetration of the neural canal in one case which was not detected with postoperative radiographic evaluation. CLINICAL SIGNIFICANCE CT evaluation provides a useful method for the assessment of sacroiliac reduction and the accuracy of screw placement.
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Affiliation(s)
- Daniel J Wills
- Faculty of Science, Sydney School of Veterinary Science, University of Sydney, Sydney, Australia
| | - Jack Neville-Towle
- Faculty of Science, Sydney School of Veterinary Science, University of Sydney, Sydney, Australia
| | - Juan Podadera
- Faculty of Science, Sydney School of Veterinary Science, University of Sydney, Sydney, Australia
| | - Kenneth A Johnson
- Faculty of Science, Sydney School of Veterinary Science, University of Sydney, Sydney, Australia
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Paulick L, Knell SC, Smolders LA, Pozzi A, Schmierer PA. Ex vivo comparison of lateral plate repairs of experimental oblique ilial fractures in cats. Vet Surg 2021; 51:191-201. [PMID: 34637153 DOI: 10.1111/vsu.13718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 08/05/2021] [Accepted: 08/22/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To determine the biomechanical behavior of different plate systems used for oblique ilial fracture fixation in cats. STUDY DESIGN Ex vivo biomechanical study. SAMPLE POPULATION Fifty fresh-frozen feline hemipelvises. METHODS Standardized simple oblique ilial fractures were created and fixed via lateral plating, using different implant systems (10 fractures in each group) The systems were: (1) the Advanced Locking Plate System (ALPS-5); (2) the Advanced Locking Plate System (ALPS-6.5); (3) the Locking Compression Plate 2.0 (LCP); (4) the FIXIN 1.9-2.5 Series (FIXIN), and (5) the Dynamic Compression Plate 2.0 (DCP). Stepwise sinusoidal cyclic loading was applied until failure (10-mm displacement). The groups were compared with regard to construct stiffness and the number of cycles withstood before 1-, 2-, 5-, and 10-mm displacement. RESULTS Bending stiffness was lower in ALPS-5 than in other specimens (P < .05). The ALPS-6.5 specimens withstood more cycles (P < .05) before 2-, 5-, and 10-mm displacement than the ALPS-5 and DCP specimens . The LCP and FIXIN specimens endured more cycles than DCP specimens before displaying 5- and 10-mm displacement (P < .05). The ALPS-6.5, FIXIN, and LCP specimens endured higher loads before failure than the DCP specimens (P < .05). Screw loosening occurred in all nonlocking specimens, and bone slicing occurred in all locking specimens. CONCLUSION The DCP and ALPS-5 constructs are less resistant to cyclic loading. Failure in nonlocking specimens involved screw loosening. It involved bone slicing in locking specimens. CLINICAL SIGNIFICANCE Both the plate size and the plate-screw interface are key to lateral plating success in cases of feline ilial fractures. The use of locking plates reduces the risk of the screw loosening in such cases.
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Affiliation(s)
| | - Sebastian C Knell
- Clinic for Small Animal Surgery, Vetsuisse Faculty Zurich, Switzerland
| | - Lucas A Smolders
- Clinic for Small Animal Surgery, Vetsuisse Faculty Zurich, Switzerland
| | - Antonio Pozzi
- Clinic for Small Animal Surgery, Vetsuisse Faculty Zurich, Switzerland
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Wiersema T, Koolen T, Theyse LFH, Maarschalkweerd RJ, van Zuilen CD, van Rijn SJ. Comparison of Single versus Double Lateral Plating in Treatment of Feline Ilial Fractures Using Veterinary Cuttable Plates. Vet Comp Orthop Traumatol 2021; 34:321-326. [PMID: 34082458 DOI: 10.1055/s-0041-1729624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The aim of this study was to compare the frequency of implant failure and the extent of pelvic canal narrowing associated with the fixation of ilial fractures in cats with a single veterinary cuttable plate (SLP) or double veterinary cuttable plates (DLP) applied to the lateral surface of the ilium. STUDY DESIGN Radiographic evaluation of feline ilial fractures plated laterally using SLP or DLP. Pelvic canal narrowing directly postoperatively and at 6 weeks follow-up was objectively measured using the sacral index (SI). Radiographs were evaluated for implant failure and fracture healing. RESULTS Seventy-seven cats satisfied the inclusion criteria. Twenty-nine fractures were treated with a SLP and 48 with DLP. Implant failure occurred significantly more (p = 0.001) in the SLP group (14/29) compared with the DLP group (6/48). Follow-up SI was significantly different between the two groups (p = 0.048, SLP median: 1.0 range: 0.83-2.4, DLP median: 0.98; range: 0.76-1.45). Median change in SI was -0.04 (range: -1.4-0.05) in the SLP group and 0.0 (range: -0.23-0.23) in the DLP group. This difference was significantly different (p = 0.031). CONCLUSION DLP leads to significantly less implant failure and significantly less pelvic canal narrowing compared with SLP. This difference in pelvic canal narrowing was small and the clinical relevance remains unclear.
