Repair of an Isolated Traumatic Cranial Luxation of the Radial Head Using a TightRope System in a Cat

Abstract

A 4.4 kg, a 6-year-old Domestic Shorthair male neutered outdoor cat was diagnosed with an isolated traumatic cranial luxation of the left radial head. Surgical stabilization was achieved using a mini TightRope system (Arthrex Vet Systems, Naples, Florida, United States) to hold the radial head to the ulna without attempting to reconstruct the annular ligament. A range of motion within the normal range was achieved after reduction. At 7-week follow-up after surgery, the cat was walking without lameness; at follow-up by telephone 3 years postoperatively, the owner described the overall quality of life as excellent with good mobility in everyday activities such as jumping, running, and playing. Many publications in veterinary medicine detail congenital radial head luxation, Monteggia lesions, or complete elbow luxation, but traumatic radial head luxation is barely cited as the occurrence is rare. To our knowledge, this is the first reported case of a feline isolated traumatic radial head luxation managed with this technique.

Keywords

cat - radial head luxation - elbow - mini TightRope

Publikationsverlauf

Eingereicht: 02. April 2022

Angenommen: 19. September 2022

Artikel online veröffentlicht:
14. Dezember 2022

• References

• 1 Krotscheck U, Böttcher P. Surgical diseases of the elbow. In: Johnston SA. and Tobias KM, eds. Veterinary Surgery Small Animal. 2nd ed.. St. Louis: Elsevier; 2018: 838-848
• 2 Valastro C, Di Bello A, Crovace A. Congenital elbow subluxation in a cat. Vet Radiol Ultrasound 2005; 46 (01) 63-64
• 3 Rossi F, Vignoli M, Terragni R, Pozzi L, Impallomeni C, Magnani M. Bilateral elbow malformation in a cat caused by radio-ulnar synostosis. Vet Radiol Ultrasound 2003; 44 (03) 283-286
• 4 Voss K, Langley-Hobbs SJ, Montavon PM. Elbow joint. In: Feline Orthopaedic Surgery and Musculoskeletal Disease. 1st ed.. Philadelphia: W.B. Saunders; 2009: 359-370
• 5 Autefage A. Fracture of the ulna. In: Johnson AL, Houlton JEF, Vannini R. eds. AO Principles of Fracture Management in the Dog and Cat. New York: Thieme; 2005: 260-272
• 6 Bado JL. The Monteggia lesion. Clin Orthop Relat Res 1967; 50 (50) 71-86
• 7 Bruce WJ. Radius and ulna. In: Cough- lan A, Miller A. eds. Manual of Small Animal Fracture Repair and Management. Cheltenham: BSAVA; 1998: 197-215
• 8 Fox D. Radius and ulna. In: Johnston SA, Tobias KM. eds. Veterinary Surgery Small Animal. 2nd ed.. St. Louis: Elsevier; 2018: 896-920
• 9 Schwarz PD, Schrader SC. Ulnar fracture and dislocation of the proximal radial epiphysis (Monteggia lesion) in the dog and cat: a review of 28 cases. J Am Vet Med Assoc 1984; 185 (02) 190-194
• 10 Bush M, Owen M. Type-IV variant Monteggia fracture with concurrent proximal radial physeal fracture in a Domestic Shorthaired Cat. Vet Comp Orthop Traumatol 2009; 22 (03) 225-228
• 11 Garcia M, Bismuth C, Deroy-Bordenave C. Repair of a divergent elbow dislocation with distal ulnar fracture in a dog using TightRope and external skeletal fixation. Vet Comp Orthop Traumatol Open 2021; 4: e58-e64
• 12 Evans HE, de Lahunta A. Miller's Anatomy of the Dog. 4th ed.. St. Louis: Elsevier; 2013: 190-193
