Management of traumatic tarsal luxations with transarticular external fixation in cats

Cenk Yardımcı; Ahmet Özak; Taylan Önyay; Kamil Serdar İnal

doi:10.3415/VCOT-15-04-0056

Veterinary and Comparative Orthopaedics and Traumatology, Table of Contents

Vet Comp Orthop Traumatol 2016; 29(03): 232-238
DOI: 10.3415/VCOT-15-04-0056

Clinical Communication

Schattauer GmbH

Management of traumatic tarsal luxations with transarticular external fixation in cats

Cenk Yardımcı

¹Department of Surgery, Faculty of Veterinary Medicine, Ondokuz Mayıs University, Kurupelit, Samsun, Turkey

,

Ahmet Özak

¹Department of Surgery, Faculty of Veterinary Medicine, Ondokuz Mayıs University, Kurupelit, Samsun, Turkey

,

Taylan Önyay

¹Department of Surgery, Faculty of Veterinary Medicine, Ondokuz Mayıs University, Kurupelit, Samsun, Turkey

,

Kamil Serdar İnal

¹Department of Surgery, Faculty of Veterinary Medicine, Ondokuz Mayıs University, Kurupelit, Samsun, Turkey

› Author Affiliations

Abstract

Summary

Objective: To report our experience with the use of contoured mini circular transarticular external skeletal fixators for the management of traumatic tarsal luxations in 15 cats.

Materials and methods: Fifteen cats with traumatic tarsal joint luxation treated by using mini circular transarticular external fixators with available clinical records and complete clinical and radiographic follow-up of at least 30 weeks duration were included in the study. Data collected were the signalment, history, type of injury, concomitant injury, frame configuration, stabilization technique, duration of the surgery, time to first use of the operated limb, fixator removal time, complications, final outcome and follow-up.

Results: The surgical procedure chosen was based on the type of luxation; partial tarsal arthrodesis was performed in 10 cases, tarsocrural stabilization in four cases, and pantarsal arthrodesis in three cases. Five cats started to use the operated limb immediately after recovering from anaesthesia. In the other 10 cats, time to first use ranged from one to four days (mean 2 days). In one case, early pin loosening due to half pin fixation bolt failure was observed as a postoperative complication. Fixator removal time ranged from 24 to 60 days (mean 45 days). Functional outcome was excellent in 15 cats and good in two.

Clinical relevance: This is a preliminary report about the treatment of tarsal luxations with a mini circular transarticular external fixation system in which early postoperative and long-term results seem to be favourable.

Online Supplementary Material: Please note that a Supplementary Table and 3 Supplementary Videos are available for this paper online at: http://dx.doi.org/10.3415/VCOT-15-04-0056