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Affiliation(s)
- Tijn Wiersema
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht, The Netherlands
| | - Ties Koolen
- Department of Orthopaedics, Evidensia Dierenziekenhuis Nieuwegein, Nieuwegein, The Netherlands
| | - Lars F H Theyse
- Department for Small Animals Soft Tissue and Orthopaedic Surgery Service, College of Veterinary Medicine, University of Leipzig, Leipzig, Germany
| | | | | | - Sarah J van Rijn
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht, The Netherlands
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15
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Rodriguez NAR, Bailey SJ, Langley-Hobbs SJ. Treatment of pelvic fractures in cats with patellar fracture and dental anomaly syndrome. J Feline Med Surg 2020; 23:375-388. [PMID: 33206028 PMCID: PMC8008437 DOI: 10.1177/1098612x20959616] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Objectives The aim of this study was to describe the treatment and outcome of acetabular and other pelvic fractures in cats with patellar fracture and dental anomaly syndrome (PADS) and to provide advice on how to manage these cases in practice. Methods Data were collated on cats with PADS that were reported to have sustained pelvic fractures or had fractures or fissures of the pelvis identified on submitted radiographs. The details of the fractures were recorded, in addition to any treatment and outcome information. Results Of the 215 cases reported with PADS, 58 cats (27%) were found to have pelvic fractures, none of which were known to have resulted from significant trauma. There were 101 fractures in total and of these 15 were treated with surgery, including 10 acetabular fractures, two ilial, two pubic and one ischial fracture. Screw loosening and loss of fracture reduction was seen in four of the surgically treated fractures (two pubic fractures, one ilial and one acetabular fracture). Fourteen cats were euthanased as a direct result of a fracture occurring. While most pelvic fractures healed uneventfully, some cats remained intermittently lame, but it was not always possible to determine the cause of the lameness from the information available and because all cats had concurrent patellar fractures. Conclusions and relevance Many of the pelvic fractures healed with conservative management. Fractures involving articular surfaces such as acetabular fractures may benefit from surgical stabilisation as surgery may offer the benefits of articular fracture repair with improved joint congruency and a faster return to normal activity.
