Clinical experience and outcomes using a commercially available micro-plating system for metabone fractures in dogs and cats: 10 cases (2019-2023)

OBJECTIVES

To report the clinical experience and long-term outcome following metabone fracture stabilisation using a commercially available micro-plating system (VetKISS, 1.0-mm, IMEX Veterinary, USA).

MATERIALS AND METHODS

Consecutive, client-owned cats and dogs weighing <7 kg, with traumatic metabone fractures stabilised using VetKISS micro-plates were prospectively enrolled with informed owner consent. Clinical and radiographic parameters were recorded. Either short-term or long-term clinical and radiographic follow-up was required for study inclusion.

RESULTS

Four cats and six dogs were enrolled and operated by one of two board-certified surgeons. Bodyweight ranged from 1.9 to 6.6 kg. Number of metabones fractured: all four (60%), three (30%) and two (10%). Anatomical alignment was restored for each metabone. External coaptation was not used in any case. Radiographic follow-up documented clinical or bony union in all cases. Mean time to clinical union was 51 days. One major complication (screw removal) and two minor complications (partial construct failure) were observed. All patients made a complete functional recovery at the time of documented union. Long-term follow-up was available in five cases. No lameness (evaluated independently by both surgeons) or plate sensitivity was noted.

CLINICAL SIGNIFICANCE

This is the first clinical evaluation of the VetKISS for metabone fracture repair, and includes long-term follow-up. Results demonstrated complete functional recovery and 100% clinical union rates in all patients, with acceptable complication rates. This system can be considered for metabone repair in patients weighing <7 kg without the use of external coaptation.

Radiomorphometric analysis of the metapodial bones in the Scottish fold cats

Scottish Fold cats (Felis catus, Linnaeus 1758) are one of the most well-known and popular cat breeds in the world, characterized by their folded ears attached to the head. Very frequently, cats fall prey of different trauma and accidents that can cause bone fractures especially in the metapodial bones. The method of radiometry is used in veterinary practice to visualize and measure different parts of the animal skeleton. The aim of this study was to assess the linear parameters derived from radiographic images of the metacarpals and metatarsals in Scottish Fold cats and additionally detecting potential sexual dimorphism. Radiographic images of 24 adult Scottish Fold cats (12 male and 12 females) of different ages and weights were analysed. Six linear measurements of the metapodial bones were evaluated to investigate any differences between the sexes. The linear radiometric measurements of the five metacarpals (MC1-5) and the four metatarsals (MT2-5) bones were larger in male metapodial bones than that of female cats. The maximum length (Ml) of the MC1 and MC2 was statistically different between sex, respectively, (p = 0.001) and (p = 0.05). The others metacarpal bones were different in mostly all linear parameters but not statistically significant. The most significant differences between sexes were observed in the parameter of width proximal end (Wp) of MC1-3 (p = 0.001) and MC4 (p = 0.05). More statistical different was MT2 and less MT3. The linear parameter of Bd of the MT4 was the most different statistically between sex (p = 0.001). The results of the study will be useful in function of comparative anatomy, in veterinary clinical practice, in zoo archaeology and in the veterinary forensic investigation.

Outcomes of 15 dogs and two cats with metabone fractures treated with fluoroscopically guided normograde metabone pinning

OBJECTIVE

To report the outcomes of 15 dogs and two cats with metabone fractures treated with fluoroscopically guided normograde metabone pinning (FGNMP).

STUDY DESIGN

Retrospective case series.

ANIMALS

A total of 15 client owned dogs and two cats with 57 metabone fractures.

METHODS

Description of FGNMP and reporting of the following data: signalment, pre- and postoperative radiographs, intramedullary pin diameter used, anesthesia, surgery and coaptation times, duration to normal weightbearing and bone union, postoperative care and complications.

RESULTS

Median surgery time was 54 min (range: 26-99), median duration of coaptation was 14 days (range: 1-5 weeks), median time to normal weightbearing was 16 days (range: 2-45) and median time to bone union was 6 weeks (range: 4-12). All cases had at least 12 months of post-surgical follow-up with a median follow-up of 18 months (range: 12-70). No major complications occurred. Mild radiographic changes associated with subchondral bone sclerosis were noted on follow-up radiographs in 13/57 fractures. All cases returned to normal gait and full (15) or acceptable (2) function.

CONCLUSION

In this study, FGNMP was an effective and safe technique for metabone fracture repair, requiring only short-term external coaptation in most patients. Time to bone union and return to normal function compared favorably to previously reported techniques.

CLINICAL RELEVANCE

Fluoroscopically guided normograde metabone pinning provides an alternative technique for treatment of metabone fractures.

Comparison of post-operative outcomes after open or closed surgical techniques to stabilize metacarpal and metatarsal fractures in dogs and cats

BACKFROUND

Treatment options for metacarpal/metatarsal fractures include conservative and surgical management. The aim of this study is to determine whether there is any significant difference in healing and complication rates, between open and closed treatment. Medical records of dogs and cats with metacarpal/metatarsal fractures with complete follow-up were retrospectively reviewed. Patients were allocated in two groups: open or closed stabilization. Minor and major complications were recorded and compared. Fracture healing was classified as good, delayed and non-union, and it was statistically compared.

