The Use of Combined Transarticular Pinning and External Skeletal Fixation for the Reduction and Stabilization of Multiple Metatarsophalangeal Luxations in a Cat

A 1-year-old spayed female domestic short-hair cat presented for a nonweight-bearing right pelvic limb lameness sustained after falling from a 4-m banister. Substantial swelling and pain on manipulation of the right pes was appreciated on examination. Radiographs revealed dorsoproximal metatarsophalangeal luxation of digits III- V. Closed reduction was attempted prior to surgery but was unsuccessful. Transarticular Kirschner’s wires were placed to maintain reduction of digits III and IV. Two additional Kirschner’s wires were placed transversely through the base of metatarsals II-V. All wires were bent to converge over the paw and the ends were incorporated in a sphere of polymethylmethacrylate. Early complications included marked postoperative swelling and distortion of the pes. Three weeks postoperatively a persistent weight-bearing lameness and mild wire tract inflammation were noted. The implants were removed, and the limb was coapted with a splint for a week. The paw distortion and wire tract inflammation resolved by splint removal and the lameness resolved within 6 weeks postoperatively. No lameness was observed on orthopaedic examination at 6 months. Radiographs revealed mild degenerative changes of the third and fourth metatarsophalangeal and distal intertarsal joints and moderate degenerative changes of the tarsometatarsal joints.

There are limited reports describing metatarsophalangeal luxations in cats. Although several surgical techniques have been described, specific outcomes in clinical cases have not been reported. The use of combined transarticular pinning and external skeletal fixation to address multiple metatarsophalangeal luxations yielded an acceptable outcome in the cat reported here.

Acknowledgment: There was no proprietary interest or funding provided for this project.