Surgical management of superficial digital flexor tendon luxation in dogs: 48 cases (2005-2020).

OBJECTIVES: To report the outcome, frequency of complications and potential prognostic factors associated with surgical repair of superficial digital flexor tendon (SDFT) luxation in dogs. MATERIALS AND METHODS: Medical records from 10 referral hospitals were reviewed retrospectively for cases of SDFT luxation in dogs that underwent surgical stabilisation. Signalment, clinical presentation, diagnostic imaging, surgical method, type and length of post-operative limb immobilisation, nature of and length of exercise restriction, presence of post-operative complications and outcomes were recorded. Data were summarised descriptively and prognostic risk factors assessed for association with surgical outcome using risk ratios. RESULTS: Forty-eight cases were included. A successful surgical outcome was recorded in 35 of 48 (73%) cases. Re-luxation of the SDFT occurred in seven of 48 (15%). Six out of 48 (13%) had a persistent lameness despite a stable non-luxating SDFT. A high frequency of post-operative complications occurred (71%), with the majority resolved medically. The risk of surgical failure was 60% higher (risk ratio 1.6, 95% confidence interval 1.1 to 2.4) where absorbable suture material was used compared to non-absorbable suture material. Surgical failure was more common in cases managed with non-rigid immobilisation post-operatively (57% failure) compared to cases managed with rigid immobilisation (19% failure), although this result was not statistically significant. Limb immobilisation of 6 weeks or longer did not significantly affect surgical outcome, compared to shorter periods of exercise restriction or limb immobilisation. CLINICAL SIGNIFICANCE: A good outcome can be expected following surgical stabilisation of SDFT luxation. The use of non-absorbable suture was associated with a more successful surgical outcome.

Multi-centre retrospective study of the long-term outcome following suspected traumatic elbow luxation in 32 cats.

OBJECTIVES: To describe reduction techniques and clinical outcome in a series of traumatic elbow luxations in cats. MATERIALS AND METHODS: Retrospective review of unilateral elbow luxations treated at five specialist referral centres. Data included signalment, aetiology, concurrent injuries, luxation direction, time to reduction, primary reduction technique, surgical procedure and complications. Cases were excluded if reduction technique was unknown. Telephone owner questionnaire follow-up was completed using a Feline Musculoskeletal Pain Index. RESULTS: Thirty-two cats were included. Lateral luxations were most common (n = 21). Time (hours) until attempted initial closed reduction was <24 (n = 12), 24-48 (n = 13), >48 (n = 3) or unrecorded (n = 4). Luxation was treated by closed reduction alone (n = 7) or by surgery (n = 25); 14 of 25 cases underwent primary surgical reduction and 11 of 25 were secondary procedures following failure of closed reduction. Transcondylar bone tunnels and circumferential suture (n = 19) was the most commonly used surgical technique. Catastrophic (n = 1), major (n = 11) and minor complications (n = 5) were recorded; reluxation occurred more frequently after closed reduction (n = 8) than after open reduction with fixation (n = 0). Feline Musculoskeletal Pain Index data were available for 12 cats; outcome was good-excellent in all 12, with a median function score of 64.5/68 (range: 55-68) and a median pain score of 0/15 (range: 0-5). Outcome was not associated with reduction technique. CLINICAL SIGNIFICANCE: Elbow reluxation occurred in 61% of cats following primary closed reduction but did not occur in any open reduction cases. Reluxation rate increased with duration from injury. Most cats had good-excellent owner-assessed outcome, regardless of reduction technique.

Multi-centre retrospective study of long-term outcomes following traumatic elbow luxation in 37 dogs.

OBJECTIVES: Limited guidelines exist regarding the optimal treatment of traumatic canine elbow luxation, and there is a lack of information on long-term functional outcome. Here we report reduction and stabilisation techniques for a series of traumatic elbow luxations and describe clinical outcome plus long-term questionnaire-based follow-up. METHODS: Retrospective review of canine traumatic elbow luxations (2006 to 2013) treated at five referral centres. Data recorded included signalment, luxation aetiology, time to reduction, reduction technique, surgical procedure, post-reduction care and complications. Questionnaire follow-up was attempted for all cases with owners completing the Canine Brief Pain Inventory. RESULTS: Thirty-seven dogs were included. The most frequent cause of luxation was road traffic accident (n=22). Twenty cases were treated surgically. Seven dogs suffered major postoperative complications: reluxation (n=6), infection requiring implant removal (n=1). Four of the six reluxations occurred in dogs that had other orthopaedic injuries. Twenty-two owners completed the Canine Brief Pain Inventory questionnaire: there were 13 excellent, 6 very good, 1 good and 2 fair outcomes. Outcome was not associated with the reduction technique. CLINICAL SIGNIFICANCE: Initial closed reduction, followed by surgical stabilisation if unsuccessful, results in good-to-excellent outcomes in the majority of traumatic canine elbow luxations. Reluxation was the most common major complication and there was a higher incidence of reluxation in patients with multiple orthopaedic injuries.

Feline pantarsal arthrodesis using pre-contoured dorsal plates applied according to the principles of percutaneous plate arthrodesis.

OBJECTIVE: To describe the surgical technique for pantarsal arthrodesis (PTA) in cats according to the principles of percutaneous plate arthrodesis with application of a pre-contoured dorsal plate, without external coaptation and to report the long-term clinical outcome. MATERIALS AND METHODS: Retrospective review was performed of all cats treated by percutaneous plate application using a new pre-contoured dorsal plate for PTA between 2008 and 2011. Inclusion criteria were clinical and radiographic records plus clinical follow-up to at least six weeks. Data recorded included signalment, indication for surgery, postoperative care, and complications encountered. Radiographs were assessed for arthrodesis progression and complications. Outcome was assessed using an owner questionnaire. RESULTS: Eleven cats were treated for tarsal injuries and met the inclusion criteria. Mean age was 86 ± 45 months, weight 4.50 ± 0.92 kg. The only major short-term complication encountered was wound dehiscence requiring sedation and re-suturing. In the medium-term (23.3 months ± 11.6 months) eight out of nine cats returned to normal activity and one cat showed intermittent lameness. Long-term (34.3 months ±17.5 months) radiographic evaluation was performed in seven out of nine cats; six manifested complete arthrodesis and one sustained plate breakage. Based on owner questionnaire, all nine cats returned to normal activity in the long-term, even the case with plate breakage. CONCLUSION: Based on our results, PTA using a custom pre-contoured dorsal plate is a suitable salvage surgery for treatment of severe tarsal injuries in cats.