Feline radial and ulnar diaphyseal fractures: a retrospective study of 49 cases comparing single bone fixation and dual bone fixation.

OBJECTIVES: The objectives of this study were to report the complications in radial and ulnar diaphyseal fractures in cats and to compare the differences in outcome between single and dual bone internal fixation. METHODS: Medical records between 2004 and 2022 were searched retrospectively for cats with antebrachial diaphyseal fractures treated with internal bone-plate fixation. In total, 49 cases were included from six referral hospitals, including one teaching hospital. Patient information was collated, including fracture configuration, location, repair method and clinical outcome as assessed by veterinary physical examination, radiography and owner questionnaire. RESULTS: A total of 47 cats (mean age 4.2 years) were included. Fractures were located distally (24/49, 49%), proximally (13/49, 26.5%) and mid-diaphyseally (12/49, 24.5%). Dual bone fixation was used in 13/49 (26.5%) cases, with only 1/13 (7.7%) having major complications. By comparison, 4/36 (11.1%) of single plated fractures had major complications. Single bone fixation was 14.25 times more likely (95% confidence interval [CI] 2.07-97.99) to have a successful outcome (veterinarian-assigned score of 0) compared with dual bone fixation (P = 0.007). When evaluating owner-assessed outcomes, single bone fixation was 9.4 times more likely (95% CI 1.4-61.96) to have a successful outcome (owner score of 0) compared with dual bone fixation (P = 0.019). CONCLUSIONS AND RELEVANCE: Fractures that were repaired with single bone fixation had a greater chance of a better outcome. Although the difference was not significant, there was a higher major complication rate and a lower minor complication rate for cases treated with single bone fixation compared with dual bone fixation. The majority of fractures were located in the distal diaphysis. Comminution of the fracture and concurrent orthopaedic issues did not significantly affect the outcome. Further prospective studies with standardised follow-up, radiographic assessment, surgeon and implants are required to truly assess the difference between dual and single bone fixation.

Caudal cruciate ligament disease in three Basset Hounds.

CASE DESCRIPTION: 3 adult Basset Hounds were referred for evaluation of chronic, unilateral, pelvic limb lameness with no history of trauma. CLINICAL FINDINGS: On examination, all dogs had mild lameness of the affected limb; signs of pain were evident during manipulation of the stifle joint in the affected limb, along with effusion of that joint. No stifle joint instability was palpable. Radiographs were available for review for 2 of the 3 dogs. Effusion was confirmed radiographically, but severity of degenerative joint disease varied. Central intercondylar notch width ratios for the 2 dogs were 0.16 and 0.17, and tibial plateau angles were -10° and 15°; relative tibial tuberosity width was 1.1 for both dogs. Exploratory arthroscopy revealed moderate degeneration of the caudal cruciate ligament in all 3 dogs; the cranial cruciate ligaments were grossly normal. TREATMENT AND OUTCOME: Corrective osteotomy to increase the tibial plateau angle was performed in 1 dog, and the lameness resolved by 2 months after surgery. The 2 other dogs were managed without additional surgery. One dog was persistently lame. The other dog reportedly had normal limb function 2.5 years after undergoing exploratory arthroscopy. CLINICAL RELEVANCE: Morphological characteristics of the tibia in Basset Hounds may predispose to abnormal stresses on the caudal cruciate ligament. Isolated degeneration of the caudal cruciate ligament should be considered as a differential diagnosis for Basset Hounds with lameness originating from the stifle joint. Without direct inspection of the joint, caudal cruciate ligament disease could be confused for cranial cruciate ligament injury.

A Retrospective Study Using the String of Pearls Tibial Plateau Levelling Osteotomy Locking Plate for the Treatment of Cranial Cruciate Ligament Disease.

