Computed tomography of coxofemoral injury in five mute swans (Cygnus olor).

Five mute swans (Cygnus olor) were presented with inability to stand or with abnormal positioning of a leg. Clinical examinations indicated the possibility of femoral fractures or coxofemoral luxations. The suspected diagnosis was proven by means of computed tomography (CT), while superimposition of gastrointestinal contents or other artefacts limited radiographic diagnosis in three birds. A typical CT sign for lesions of the coxofemoral joint apart from femoral displacement was haemorrhage within the pelvic bones (especially around the acetabulum), found in four of the five birds. Small femoral head avulsion fractures could be detected only with CT.

Successful management of simple fractures of the femoral neck with femoral head and neck excision arthroplasty in two free-living avian species.

A red-tailed hawk (Buteo jamaicensis) and a Canada goose (Branta canadensis) were evaluated for unilateral pelvic limb lameness. Physical examination findings and results of diagnostic imaging revealed femoral neck fractures in both birds. Both birds were treated with a femoral head and neck excision arthroplasty. The affected legs were not immobilized, and the birds were encouraged to use the legs immediately after surgery to encourage formation of a pseudoarthrosis. Within 2 weeks, both birds were using the affected limb well enough to be either successfully released or transferred to a wildlife rehabilitation facility. Femoral head and neck excision arthroplasty without immobilization of the limb is recommended for managing avian femoral neck fractures, especially in free-ranging species in which a rapid and complete or near complete return to function is vital for survival in the wild.

Treatment of pelvic fractures in cats with patellar fracture and dental anomaly syndrome.

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.

Fractures of the tuber coxa of the ilium in horses: 29 cases (1996-2007).

OBJECTIVE: To determine history; clinical, radiographic, ultrasonographic, and scintigraphic abnormalities; treatment; and outcome in horses with tuber coxae fractures and to describe a useful technique for obtaining a dorsomedial-ventrolateral 50 degrees oblique radiographic view of the tuber coxa of the ilium in standing horses. DESIGN: Retrospective case series. ANIMALS: 29 horses with fractures of tuber coxa. PROCEDURES: Data collected from medical records included signalment; history; horse use; severity and duration of lameness; radiographic, ultrasonographic, and scintigraphic findings; treatment; and outcome. RESULTS: All horses had a traumatic event leading to acute, unilateral hind limb lameness. Eighteen horses had a more severe lameness at the walk than at the trot; 22 of 29 horses had an abnormal gait with the hind limbs tracking to 1 side of the forelimbs. Twenty-four of 29 horses had palpable and visual asymmetry between the affected and unaffected tuber coxae. Twenty horses had radiography performed while sedated but standing, and fractures were reliably identified on the dorsomedial-ventrolateral 50 degrees oblique radiographic views. Twenty-seven (27/29 [93%]) horses returned to athletic use. Horses sustaining partial fractures of the caudal aspect of tuber coxae returned to previous use significantly earlier (mean, 3 months), compared with horses with complete tuber coxae fractures (6.5 months). CONCLUSIONS AND CLINICAL RELEVANCE: Horses with tuber coxae fractures returned to athletic soundness following extended periods of rest. Findings emphasized the need for obtaining a dorsomedial-ventrolateral 50 degrees oblique radiographic view of the tuber coxa of the ilium in horses suspected of sustaining injury to this region.

Feline ilial fractures: assessment of screw loosening and pelvic canal narrowing after lateral plating.