RESULTS

Sixty-three patients (35 dogs and 28 cats) were included. Thirty-one were treated with an open approach and 32 by a closed stabilization. Regarding fracture healing a significantly higher proportion of delayed healing/non-union was found in the closed group (12/32 vs 2/31). Regarding postoperative complications, a significantly higher number of animals in the open group did not develop any complications (12/31 vs 3/32). A significantly higher proportion of minor complications were reported in the closed group (27/32 vs 12/31). However, a higher number of major complications was reported in the open group (7/31 vs 2/32) although this was not statistically significant. Fracture malalignment was significantly more prevalent in patients undergoing closed stabilization (11/32 vs 2/31).

CONCLUSION

According to the results, better healing, fracture alignment and a lower complication rate are found when fractures are stabilised with an open technique. However, other factors such as configuration of the fracture, soft tissue involvement, patient´s character and client´s situation would also need to be taken into account in the decision of stabilization technique.

Forelimb Examination, Lameness Assessment, and Kinetic and Kinematic Gait Analysis

This article contains a guide for small animal practitioners to use when confronted with the challenge of diagnosing a forelimb lameness. The examination begins by monitoring the dog at a stance and a visual gait assessment. A hands-on evaluation includes the initial examination, checking for asymmetry and muscle atrophy while the dog is standing, and step-by-step instructions for a thorough forelimb examination.

Fibular and metatarsal osteosynthesis in a southern brown howler monkey (Alouatta guariba clamitans)

Here we describe a successful surgical management of a distal fibular fracture combined with a tarsocrural luxation and multiple metatarsal fractures in the left foot of a southern brown howler monkey (Alouatta guariba clamitans). We achieved satisfactory outcome by applying intramedullary pinning for each of the bone fractures and closed reduction of joint luxation-kept in place only by bone alignment, without further ligament reconstruction. Bone healing occurred uneventfully within eight weeks and the monkey's foot regained its normal function. Therefore, we could properly release the patient back into the wild.

[Dowel pinning for metacarpal and metatarsal fractures in dogs]

OBJECTIVE

To evaluate a dowel pinning technique for metacarpal and metatarsal fractures in dogs.

MATERIAL AND METHODS

Medical records of 13 dogs with complete clinical and radiographic follow-up examinations after a median observation time of 5 months were evaluated retrospectively. Assessment included fracture data, number of stabilized bones versus number of fractured bones and parameters of internal fixation including postoperative axial alignment and position of implants assessed on serial radiographs. Complications during the healing period and the final radiographic and functional outcome were analysed in relation to the details of fracture fixation.

RESULTS

Most dogs in this study (mean age: 2.9 years, mean weight: 9.9 kg) had fractures of three or four bones, and fractures were closed in all but one dog. All fractures involved the metacarpal/metatarsal body, and all but five were transverse. The size of Kirschner wires used for dowel pinning ranged from 0.8 to 2.0 mm, and the length in relation to bone length ranged from 39 to 91%. Axial alignment of internal fixation was and remained anatomically correct and the dowel pins remained in place in all but one dog. This dog had open metatarsal fractures and dowel pinning was contraindicated. Additionally, the Kirschner wires perforated the cortex of the proximal segments, which resulted in implant migration, malunion and residual lameness. The other dogs achieved complete functional union even though seven of 13 dogs developed radiographic signs of synostosis.

CLINICAL SIGNIFICANCE

Although the number of dogs in this study was small, dowel pinning was shown to be technically straightforward, inexpensive and effective for surgical repair of canine metacarpal and metatarsal bone fractures. Further studies should focus on the need for and duration of additional external coaptation.

Surgical management of multiple metatarsal fractures in a chinchilla (Chinchilla lanigera)

CASE DESCRIPTION A 3-month-old sexually intact female chinchilla (Chinchilla lanigera) was examined for sudden onset of non-weight-bearing lameness of the right hind limb. CLINICAL FINDINGS On physical examination, the right pes was swollen. An open wound on the medial aspect of the metatarsal region exposed the second metatarsal bone, and the pes was displaced laterally. Radiographs of the right pes revealed oblique displaced fractures of the 4 metatarsal bones. TREATMENT AND OUTCOME Surgical treatment was elected, and enrofloxacin was administered prior to surgery. The protruding fragment of the second metatarsal bone was excised, and the third and fourth metatarsal bones were repaired with intramedullary pins and external skeletal fixation. The chinchilla was bearing weight on the affected limb 9 days after surgery with only mild lameness. The implants were removed 35 days after surgery when radiographs showed bony union of the third and fourth metatarsal bones and continued reduction of the fractures of the second and fifth metatarsal bones. Fifty-six days after surgery, the chinchilla was bearing full weight on the limb, and radiographs showed bony union of the third, fourth, and fifth metatarsal bones. CLINICAL RELEVANCE Findings suggested that intramedullary pinning combined with an epoxy resin external fixator may be an effective technique for metatarsal fracture repair in chinchillas. This method allowed physiologic positioning of the limb and functional hind limb use during fracture healing. Prospective studies of fracture healing in exotic small mammals are indicated.