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CC BY 4.0 · VCOT Open 2020; 03(02): e103-e111
DOI: 10.1055/s-0040-1716350
Original Article

Tarsocrural Instability in Cats: Combined Internal Repair and Transarticular External Skeletal Fixation

Meike Hammer 
1   Clinique Vétérinaire Aquivet, Parc D'activités Mermoz, Eysines, France
,
Iban Irubetagoyena
1   Clinique Vétérinaire Aquivet, Parc D'activités Mermoz, Eysines, France
,
Jean-Guillaume Grand
1   Clinique Vétérinaire Aquivet, Parc D'activités Mermoz, Eysines, France
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Abstract

Objective The aim of this study was to report outcomes after combined internal repair and transarticular external skeletal fixation (TESF) for the treatment of tarsocrural joint instabilities (TCI) in cats.

Materials and Methods Open reduction of the tarsal joint was performed followed by combined (1) internal repair (tibial/ fibular malleolar osteosynthesis or primary ligament suture and/or prosthetic ligament repair) and (2) temporary TESF. Stability of the tarsus was determined at short-term follow-up (4–8 weeks postoperatively). Short-term complications were evaluated and midterm outcome assessed by an owner telephone questionnaire.

Results Fourteen cats were included of which nine had open TCI. Median time for frame removal was 47 days. Eleven patients had satisfactory stability of the tarsus at short-term follow-up. Catastrophic complications occurred in three cats consisting of extensive skin necrosis of the paw with subsequent hindlimb amputation in two and multiple digit amputations in one cat. Major complications occurred in one cat with persistent TCI requiring pantarsal arthrodesis. Nine cat owners indicated a ‘full or acceptable’ outcome at midterm (median, 1.5 years).

Conclusion Close monitoring in the postoperative period until TESF removal is important for early identification of complications. Despite good joint stability at short-term, persistent or recurrent lameness at midterm can occur.

Keywords

tarsocrural joint instability - internal fixation - transarticular external skeletal fixation - cats

Supplementary Material



Publikationsverlauf

Eingereicht: 15. Januar 2020

Angenommen: 20. Juli 2020

Artikel online veröffentlicht:
08. September 2020

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).

Georg Thieme Verlag KG
Stuttgart · New York

 