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Affiliation(s)
| | - Steven J Bailey
- Michigan State University College of Veterinary Medicine, Feline Medicine, East Lansing, MI, USA
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16
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Bouabdallah R, Meghiref FZ, Azzag N, Benmohand C, Zenad W, Rebouh M. Conservative management of pelvic fractures in dogs and cats in Algiers: Incidence and long-term clinical outcomes. Vet World 2020; 13:2416-2421. [PMID: 33363335 PMCID: PMC7750232 DOI: 10.14202/vetworld.2020.2416-2421] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 10/09/2020] [Indexed: 11/25/2022] Open
Abstract
Aim: We performed a retrospective study to evaluate clinical complications and outcomes associated with non-operative management of pelvic fractures in dogs and cats and described owner satisfaction. Materials and Methods: Based on radiographic findings and fracture location, case records were classified into two groups. Group 1 included animals with acetabulum involvement that underwent conservative treatment plus femoral head-and-neck excision. Group 2 included animals without acetabulum involvement that underwent conservative treatment only. Compliance with rest instructions, time to locomotion recovery, and the evaluation of persistent lameness were data collected from the questionnaire. The level of satisfaction was classified as excellent, good, or bad. Clinical outcome was evaluated at least 10 months after the fracture. Results: Pelvic injuries included sacroiliac luxations (59.52%) and ilial body (35.7%), acetabular (21.4%), pubic (21.4%), and ischial (14.28%) fractures alone or combined. According to the owners, the proposed strategy yielded good to excellent outcomes in dogs and cats in this study, with 95.23% of animals regaining full function of their hind limbs. Two dogs had slight chronic lameness, and some degree of gait abnormality persisted. Conclusion: Because of financial constraints, the chronicity of fractures, or lack of surgical techniques, the surgical treatment of pelvic fractures may not be possible. Non-operative treatment can then be considered to allow the animal to return to acceptable function.
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Affiliation(s)
- Ryhan Bouabdallah
- Department of Surgery, Higher National Veterinary School, Algiers, Algeria.,Research Laboratory Management of Local Animal Resources (GRAL), Higher National Veterinary School, Algiers, Algeria
| | | | - Naouelle Azzag
- Research Laboratory Management of Local Animal Resources (GRAL), Higher National Veterinary School, Algiers, Algeria.,Department of Clinic, Higher National Veterinary School, Algiers, Algeria
| | - Chabha Benmohand
- Department of Surgery, Higher National Veterinary School, Algiers, Algeria
| | - Wahiba Zenad
- Department of Surgery, Higher National Veterinary School, Algiers, Algeria
| | - Myriem Rebouh
- Department of Surgery, Higher National Veterinary School, Algiers, Algeria
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17
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Bird FG, de Vicente F. Conservative management of sacroiliac luxation fracture in cats: medium- to long-term functional outcome. J Feline Med Surg 2020; 22:575-581. [PMID: 31407942 PMCID: PMC10814328 DOI: 10.1177/1098612x19867516] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The aim of this study was to determine the functional medium- to long-term outcome for cats with a conservatively managed sacroiliac luxation fracture (SILF). METHODS Inclusion criteria were conservative management of SILF in cats with no other concurrent fractures of the pelvic weightbearing axis and availability of radiographs for review. Radiographic measurements of percentage displacement of the sacroiliac joint and the sacral index were obtained and fracture configuration was assessed. A specific owner questionnaire was completed a minimum of 6 months after the injury. The questionnaire assessed the ability of the cat to perform normal activities, the time to recovery, any behavioural changes and any requirement for long-term analgesia. RESULTS Seventeen cats met the inclusion criteria, and 13 owners completed the questionnaire. Twelve cats had an excellent outcome, with no difficulty performing normal activities. One cat had a good outcome, with slight or occasional difficulty performing normal activities. CONCLUSIONS AND RELEVANCE Our study provides evidence to support the current guidelines of conservative management of SILF. The inherent bias of case selection in our population implies that this treatment cannot be recommended for all cases of SILF.
