Subscribe to RSS
Feline Distal Tibial Physeal Fracture Repair Using a Modified Cross-Pin Technique with Four PinsFunding None.
26 January 2019
23 November 2019
05 February 2020 (online)
Objective The aim of this article was to report the surgical technique and clinical outcome of a modified cross-pin technique for the treatment of distal tibial physeal fractures in cats without postoperative external coaptation.
Study Design This study was a retrospective clinical study.
Animals A total of 9 cats were presented with fracture of the distal tibial physis.
Materials and Methods Medical records from July 2014 to September 2018 were reviewed. In all cases, a second medial and a craniolateral Kirschner wires were added to the traditional cross-pin technique. Information reviewed included orthogonal radiographs pre- and post-surgery and at subsequent re-examinations, subjective assessment of lameness and passive range of motion, veterinary clinical assessment and completion of a functional questionnaire (feline musculoskeletal pain index) at the time of writing this report. Eight owners completed the questionnaire. The mean questionnaire follow-up time was 12.7 months.
Results Uncomplicated fracture healing occurred in all patients. Two patients required implant removal due to Kirschner wire migration and protrusion through the skin at 5 and 12 months post-surgery. No other complications were noticed. Eight patients had an excellent outcome, and one patient had a good outcome.
Conclusion Distal tibial physeal fractures in cats can be treated successfully with the use of a modified cross-pin technique and without the use of external coaptation. Prognosis should be considered favourable for this type of fracture.
Diogo Miraldo and Russell Yeadon contributed to conception of study, study design, acquisition of data and data analysis and interpretation. Bettina Salmelin contributed to acquisition of data and data analysis and interpretation. All authors drafted, revised and approved the submitted manuscript.
- 1 Phillips IR. A survey of bone fractures in the dog and cat. J Small Anim Pract 1979; 20 (11) 661-674
- 2 Unger M, Montavon PM, Heim UFA. Classification of fractures of long bones in the dog and cat: introduction and clinical application. Vet Comp Orthop Traumatol 1990; 03 (02) 41-50
- 3 Johnson AL. Tibia and tarsus. In: Bojrab M, Waldron D, Toombs J. , eds. Current Techniques in Small Animal Surgery. Jackson, MS: Teton Media; 2014: 1092-1099
- 4 DeCamp CE, Johnston SA, Déjardin LM, Schaefer SL. Fractures of the tibia and fibula. In: Brinker, Piermattei, and Flo's Handbook of Small Animal Orthopedics and Fracture Repair. 5th ed. St. Louis, MO: Elsevier; 2016: 670-706
- 5 Berzon JL. Closed reduction and plaster cast immobilization of distal tibial fractures (Salter II-type) in the cat. Vet Surg 1980; 9 (01) 34-38
- 6 Scott HW, Mclaughin RM. Tibial and fibular fractures. In: Scott HW, Mclaughin RM. , eds. Feline Orthopedics. London, UK: CRC Press; 2007: 233-243
- 7 Voss K, Langley-Hobbs SJ, Montavon PM. Tibia and fibula. In: Montavon PM, Voss K, Langley-Hobbs SJ. , eds. Feline Orthopedic Surgery and Musculoskeletal Disease. London, UK: Saunders Elsevier; 2009: 491-505
- 8 Kim SE, Hudson CC, Pozzi A. Percutaneous pinning for fracture repair in dogs and cats. Vet Clin North Am Small Anim Pract 2012; 42 (05) 963-974 , vi–vi
- 9 Boekhout-Ta CL, Kim SE, Cross AR, Evans R, Pozzi A. Closed reduction and fluoroscopic-assisted percutaneous pinning of 42 physeal fractures in 37 dogs and 4 cats. Vet Surg 2017; 46 (01) 103-110
- 10 von Pfeil DJF, Glassman M, Ropski M. ; Pfeil von DJF. Percutaneous tibial physeal fracture repair in small animals: technique and 17 cases. Vet Comp Orthop Traumatol 2017; 30 (04) 279-287
- 11 Johnson KA. Piermattei's Atlas of Surgical Approaches to the Bones and Joints of the Dog and Cat. 5th edition. St Louis, United States: Elsevier; 2014: 438-443
- 12 Voss K, Langley-Hobbs SJ, Montavon PM. Stifle Joint. In: Montavon PM, Voss K, Langley-Hobbs SJ. , eds. Feline Orthopedic Surgery and Musculoskeletal Disease. London, UK: Saunders Elsevier; 2009: 475-490
- 13 Gruen ME, Griffith EH, Thomson AE, Simpson W, Lascelles BDX. Criterion validation testing of clinical metrology instruments for measuring degenerative joint disease associated mobility impairment in cats. PLoS One 2015; 10 (07) e0131839
- 14 Lorinson D, Millis DL, Bright RM. Determination of safe depth of pin penetration for repair of distal femoral physeal fractures in immature dogs: a comparison of normograde and retrograde pin placement. Vet Surg 1998; 27: 69-74
- 15 Smith RN. Fusion of ossification centres in the cat. J Small Anim Pract 1969; 10 (09) 523-530
- 16 May C, Bennett D, Downham DY. Delayed physeal closure associated with castration in cats. J Small Anim Pract 1991; 32 (07) 326-328
- 17 Root MV, Johnston SD, Olson PN. The effect of prepuberal and postpuberal gonadectomy on radial physeal closure in male and female domestic cats. Vet Radiol Ultrasound 1997; 38 (01) 42-47
- 18 Perry KL, Fordham A, Arthurs GI. Effect of neutering and breed on femoral and tibial physeal closure times in male and female domestic cats. J Feline Med Surg 2014; 16 (02) 149-156
- 19 Schwarz G. Fractures of the distal tibia and malleoli. In: Johnson AL, Houlton JE, Vanini R. , eds. AO Principles of Fracture Management in the Dog and Cat. Stuttgart: Thieme; 2005: 333-338
- 20 Brioschi V, Langley-Hobbs SJ, Kerwin S, Meeson R, Radke H. Combined physeal fractures of the distal radius and ulna: complications associated with K-wire fixation and long-term prognosis in six cats. J Feline Med Surg 2017; 19 (08) 907-914
- 21 Anderson DM, White RAS. Ischemic bandage injuries: a case series and review of the literature. Vet Surg 2000; 29 (06) 488-498
- 22 Langley-Hobbs SJ, Keller M, Voss K. External coaptation. In: Feline Orthopedic Surgery and Musculoskeletal Disease. London, UK: Saunders Elsevier; 2009: 239-248
- 23 Ma J, Wang T, Lovric V, Johnson KA, Walsh WR. A biomechanical comparison of Kirschner-wire fixation on fracture stability in Salter-Harris type I fractures of the proximal humeral physis in a porcine cadaveric model. BMC Vet Res 2017; 13 (01) 306