OBJECTIVE: To report the incidence of (1) screw loosening and (2) severity of pelvic canal narrowing in cats after repair of ilial fractures by a lateral bone plate. STUDY DESIGN: Case series. ANIMALS: Cats (n=21) with ilial fractures. METHODS: Medical records (June 1994 to February 2004) and radiographs were reviewed. Retrieved data were: signalment, fracture description, screw purchase, screw loosening, complications, and clinical outcome. Sacral index (SI) was used to objectively assess degree of pelvic canal narrowing. Long-term follow-up was by owner telephone interview or postal questionnaire. RESULTS: Screw loosening occurred in 13 cats (62%), with a mean loss of total screw purchase of 13% (range, 0-46%). Pelvic canal narrowing (mean decrease, 25%; range, 5-60%) occurred in all cats. Six cats (28%) had severe pelvic canal narrowing (mean, 52%); 5 of these had signs of recurrent constipation within 12 months postoperatively. Mean loss of total screw purchase in cats with severe pelvic narrowing was 28% compared with 9% for all other cats with narrowing. CONCLUSIONS: Lateral plating of ilial fractures in cats is associated with a high incidence of screw loosening. CLINICAL RELEVANCE: Pelvic canal narrowing >45% is associated with a high risk of recurrent constipation.

Feline ilial fractures: a prospective study of dorsal plating and comparison with lateral plating.

OBJECTIVE: To (1) report a technique for repair of feline ilial fractures using a dorsally applied bone plate and (2) compare outcome with cats treated by a lateral plate. STUDY DESIGN: Prospective study. ANIMALS: Cats (n=10) with iliac fractures. METHODS: Cats with ilial fractures (January 2005-December 2006) were treated by application of a dorsally applied bone plate. Immediate postoperative radiographs were compared with those taken 4-6 weeks later to assess screw loosening, screw purchase, and pelvic canal narrowing. Owners were contacted for medium-term (>3 month) follow-up. Data were compared with a report of outcome after lateral plating (LP) in 21 cats. RESULTS: Mean (+/- SD) screw purchase (89 +/- 11 mm) was significantly greater (P<.01) with a dorsal plate compared with a lateral plate (33 +/- 8 mm). Significantly more screws (P<.01) were used with a dorsal plate (median, 7) compared with a lateral plate (median, 6). Significantly less postoperative pelvic canal narrowing developed in the dorsal plating group between postoperative and 4-6-week follow-up radiography compared with the LP group (2% versus 15%, P<.01). CONCLUSION: Dorsal plating of feline ilial fractures results in significantly less screw loosening and pelvic canal narrowing at 4-6 weeks after surgery compared with LP. CLINICAL RELEVANCE: Dorsal plating of feline iliac fractures may reduce complications associated with pelvic canal narrowing such as constipation and megacolon.

Outcome of surgical stabilisation of acetabular fractures in 16 cats.

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.

Slipped capital femoral epiphysis in 17 Maine Coon cats.

Objectives From May 2009 to January 2015, 208 Maine Coon cats presented to the Tierklinik Hollabrunn - a small animal referral and first-opinion centre - and 17 (8.17%) cats were diagnosed with a slipped capital femoral epiphysis (SCFE). Over the same time period, 29 (0.67%) of 4348 cats (all breeds) were diagnosed with SCFE. Methods Clinical and orthopaedic examinations and diagnostic imaging were performed on all affected Maine Coons. Age at first presentation, sex, body weight, body condition score (BCS), unilateral or bilateral manifestation of the disease, activity level and duration of lameness, age at neutering and known family history of disease were recorded. Sixteen of 17 Maine Coons were surgically treated. Surgically removed femoral tissue samples were histologically examined in 13 cases. Results The mean age at first presentation was 21.47 months; male to female ratio was 16:1; mean body weight was 7.5 kg (range 5.3-9.3 kg); and mean BCS was 5.06/9.0. Seven cats were bilaterally affected; the median duration of decreased activity level and lameness was 2 weeks; mean age at neutering was 7.7 months (range 3.0-12.0 months); and four cats were littermates. Fourteen femoral head and neck ostectomies, eight total hip replacements and one primary fixation were performed. All 13 histologically available samples confirmed the diagnosis of SCFE. Conclusions and relevance To date, SCFE has been reported only occasionally in Maine Coon cats. However, the results of this study showed that Maine Coons were approximately 12-fold more likely to develop SCFE than the overall population of cats presenting to the Tierklinik Hollabrunn over the same time period. Male sex, neutering, delayed physeal closure and breed-specific high body weight may play an important role in the pathogenesis of SCFE in Maine Coon cats.