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Affiliation(s)
| | - Felipe de Vicente
- Pride Veterinary Centre, Derby, UK
- Puchol Veterinary Hospital, Madrid, Spain
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18
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Piana F, Solano M, Kalff S, Yeadon R. Locking Plate Fixation for Canine Acetabular Fractures. Vet Comp Orthop Traumatol 2020; 33:294-300. [PMID: 32349136 DOI: 10.1055/s-0040-1708522] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE The aim of this study was to document application of locking plates for stabilization of acetabular fractures along with complications and clinical outcomes. We hypothesized that complications and clinical outcomes would be comparable to historical reports using non-locking plate and screw constructs. STUDY DESIGN Medical records of dogs presented with acetabular fractures at a single referral centre between 2010 and 2018 were reviewed. Cases surgically managed by open reduction and internal fixation, involving placement of at least one locking plate and screws, were included. Signalment, fracture classification, type of implant used, additional methods of stabilization, along with complications and neurological deficits, were collected. Long-term follow-up was based on Liverpool Osteoarthritis in Dogs questionnaire. RESULTS Eighteen acetabula were repaired in 17 dogs. Locking implants were VetLOX (4/18), string-of-pearls (7/18) and locking compression plates (7/18). Locking plates and screws were used as the sole method of fixation in 10/18 acetabula, and as adjunctive fixation with other implants in 8/18 acetabula. Two minor complications and one catastrophic complication were reported. Sixteen of seventeen dogs returned to function with radiographic documentation of fracture healing. Complication rate was comparable to historic reports using non-locking implants. Long-term outcomes assessed by Liverpool Osteoarthritis in Dogs questionnaire were positive in most cases. CONCLUSION Locking plates are a viable means of stabilizing acetabular fractures in dogs and can provide positive clinical outcomes. Surprisingly, problems including inaccurate fracture reduction and implant loosening were not fully avoided by use of locking implants but incidence was low.
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Affiliation(s)
- Francesco Piana
- Langford Veterinary Services, Small Animal Hospital, University of Bristol, Langford, Bristol, United Kingdom
| | - Miguel Solano
- Fitzpatrick Referrals Orthopaedics and Neurology, Eashing, Godalming, United Kingdom
| | - Stephen Kalff
- Pacific and Santa Cruz Veterinary Specialists, Santa Cruz, California, United States
| | - Russell Yeadon
- Lumbry Park Veterinary Specialists, Alton, United Kingdom
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Cinti F, Cavaliere L, Degna MT, Rossi F, Pisani G. Triple Pelvic Osteotomy Fixed with Lag Screw for the Treatment of Pelvic Canal Stenosis in Five Cats. Vet Comp Orthop Traumatol 2020; 33:363-369. [PMID: 32316059 DOI: 10.1055/s-0040-1709462] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE The aim of this study was to describe the technique and the clinical outcome of cats with obstipation as a result of pelvic canal narrowing, treated using an alternative triple pelvic osteotomy technique. METHODS Five cats with obstipation as a result of pelvic canal narrowing due to pelvic fracture malunion or secondary hyperparathyroidism were treated by triple pelvic osteotomy. After performing the iliac osteotomy and medial partial cortical debridement (4/5 cases), the pelvic canal was widened by moving the caudal fragment of the ilium to the lateral aspect of the cranial fragment. The iliac fragments were fixed by a 2.7-mm lag screw (5/5 cases) and an additional 2 Kirschner wires 0.8 mm (1/5 cases). RESULTS The radiographic examination immediately postoperatively and 8 weeks postoperatively showed a mean pelvic canal enlargement of 20% (range 7-38%). Minor complication occurred in one case; this resolved 15 days postoperatively without any treatment. Complications and recurrence of obstipation did not occur during the final follow-up, ranging between 5 months and 1 year in any of these cases. CLINICAL SIGNIFICANCE The use of lag screw fixed triple pelvic osteotomy resulted in widening of the pelvic canal and led to a satisfactory outcome with no major complications. This technique is fast, requires no expensive implants and it is relatively straightforward. Further cases are required to determine the success and complication risk of the procedure.