Keywords

Cat - tarsal luxation - external fixation - arthrodesis

Full Text

References

References
1 Vannini R, Bonath KH. Arthrodesis of the tarsus. In Johnson AL, Houlton JEF, Vannini R. editors AO Principles of Fracture Management in the Dog and Cat Davos Platz, Switzerland: AO Publishing; 2005: 465-471.
2 Carmichael S, Marshall W. Tarsus and metatarsus. In Tobias KM, Johnston SA. editors Veterinary Surgery Small Animal. St Louis: Elseiver; 2012: 1014-1028.
3 Owen MA. Use of contoured bar transhock external fixators in 17 cats. J Small Anim Pract 2000; 41: 440-446.
4 Roch SP, Stork CK, Gemmil TJ. et al. Treatment of fractures of the tibial and/or fibular malleoli in 30 cats. Vet Rec 2009; 165: 165-170.
5 Hurter K, Schawalder P, Schmökel HG. Talocalcaneal luxation combined with lateral instability of the talocrural joint in a dog and a cat. Vet Comp Orthop Traumatol 2004; 17: 53-56.
6 Corr S. Management of distal limb shearing injuries in cats. J Feline Med Surg 2009; 11: 747-757.
7 Schmökel HG, Ehrisman G. The surgical treatment of talocrural luxation in nine cats. Vet Comp Orthop Traumatol 2001; 14: 46-50.
8 Dee JF. Tarsal injuries. In Bloomberg MS, Dee JF, Taylor RA. editors Canine Sports Medicine and Surgery Philadelphia: WB Saunders; 1998: 120-137.
9 Welch JA. The tarsus and metatarsus. In Slatter D. editor Texbook of Small Animal Surgery 3rd ed.. Philadelphia: Saunders; 2003: 2158-2163.
10 Taylor RA, Dee JF. Tarsus and metatarsus. In Slatter D. editor Textbook of Small Animal Surgery 2nd ed.. Philadelphia: Saunders; 1993: 1876
11 Earley TD, Dee JF. Trauma to the carpus, tarsus, and phalanges of dogs and cats. Vet Clin North Am Small Anim Pract 1980; 10: 717-747.
12 Meeson RL, Davidson C, Arthurs I G. Soft tissue injuries associated with cast application for distal limb orthopaedic conditions. Vet Comp Orthop Traumatol 2011; 24: 126-131.
13 Behrens F, Kraft EL, Oegema TR. Biochemical changes in articular cartilage after joint immobilization by casting or external fixation. J Orthop Res 1989; 7: 335-343.
14 Penwick RC, Clark DM. A simple technique for tarsometatarsal arthrodesis in small animals. J Am Anim Hosp Assoc 1988; 24: 183-188.
15 Barnes DC, Knudsen CS, Gosling M. et al. Complications of lateral plate fixation compared with tension band wiring and pin or lag screw fixation for calcaneoquartal arthrodesis. Vet Comp Orthop Traumatol 2013; 26: 445-452.
16 Fitzpatrick N, Sajik D, Farrel M. Feline pantarsal arthrodesis using pre-contoured dorsal plates applied according to the principles of percutaneous plate arthrodesis. Vet Comp Orthop Traumatol 2013; 26: 399-407.
17 Roch SP, Clements DN, Mitchell RAS. et al. Complications following tarsal arthrodesis using bone plate fixation in dogs. J Small Anim Pract 2008; 49: 117-126.
18 Dyce J, Whitelock RG, Robinson KV. et al. Arthrodesis of the tarsometatarsal joint using a laterally applied plate in 10 dogs. J Small Anim Pract 1998; 39: 19-22.
19 Wilke VL, Robinson TM, Dueland RT. Intertarsal and tarsometatarsal arthrodesis using a plantar approach. Vet Comp Orthop Traumatol 2000; 13: 28-33.
20 DeCamp CE, Martinez SA, Johnston SA. Pantarsal arthrodesis in dogs and a cat: 11 cases (1983-1991). J Am Vet Med Assoc 1993; 203: 1705-1707.
21 Kulendra E, Grierson J, Okushima S. et al. Evaluation of the transarticular external skeletal fixator for the treatment of tarso-crural instability in 32 cats. Vet Comp Orthop Traumatol 2011; 24: 320-325.
22 Toombs JP. Transarticular application of external skeletal fixation. Vet Clin North Am Small Anim Pract 1992; 22: 181-194.
23 Benson JA, Boudrieau RJ. Severe carpal and tarsal shearing injuries treated with immediate arthrodesis in seven dogs. J Am Anim Hosp Assoc 2002; 38: 370-380.
24 McLennan MJ. Ankylosis of tarsometatarsal luxations using external fixation. J Small Anim Pract 2007; 48: 508-513.
25 Jaeger GH, Wosar MA, Marcellin-Little DJ. et al. 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: 586-591.
26 Trostel CT, Radasch RM. Tarsocrural arthrodesis: A clinical report using a circular external fixator. Vet Comp Orthop Traumatol 1998; 11: 193-196.
27 Klause SE, Piermattei DL, Schwarz PD. Tarso-crural arthrodesis: Complications and recommendations. Vet Comp Orthop Traumatol 1989; 3: 119-124.
28 Shani J, Yeshurun Y, Shahar R. Arthrodesis of the tarsometatarsal joint, using type-II ESF with acrylic connecting bars in four dogs. Vet Comp Orthop Traumatol 2006; 19: 61-63.
29 Halling KB, Lewis DD, Jones RW. et al. Use of circular external skeletal fixator constructs to stabilize tarsometatarsal arthrodeses in three dogs. Vet Comp Orthop Traumatol 2004; 17: 204-209.
30 Aron DN. Prosthetic ligament replacement for severe tarsocrural joint instability. J Am Anim Hosp Assoc 1987; 23: 41-55.
31 Holt PE. Collateral ligament prostheses in the canine tarsus. Canine Pract 1979; 6: 53-60.
32 Montavon PM, Voss K, Langley-Hobbs SJ. Tarsal Joint. In: Feline Orthopaedic Surgery and Musculoskeletal Disease. Philadelphia: Saunders 2009; 515-525.
33 Lincoln JD. Treatment of open, delayed union, and nonunion fractures with external skeletal fixation. Vet Clin North Am Small Anim Pract 1992; 22: 195-207.
34 Harari J. Complications of external skeletal fixation. Vet Clin North Am Small Anim Pract 1992; 22: 99-107.
35 Whitney WO, Mehlhaff CJ. High-rise syndrome in cats. J Am Vet Med Assoc 1987; 191: 1399-1403.

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