Outcomes for 15 cats with bilateral sacroiliac luxation treated with transiliosacral toggle suture repair.

OBJECTIVE: To report a surgical technique and outcomes of transiliosacral toggle suture repair to treat feline bilateral sacroiliac luxation/fracture (SILF). STUDY DESIGN: Retrospective study. ANIMALS: Fifteen client-owned cats. METHODS: The medical records of cats with bilateral SILF treated using a transiliosacral toggle suture repair were reviewed. Short- and medium-term outcomes were assessed through standard postoperative clinical evaluation and radiographs, including measurements of angle of deviation (AoD), percentage of reduction (PoR), and pelvic canal width ratio (PCWR). Long-term functional follow up was obtained from a questionnaire derived from the Feline Musculoskeletal Pain Index (FMPI). RESULTS: Fifteen cats were enrolled retrospectively, among which 13 survived to discharge. One minor wound complication, treated by secondary intention healing, was encountered. No major complication was reported. Immediately postoperatively, the mean absolute PoR values were 88.1 ± 11.2% and 91 ± 11.6% on the right and left side, respectively. The mean absolute AoD was 3.1 ± 2.8°, and the mean PCWR was 1.24 ± 0.08. The medium-term radiographic follow up at a median of 205 (71-682) days postsurgery revealed the good stability of the repair. Excellent functional outcomes were identified upon the analysis of 12 long-term questionnaires at a median of 365 (119-798) days postsurgery. CONCLUSION: Anatomic reduction was satisfactory and comparable with previously described techniques with good implant placement documented. Functional outcomes based on FMPI-derived questionnaires were good to excellent in our population. CLINICAL SIGNIFICANCE: Transiliosacral toggle suture stabilization of bilateral SILF was associated with good outcomes in cats. Further studies are required to compare biomechanical properties and outcomes between this technique and previously described transiliosacral stabilization.

Biomechanical Comparison of Two Locking Plate Constructs Under Cyclic Loading in Four-Point Bending in a Fracture Gap Model: Two Screws versus Three Screws Per Fragment.

OBJECTIVES: The number of locking screws required per fragment during bridging osteosynthesis has not been fully determined in the dog. The purpose of this study was to assess the survival of two constructs, with either two or three screws per fragment, under cyclic bending. METHODS: A 10-hole, 3.5-mm stainless steel locking compression plate was fixed 1 mm away from a bone surrogate in which the fracture gap was 47 mm. Two groups of 10 constructs, prepared with either two or three bicortical locking screws placed at the extremities of each fragment, were tested in a load-controlled 4-point bending test (range 0.7 to + 7 Nm) until failure. RESULTS: The 3-screw constructs were stiffer than the 2-screw constructs (19.73 ± 0.68 N/mm vs. 15.52 ± 0.51 N/mm respectively) and the interfragmentary relative displacements were higher for the 2-screw constructs (11.17 ± 0.88%) than for the 3-screw constructs (8.00 ± 0.45%). The difference between the number of cycles to failure for the 3-screw constructs (162,448 ± 30,073 cycles) and the 2-screw constructs (143,786 ± 10,103 cycles) was not significant. Failure in all constructs was due to plate fracture at the level of the compression holes. CLINICAL SIGNIFICANCE: Omission of the third innermost locking screw during bridging osteosynthesis subjected to bending forces led to a 20% reduction in construct stiffness and increased relative displacement (+39.6%) but did not change fatigue life.