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Affiliation(s)
- Filippo Cinti
- Eastcott Veterinary Hospital, Swindon, Wiltshire, United Kingdom
| | | | | | - Federica Rossi
- Clinica Veterinaria dell'Orologio, Sasso Marconi (BO), Italy
| | - Guido Pisani
- Centro Veterinario Luni Mare, Luni Mare, Luni (SP), Italy
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20
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Hammer M, Gutbrod A, Sigrist NE, Jacot V, Del Chicca F, Evans R, Pozzi A. Predictors of comorbidities and mortality in cats with pelvic fractures. Vet Surg 2019; 49:281-290. [PMID: 31876001 DOI: 10.1111/vsu.13369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 09/14/2019] [Accepted: 11/30/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To characterize and evaluate risk factors for comorbidities and death of cats with pelvic fractures. STUDY DESIGN Retrospective case study. ANIMALS Cats (n = 280). METHODS Medical records were reviewed for cats in which pelvic fractures had been diagnosed (January 2003 to November 2016). Retrieved data included signalment, mechanism of injury, clinical findings, diagnostic imaging investigations, type and number of concurrent injuries based on anatomical location, type of therapy, and survival. Pelvic fractures were classified according to location and severity. Descriptive statistics were performed, and logistic regression models were constructed to examine associations between risk factors and outcome. RESULTS Cases consisted of 280 cats with no (9%), unilateral (43%), and bilateral (48%) involvement of the weight-bearing axis. Sacral fractures were found in 12% of cats. Surgical treatment and mortality rates increased progressively with the severity of the pelvic fractures (P < .001). Mean number of concurrent body regions injured was 2.4 ± 1.2 and was associated with mortality (P < .01). Twenty percent of cats did not survive to discharge. Cats with neurologic injuries were more likely not to survive (P = .02). CONCLUSION Concurrent injuries to at least one body region, especially the abdomen and thorax, were observed in cats sustaining pelvic fractures. Mortality was associated with increased severity of the fractures, neurologic injuries, and increased number of concurrent injuries. CLINICAL SIGNIFICANCE Concurrent injuries are common in cats with pelvic fractures, and comorbidities may be associated with mortality.
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Affiliation(s)
- Meike Hammer
- Clinic for Small Animal Surgery, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | | | - Nadja E Sigrist
- Division of Critical Care Medicine, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | | | - Francesca Del Chicca
- Clinic for Diagnostic Imaging, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | | | - Antonio Pozzi
- Clinic for Small Animal Surgery, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
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Knight R, Meeson RL. Feline head trauma: a CT analysis of skull fractures and their management in 75 cats. J Feline Med Surg 2019; 21:1120-1126. [PMID: 30571454 PMCID: PMC10814275 DOI: 10.1177/1098612x18819183] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2024]
Abstract
OBJECTIVES The aim of this study was to describe and evaluate the configurations and management of feline skull fractures and concurrent injuries following head trauma. METHODS Medical records and CT images were reviewed for cats with skull fractures confirmed by CT that were managed conservatively or with surgery. Details of signalment, presentation, skull fracture configuration, management, re-examination, and complications or mortality were recorded and analysed. RESULTS Seventy-five cats (53 males, 22 females) with a mean age of 4.8 ± 3 years met the inclusion criteria. Eighty-nine percent of cats had fractures in multiple bones of the skull, with the mandible, upper jaw (maxilla, incisive and nasal bones) and craniofacial regions most commonly affected. Temporomandibular joint injury occurred in 56% of cats. Road traffic accidents (RTAs) were the most common cause of skull fractures, occurring in 89% of cats, and caused fractures of multiple regions of the skull. RTAs were also associated with high levels of concurrent injuries, particularly ophthalmic, neurological and thoracic injuries. A more limited distribution of injuries was seen in non-RTA cats. Equal numbers of cats were managed conservatively or surgically (47%). Mortality rate was 8% and complications were reported in 22% of cats. Increasing age at presentation and presence of internal upper jaw fractures were risk factors for development of complications. No risk factors were identified for mortality. CONCLUSIONS AND RELEVANCE RTAs were the most common cause of feline skull fractures and resulted in fractures in multiple regions of the skull and concurrent injuries occurred frequently. Problems with dental occlusion were uncommon post-treatment. An increased risk of implant loosening and malocclusion was seen with palatine and pterygoid bone fractures and hard palate injuries. This study provides useful additional information regarding feline skull fractures, concurrent injuries and management techniques following head trauma.