Management and long-term outcome of pelvic fractures: a retrospective study of 43 cats.

Objectives The aim of the study was to evaluate the management and long-term outcome of cats with pelvic fractures. Methods Cats with pelvic fractures had their records and radiographs reviewed. Radiographs were reviewed for fracture configuration, implants and pelvic canal narrowing. Owners were contacted for long-term follow-up. Results Forty-three cats met the criteria (mean follow-up 24 months [range 6-45 months]). The majority (93%) had more than one orthopaedic pelvic injury, with sacroiliac fracture luxations seen most commonly; 23% had presurgical neurological deficits. Most cats (74%) were managed surgically; 60% of sacroiliac fracture luxations, 82% of ilial fractures and 50% of acetabular fractures received surgery. The complication rate was 22%, most commonly sciatic neurapraxia (13%). Seventy-nine percent of all neurological deficits resolved and the remainder improved. Mean pelvic canal narrowing after trauma was -15% in surgical and -16% in conservatively managed cats. Canal width was improved postoperatively (-8%) but mildly narrowed further by follow-up (-12%); however, these changes were not significant. Nineteen percent of cats had constipation postsurgery; none developed megacolon. There was no clear correlation between the degree of narrowing of the pelvic canal up to -50%, or whether conservative treatment was opted for, and the development of constipation. Long-term mobility was not impaired in 86% of cats, and 84% did not have any lameness detectable. Conclusions and relevance The majority of cats were managed surgically, with a 22% complication rate; the most common being transient sciatic neurapraxia. Long-term outcome was generally excellent and most had a full recovery. Constipation/obstipation was very uncommon and no clear relationship with pelvic canal narrowing could be found when considering narrowing of up to -50% in both surgical and conservative groups. As no cats in this cohort had narrowing greater than -50%, the current recommendation of surgery to improve the canal width if narrowing is greater than -45% to -50% should remain.

Repair of femoral capital physeal fractures with 7.0 mm cannulated screws in cattle: 20 cases (1988-2002).

OBJECTIVE: To evaluate long-term outcome of repair of femoral capital physeal fractures with 70 mm cannulated screws in juvenile bulls that weighed >350 kg (770 lb). DESIGN: Retrospective study. ANIMALS: 20 bulls. PROCEDURE: Medical records of affected cattle were identified and reviewed. Follow-up information was obtained by means of a written questionnaire, 1 to 15 years after discharge, from the veterinarians who supervised the postoperative care at bull stud facilities. RESULTS: Mean age and body weight at time of repair were 19 months (range, 11 to 27 months) and 513 kg (1128.6 lb; range, 364 to 720 kg [800.8 to 1584 lb]), respectively. Surgical repair was performed with 70 mm cannulated screws. A second surgery to replace malpositioned implants was required in 1 bull. Fourteen of the 20 bulls were considered serviceable for semen collection after surgical repair, and persistent lameness was evident in 11 of the 14. Mean duration for bulls to become serviceable was 5.5 months (range, 2 to 11 months). Age, weight, duration of injury at the time of repair, and degree of reduction did not have a significant effect on whether surgical repair was successful. Six bulls remained severely lame and were euthanatized. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that surgical repair of femoral capital physeal fractures in adolescent bulls with 70 mm cannulated screws placed in lag fashion has a good prognosis for long-term function in a semen collection facility.

Traumatic avulsion fracture of the lesser trochanter in a dog.