  • References

  • 1 Kulendra E, Arthurs G. Management and treatment of feline tarsal injuries. In Pract 2014; 36: 119-132
    CrossrefPubMedGoogle Scholar
  • 2 Corr S. Intensive, extensive, expensive. Management of distal limb shearing injuries in cats. J Feline Med Surg 2009; 11 (09) 747-757
    CrossrefPubMedGoogle Scholar
  • 3 Yardımcı C, Özak A, Önyay T, İnal KS. Management of traumatic tarsal luxations with transarticular external fixation in cats. Vet Comp Orthop Traumatol 2016; 29 (03) 232-238
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 4 DeCamp CE, Johnston SA, Déjardin LM, Schaefer SL. 20 - Fractures and other orthopedic injuries of the tarsus, metatarsus, and phalanges. In: DeCamp CE, Johnston SA, Déjardin LM, Schaefer SL. , eds. Brinker, Piermattei and Flo's Handbook of Small Animal Orthopedics and Fracture Repair (Fifth Edition). London, UK: W.B. Saunders; 2016: 707-758
    Google Scholar
  • 5 Roch SP, Störk CK, Gemmill TJ, Downes C, Pink J, McKee WM. Treatment of fractures of the tibial and/or fibular malleoli in 30 cats. Vet Rec 2009; 165 (06) 165-170
    CrossrefPubMedGoogle Scholar
  • 6 Nicholson I, Langley-Hobbs S, Sutcliffe M, Jeffery N, Radke H. Feline talocrural luxation: a cadaveric study of repair using ligament prostheses. Vet Comp Orthop Traumatol 2012; 25 (02) 116-125
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 7 Owen MA. Use of contoured bar transhock external fixators in 17 cats. J Small Anim Pract 2000; 41 (10) 440-446
    CrossrefPubMedGoogle Scholar
  • 8 Luescher M, Schmierer PA, Park BH. , et al. Biomechanical comparison of knotted and knotless stabilization techniques of the tarsal medial collateral ligament in cats: a cadaveric study. Vet Surg 2020; 49: 390-400
    CrossrefPubMedGoogle Scholar
  • 9 Johnston SA, Tobias KM. Tarsus and metatarsus. In: Veterinary Surgery: Small Animal. Vol 1. Second edition.. Elsevier Health Sciences; 2017: 1200-1203
    Google Scholar
  • 10 Diamond DW, Besso J, Boudrieau RJ. Evaluation of joint stabilization for treatment of shearing injuries of the tarsus in 20 dogs. J Am Anim Hosp Assoc 1999; 35 (02) 147-153
    CrossrefPubMedGoogle Scholar
  • 11 Aron DN, Purinton PT. Replacement of the collateral ligaments of the canine tarsocrural joint: a proposed technique. Vet Surg 1985; 14: 178-184
    CrossrefPubMedGoogle Scholar
  • 12 Voss K, Langley-Hobbs SJ, Montavon PM. Tarsal joint. In: Montavon PM, Voss K, Langley-Hobbs SJ. , eds. Feline Orthopedic Surgery and Musculoskeletal Disease. Edinburgh: W.B. Saunders; 2009: 507-525
    CrossrefGoogle Scholar
  • 13 Fox SM, Guerin SR, Burbidge HM, Lindsay RG. Reconstruction of the medial collateral ligament for tarsocrural luxation in the dog: a preliminary study. J Am Anim Hosp Assoc 1997; 33 (03) 268-274
    CrossrefPubMedGoogle Scholar
  • 14 Beever LJ, Kulendra ER, Meeson RL. Short and long-term outcome following surgical stabilization of tarsocrural instability in dogs. Vet Comp Orthop Traumatol 2016; 29 (02) 142-148
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 15 Anderson DM, Langley-Hobbs SJ. Wounds and wound management. In: Langley-Hobbs SJ, Demetriou JL, Ladlow JF. , eds. Feline Soft Tissue and General Surgery. W.B. Saunders; 2014: 177-194
    CrossrefGoogle Scholar
  • 16 Jaeger GH, Wosar MA, Marcellin-Little DJ, Lascelles BDX. Use of hinged transarticular external fixation for adjunctive joint stabilization in dogs and cats: 14 cases (1999-2003). J Am Vet Med Assoc 2005; 227 (04) 586-591
    CrossrefPubMedGoogle Scholar
  • 17 Kulendra E, Grierson J, Okushima S, Cariou M, House A. Evaluation of the transarticular external skeletal fixator for the treatment of tarsocrural instability in 32 cats. Vet Comp Orthop Traumatol 2011; 24 (05) 320-325
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 18 Cook JL, Evans R, Conzemius MG. , et al. Proposed definitions and criteria for reporting time frame, outcome, and complications for clinical orthopedic studies in veterinary medicine. Vet Surg 2010; 39 (08) 905-908
    CrossrefPubMedGoogle Scholar
  • 19 Gustilo RB, Anderson JT. Prevention of infection in the treatment of one thousand and twenty-five open fractures of long bones: retrospective and prospective analyses. J Bone Joint Surg Am 1976; 58 (04) 453-458
    CrossrefPubMedGoogle Scholar
  • 20 Roe SC. Classification and nomenclature of external fixators. Vet Clin North Am Small Anim Pract 1992; 22 (01) 11-18
    CrossrefPubMedGoogle Scholar
  • 21 Langley-Hobbs SJ, Meeson RL, Hamilton MH, Radke H, Lee K. Feline ilial fractures: a prospective study of dorsal plating and comparison with lateral plating. Vet Surg 2009; 38 (03) 334-342
    CrossrefPubMedGoogle Scholar
  • 22 Burgess R, Elder S, McLaughlin R, Constable P. In vitro biomechanical evaluation and comparison of FiberWire, FiberTape, OrthoFiber, and nylon leader line for potential use during extraarticular stabilization of canine cruciate deficient stifles. Vet Surg 2010; 39 (02) 208-215
    CrossrefPubMedGoogle Scholar
  • 23 Voss K, Langley-Hobbs SJ, Montavon PM. Orthopedic implants. In: Voss K, Langley-Hobbs SJ, Montavon PM. , eds. Feline Orthopedic Surgery and Musculoskeletal Disease. First edition.. Edinburgh: W.B. Saunders; 2009: 265-271
    Google Scholar
  • 24 DeCamp CE, Johnston SA, Déjardin LcMa, Schaefer SL. External skeletal fixation. In: Brinker, Piermattei and Flo's Handbook of Small Animal Orthopedics and Fracture Repair. Fifth edition.. 2016: 66-95
    Google Scholar
  • 25 Palmer RH, Hulse DA, Hyman WA, Palmer DR. Principles of bone healing and biomechanics of external skeletal fixation. Vet Clin North Am Small Anim Pract 1992; 22 (01) 45-68
    CrossrefPubMedGoogle Scholar
  • 26 Bohling MW, Henderson RA. Differences in cutaneous wound healing between dogs and cats. Vet Clin North Am Small Anim Pract 2006; 36 (04) 687-692
    CrossrefPubMedGoogle Scholar
  • 27 Bohling MW. Wound healing. In: Langley-Hobbs SJ, Demetriou JL, Ladlow JF. , eds. Feline Soft Tissue and General Surgery. W.B. Saunders; 2014: 171-175
    CrossrefGoogle Scholar
  • 28 Roch SP, Clements DN, Mitchell RA. , et al. Complications following tarsal arthrodesis using bone plate fixation in dogs. J Small Anim Pract 2008; 49 (03) 117-126
    CrossrefPubMedGoogle Scholar
  • 29 Meeson RL, Davidson C, Arthurs GI. Soft-tissue injuries associated with cast application for distal limb orthopaedic conditions. A retrospective study of sixty dogs and cats. Vet Comp Orthop Traumatol 2011; 24 (02) 126-131
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 30 Anderson DM, White RA. Ischemic bandage injuries: a case series and review of the literature. Vet Surg 2000; 29 (06) 488-498
    CrossrefPubMedGoogle Scholar
  • 31 Schwartz Z, Griffon D. Nonrigid external fixation of the elbow, coxofemoral, and tarsal joints in dogs. Compend Contin Educ Vet 2008; 30 (12) 648-653
    PubMedGoogle Scholar
  • 32 Lauer S, Hosgood G, Ramirez S, Lopez M. In vivo comparison of two hinged transarticular external skeletal fixators for multiple ligamentous injuries of the canine stifle. Vet Comp Orthop Traumatol 2008; 21 (01) 25-35
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 33 Wiseman-Orr ML, Scott EM, Reid J, Nolan AM. Validation of a structured questionnaire as an instrument to measure chronic pain in dogs on the basis of effects on health-related quality of life. Am J Vet Res 2006; 67 (11) 1826-1836
    CrossrefPubMedGoogle Scholar