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Affiliation(s)
- Rebekah Knight
- Department of Clinical Sciences and Services, The Royal Veterinary College, Hatfield, UK
| | - Richard L Meeson
- Department of Clinical Sciences and Services, The Royal Veterinary College, Hatfield, UK
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Haine DL, Parsons K, Barthelemy N, Burton N, Langley-Hobbs SL. Outcome of surgical stabilisation of acetabular fractures in 16 cats. J Feline Med Surg 2019; 21:520-528. [PMID: 30074433 PMCID: PMC10814537 DOI: 10.1177/1098612x18788165] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The aim of this study is to describe the presentation, surgical management and perioperative outcome of cats with acetabular fractures. METHODS Case records and radiographs of cats with acetabular fractures were reviewed from presentation to the end of follow-up. Surgical technique, complications, radiographic reduction and the presence of neurological deficits were recorded. RESULTS Sixteen cats with 17 acetabular fractures met the inclusion criteria. All fractures were associated with concurrent orthopaedic injuries. All cats were either moderately or severely lame on presentation. Five fractures were stabilised using screws, wire, pins and polymethylmethacrylate, nine were repaired using a straight dynamic compression plate and three were repaired using a locking plate. Two of seven cats that were neurologically normal prior to surgery developed transient neuropraxia following surgery. There were three major complications and no minor complications. At the end of follow-up 3/16 cats had full function, whereas 13/16 had acceptable function. CONCLUSIONS AND RELEVANCE All cats undergoing surgical stabilisation of acetabular fractures returned to full or acceptable function by the end of the follow-up period and there was a low number of intraoperative and short-term complications. Neurological deficits were common preoperatively, but the majority of these deficits had resolved by follow-up.
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Affiliation(s)
- David L Haine
- Langford Small Animal Hospital, University of Bristol, Bristol, UK
| | - Kevin Parsons
- Langford Small Animal Hospital, University of Bristol, Bristol, UK
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Schmierer PA, Smolders LA, Zderic I, Gueorguiev B, Pozzi A, Knell SC. Biomechanical properties of plate constructs for feline ilial fracture gap stabilization. Vet Surg 2018; 48:88-95. [DOI: 10.1111/vsu.13124] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 07/03/2018] [Accepted: 08/10/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Philipp A. Schmierer
- Clinic for Small Animal Surgery; Vetsuisse Faculty University of Zurich; Zurich Switzerland
| | - Lucas A. Smolders
- Clinic for Small Animal Surgery; Vetsuisse Faculty University of Zurich; Zurich Switzerland
| | - Ivan Zderic
- AO Research Institute Davos; Davos Switzerland
| | | | - Antonio Pozzi
- Clinic for Small Animal Surgery; Vetsuisse Faculty University of Zurich; Zurich Switzerland
| | - Sebastian C. Knell
- Clinic for Small Animal Surgery; Vetsuisse Faculty University of Zurich; Zurich Switzerland
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García-Pertierra S, Gonzàlez-Gasch E, Catalá Puyol C, Closa Boixeda JM. Dynamic chronic rectal obstruction causing a severe colonic dilatation in a cat. JFMS Open Rep 2017; 3:2055116917725222. [PMID: 28839947 PMCID: PMC5565026 DOI: 10.1177/2055116917725222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
CASE SUMMARY A 5-year-old male neutered domestic shorthair cat was presented to our referral centre with a 13 month history of chronic tenesmus due to malunion of the right caudal iliac body. Constipation and pelvic canal stenosis were initially addressed by the referring veterinarian with a right femoral head and neck excision and a right acetabulectomy without observable clinical improvement. At admission, abdominal radiographs revealed severe colonic distension and a narrowed pelvic canal caused by the right proximal femur. Rectal examination and colonography revealed a dynamic compression of the rectum, which worsened with femoral abduction and improved with femoral adduction. A right hindlimb amputation was performed to relieve the obstruction. The cat defaecated 2 days postoperatively and was discharged uneventfully. Neither faecal tenesmus nor dyschaezia were observed over the following 10 months. RELEVANCE AND NOVEL INFORMATION The dynamic nature of the rectal obstruction most likely prevented the development of an irreversible colonic dilatation leading to a megacolon. This is the first report describing a chronic dynamic rectal compression, which was successfully managed with a right hindlimb amputation without the need for subtotal colectomy.
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