OBJECTIVE: The aim of this study was to describe the use of String of Pearls (SOP) tibial plateau levelling osteotomy (TPLO) locking plates for the treatment of cranial cruciate ligament disease and retrospectively assess osteotomy healing, tibial plateau angle (TPA) change (c) and overall complication rates. METHODS: Medical records and radiographic studies of 170 SOP TPLO surgical procedures were analysed. Radiographic measurement of TPAc and osteotomy union was determined 6 to 8 weeks postoperatively. Intra- and postoperative major and minor complications were identified. Factors influencing TPAc, osteotomy union and complications were assessed. RESULTS: Mean (standard deviation) TPAc was 1.3° (1.61) and median osteotomy union was graded as 2 (26-50%) union. Improved osteotomy union was associated with retention of the antirotational pin (odds ratio [OR]: 2.3; 95% confidence interval [CI]: 1.3-4; p = 0.005) and reduced TPAc (OR: 0.8; 95%CI: 0.66-0.97; p = 0.02). Complications occurred in 42 (24.7%) procedures with 11 (6.5%) considered major and 31 (18.2%) minor. CLINICAL SIGNIFICANCE: The use of the SOP TPLO plating system resulted in a median grade 2 (26-50%) radiographic osteotomy union score at 6 to 8 weeks' follow-up, less than previous TPLO locking plate studies. Osteotomy union was associated with retention of the antirotational pin and reduced TPAc. Major and minor complication rates were marginally greater than recent locking plate studies with fibular fracture and screw loosening common complications. The use of SOP TPLO plates is cautioned and further study is warranted.

Biomechanical comparison of pin and nitinol bone staple fixation to pin and tension band wire fixation for the stabilization of canine olecranon osteotomies.

OBJECTIVE: To compare the initial biomechanical properties of olecranon osteotomies stabilized with intramedullary pins and a Nitinol bone staple to osteotomies stabilized with pin and tension band wire fixation. STUDY DESIGN: Ex vivo mechanical evaluation on cadaveric bones. MATERIAL AND METHODS: Ten pairs of cadaveric forelimbs from skeletally mature Greyhounds with an olecranon osteotomy stabilized with either a pin and Nitinol bone staple or a pin and tension band wire. A single load to failure was applied to each specimen through the triceps tendon. Biomechanical properties were compared based on stiffness, yield load, and maximum load to failure and load at 2 mm of axial displacement. RESULTS: Specimens stabilized with the bone staple were biomechanically superior in all the variables tested. There was significantly greater stiffness (118.0 ± 25.9 N/mm versus 70.1 ± 40.4 N/mm; p = 0.005), yield load (319.0 ± 99.8 N versus 238.0 ± 42.5 N; p = 0.03), maximum load sustained (385.0 ± 99.2 N versus 287.0 ± 37.4 N; p = 0.009), and load at 2 mm of axial displacement (218.0 ± 51.5 N versus 138.0 ± 48.7 N; p = 0.002) in specimens stabilized with pins and a Nitinol bone staple than specimens stabilized with pin and tension band wire fixation. CLINICAL SIGNIFICANCE: The pin and Nitinol bone staple construct provides a biomechanically superior alternative to pin and tension band wire fixation for stabilization of olecranon osteotomies, and its use warrants further clinical investigation.

Morphometric assessment of hip dysplasia in a cat treated by juvenile pubic symphysiodesis.

OBJECTIVE: To quantitatively evaluate the change of the coxofemoral joints using computed tomography and distraction index in a cat with hip dysplasia treated by juvenile pubic symphysiodesis. STUDY DESIGN: Case report. ANIMAL: Eighteen-week-old female entire Maine Coon cat. RESULTS: Juvenile pubic symphysiodesis resulted in changes in the distraction index, acetabular angle, dorsal acetabular rim angle, dorsal acetabular sector angle, and clinical improvement at the six month follow-up. No intra-operative or postoperative complications were recorded. CONCLUSIONS: Juvenile pubic symphysiodesis performed at 18 weeks of age resulted in improvement in hip joint conformation and hip laxity in a dysplastic cat. CLINICAL RELEVANCE: Juvenile pubic symphysiodesis may be a promising treatment for feline hip dysplasia and is a safe and technically simple procedure to perform. Further investigations are warranted.