• 13 Vallone L, Schulz K. Repair of Monteggia fractures using an Arthrex Tightrope system and ulnar plating. Vet Surg 2011; 40 (06) 734-737
• 14 Obert L, Huot D, Lepage D, Garbuio P, Tropet Y. [Isolated traumatic luxation of the radial head in adults: report of a case and review of the literature]. Chir Main 2003; 22 (04) 216-219
• 15 Johnson K. Piermattei's Atlas of Surgical Approaches to the Bones and Joints of the Dog and Cat. 5th ed.. St Louis: Elsevier Saunders; 2014: 240-242
• 16 Lancelles D. Feline musculoskeletal pain index. Secondary feline musculoskeletal pain index 2015. Accessed October 21, 2022, at: https://painfreecats.org/pain-scale/
• 17 Harasen G. Congenital radial head luxation in a bulldog puppy. Can Vet J 2012; 53 (04) 439-441
• 18 Farrell M, Thomson DG, Carmichael S. Surgical management of traumatic elbow luxation in two cats using circumferential suture prostheses. Vet Comp Orthop Traumatol 2009; 22 (01) 66-69
• 19 Williams H, Calvo I, Gaines A. et al. Multi-centre retrospective study of the long-term outcome following suspected traumatic elbow luxation in 32 cats. J Small Anim Pract 2020; 61 (06) 354-362
• 20 Gupta V, Kundu Z, Sangwan S, Lamba D. Isolated post-traumatic radial head dislocation, a rare and easily missed injury-a case report. Malays Orthop J 2013; 7 (01) 74-78
• 21 Naqvi GA, Shafqat A, Awan N. Tightrope fixation of ankle syndesmosis injuries: clinical outcome, complications and technique modification. Injury 2012; 43 (06) 838-842
• 22 Flinkkilä TE, Ihanainen E. Results of arthroscopy-assisted tightrope repair of acromioclavicular dislocations. Shoulder Elbow 2014; 6 (01) 18-22
• 23 Kayiaros S, Blankenhorn BD, Dehaven J. et al. Correction of metatarsus primus varus associated with hallux valgus deformity using the Arthrex mini tightrope: a report of 44 cases. Foot Ankle Spec 2011; 4 (04) 212-217
• 24 Pinna S, Lanzi F, Tassani C, Mian G. Intra-articular replacement of a ruptured cranial cruciate ligament using the mini-TightRope in the dog: a preliminary study. J Vet Sci 2020; 21 (05) e53
• 25 Cook JL, Luther JK, Beetem J, Karnes J, Cook CR. Clinical comparison of a novel extracapsular stabilization procedure and tibial plateau leveling osteotomy for treatment of cranial cruciate ligament deficiency in dogs. Vet Surg 2010; 39 (03) 315-323
• 26 Kieves NR, Lotsikas PJ, Schulz KS, Canapp SO. Hip toggle stabilization using the TightRope® system in 17 dogs: technique and long-term outcome. Vet Surg 2014; 43 (05) 515-522
• 27 Ash K, Rosselli D, Danielski A, Farrell M, Hamilton M, Fitzpatrick N. Correction of craniodorsal coxofemoral luxation in cats and small breed dogs using a modified Knowles technique with the braided polyblend TightRope systems. Vet Comp Orthop Traumatol 2012; 25 (01) 54-60
• 28 O'Donnell EM, Canapp Jr SO, Cook JL, Pike F. Treatment of medial shoulder joint instability in dogs by extracapsular stabilization with a prosthetic ligament: 39 cases (2008-2013). J Am Vet Med Assoc 2017; 251 (09) 1042-1052
• 29 Stolarz M, Ficek K, Binkowski M, Wróbel Z. Bone tunnel enlargement following hamstring anterior cruciate ligament reconstruction: a comprehensive review. Phys Sportsmed 2017; 45 (01) 31-40
• 30 Yao J, Song Y. Suture-button suspensionplasty for thumb carpometacarpal arthritis: a minimum 2-year follow-up. J Hand Surg Am 2013; 38 (06) 1161-1165