A 15-month-old 25 kg female spayed American Staffordshire Terrier was examined to determine the cause of a six month period of lameness of the left pelvic limb. Signs of severe pain were evident on hyperextension and simultaneous internal rotation or abduction of the left hip joint; crepitus or instabiltiy was not detected. The diagnosis of avulsion fracture of the lesser trochanter was based on radiographs, computed tomography (CT) and magnetic resonance imaging (MRI), supported by initial findings such as lameness and hip joint pain in extension. The dog was treated with strict confinement for eight weeks followed by a gradual increase in activity; non-steroidal anti-inflammatory drugs were given for one month. Three months later, the dog was clinically sound and unrestricted activity was resumed. Soundness was confirmed on follow-up 18 months after injury. CT and especially MRI were powerful diagnostic tools to identify chronic iliopsoas strains with an avulsion fracture of the lesser trochanter. Complete recovery ensued following conservative treatment only, despite the proximal diplacement of an avulsed segment of the lesser trochanter. Thus, traumatic injury to the iliopsoas muscle and to the lesser trochanter should be included as differential diagnosis in cases of hind leg lameness.

Extraosseous vascular supply to the mature dog's coxofemoral joint.

Blood vessels supplying the coxofemoral joint were identified and described in 8 healthy, mature dogs. An accurate representation of the blood vessels was obtained by intra-arterial methyl methacrylate injection and sodium hydroxide corrosion of soft tissues until only the pelvis, femurs, and casts of the blood vessels remained. The sources of vascular supply to the dog's coxofemoral joint, from most to least contributory, were the lateral circumflex femoral artery, the medial circumflex femoral artery, the caudal gluteal artery, the cranial gluteal artery, and the iliolumbar artery. In addition, important vascular relationships were demonstrated. Many blood vessels were associated with the periosteal surfaces of the coxofemoral joint in areas of muscular and articular capsular attachment; fewer vessels were present in areas of loose periosteal attachment. Also, extra-articular anastomoses were identified. The most significant anastomosis was an extracapsular vascular ring located at the femoral attachment of the articular capsule. The extracapsular vascular ring was formed by branches of the lateral and medial circumflex femoral and caudal gluteal arteries.

Treatment of slipped capital femoral epiphysis in cattle: 11 cases (1974-1988).

A mixed population of 11 cattle (7 dairy, 4 beef; 9 male, 2 female) were examined because of acute onset of non-weightbearing hind limb lameness. Radiography revealed slipped capital femoral epiphyseal fracture in all cattle, with the exception of one large bull. Ten of the 11 cattle were treated with open reduction and internal fixation, using intramedullary pins. Cattle affected with slipped capital femoral epiphyseal fracture in previous reports typically have been calves that required forced extraction during dystocia. Cattle in this report were in the following 2 age groups in which trauma was the likely cause: 3 to 5 months and 1.5 to 2.3 years. Follow-up information was provided for 7 of the 10 cattle. Four of the 7 were functional and had no clinical signs of arthritis, abnormal gait, atrophy, scarring, contralateral compensation, breakdown, or other difficulty 6 months after surgical correction. If early diagnosis is achieved, it appears that reduction with intramedullary pinning can provide a good long-term prognosis in cattle when function as breeding animals is important to their future value.

Fractured capital femoral epiphysis in twin ewes.

Capital femoral physeal fractures occurred simultaneously in twin 2-year-old Shropshire ewes. The fractures resulted in gradual, progressive lameness and recumbency. There was no history of trauma and no other ewes in the flock were affected. The fractures occurred at an age when the capital physis should have been closed. Clinical and postmortem examination of the ewes and evaluation of the ration did not reveal predisposing factors for the condition. A familial tendency for fractured capital femoral epiphysis is well documented in human beings, but there is no known familial tendency in sheep.

Internal fixation of femoral capital physeal injuries in dogs: 40 cases (1979-1987).

Fractures of the femoral capital physis were stabilized with small pins or a lag screw in 36 dogs (4 bilateral injuries). Radiography was used to monitor the development of osteoarthritis in affected joints and narrowing of the femoral neck. More radiographic signs of arthritis (P less than 0.05) developed in the coxofemoral joints of dogs that were less than or equal to 4 months old when injured, compared with those in dogs greater than 4 months old. Of 40 capital physeal injuries, 35% had concurrent ipsilateral coxofemoral joint injuries and developed more radiographic signs of arthritis (P less than 0.05) than did those that had no other coxofemoral injury. Narrowing of the femoral neck developed in 70% of the healing capital physeal repairs, but in most dogs, narrowing was not associated with segmental collapse of the femoral neck. Neither time interval from injury to surgical fixation nor surgical approach used had an effect (P greater than 0.05) on the development of narrowing of the femoral neck.

Repair of fractured capital femoral epiphysis in two sheep.

Fracture of the capital femoral epiphysis occurred in two sheep. Both fractures were repaired via open reduction and lag screw fixation. A craniolateral approach to the hip (modified Watson-Jones) afforded good exposure and allowed manipulation with minimal soft tissue trauma. Rigid internal fixation in each case resulted in good long-term results. It was concluded that repair of this type of fracture in sheep is feasible if the animal is valuable.

Association between long periods without high-speed workouts and risk of complete humeral or pelvic fracture in thoroughbred racehorses: 54 cases (1991-1994).

OBJECTIVE: To determine whether a two-month or longer period without official high-speed workouts (lay-up) is associated with humeral or pelvic fracture in Thoroughbred racehorses. DESIGN: Reprospective study. ANIMALS: Thoroughbred racehorses in California that were euthanatized because of a complete humeral or pelvic fracture. PROCEDURE: Age, sex, activity, number of lay-ups, number of days from a race or official timed workout to fracture, number of days from end of last lay-up to fracture, mean duration of lay-ups, and total number of days in race training were compared between horses with humeral fractures and horses with pelvic fractures. A case-crossover study was used to estimate relative risk for fracture of the humerus or pelvis occurring within hazard periods of 10 and 21 days following lay-up, compared with periods following more regular participation in official racing or timed workout events. RESULTS: Horses with pelvic fractures were more often female, older, and had 0 or > or = 2 lay-ups. Horses with humeral fractures were typically 3-year-old males that had 1 lay-up. Horses with pelvic fractures had more total days in race training, fewer days from last exercise event to fracture, and a greater number of days from end of last lay-up to fracture than horses with humeral fractures. Return from lay-up was strongly associated with risk for humeral fracture during hazard periods of 10 and 21 days (relative risk = 71 and 45, respectively). CLINICAL IMPLICATIONS: Risk of humeral fracture may be reduced if horses are cautiously reintroduced into race training after lay-up.

Nonsurgically managed caudal acetabular fractures in dogs: 15 cases (1979-1984).

Medical records of 15 dogs with nonsurgically managed caudal one-third acetabular fractures were reviewed. In-hospital evaluation of these dogs was possible 6 to 67 months after injury. Thirteen dogs had radiographic evidence of moderate to severe degenerative joint disease in affected hips. Twelve dogs had decreased hip joint range of motion and/or signs of pain on the affected side, and 7 dogs were lame. Because of limited pain-free motion and degenerative joint disease in most affected hips, results of nonsurgical management of caudal one-third acetabular fractures in dogs were considered unsatisfactory.

Femoral capital physeal fractures in dogs: 34 cases (1979-1989).

Complications associated with femoral capital physeal (CP) fractures in 34 dogs were evaluated. Fractures were surgically repaired, using divergent K-wires or lag screws; radiographic follow-up was available for 21 CP fractures. In all cases, radiographic abnormalities such as degenerative joint disease and resorption of the femoral neck and/or head were seen. Changes were more severe when fracture occurred at an early age. For 4 of 21 dogs (20%), femoral head and neck excision was performed because of complications associated with CP fracture repair. Prognosis for femoral CP fractures is guarded, although affected dogs should be able to function as pets.

Transarticular pinning for repair of hip dislocation in the dog: a retrospective study of 40 cases.

Transarticular pinning was used for the repair of hip dislocation in 40 dogs. The mean follow-up period was 18.4 months. Satisfactory results were achieved in 80% of the cases. Body weight, ipsilateral femoral head fracture, and hip dysplasia appeared to affect long-term prognosis. The most frequent complication was pin breakage, but this did not affect final outcome and could be avoided by using pins of larger diameter. Osteonecrosis was observed in two cases.