Treatment of pelvic fractures in cats with patellar fracture and dental anomaly syndrome.

OBJECTIVES: The aim of this study was to describe the treatment and outcome of acetabular and other pelvic fractures in cats with patellar fracture and dental anomaly syndrome (PADS) and to provide advice on how to manage these cases in practice. METHODS: Data were collated on cats with PADS that were reported to have sustained pelvic fractures or had fractures or fissures of the pelvis identified on submitted radiographs. The details of the fractures were recorded, in addition to any treatment and outcome information. RESULTS: Of the 215 cases reported with PADS, 58 cats (27%) were found to have pelvic fractures, none of which were known to have resulted from significant trauma. There were 101 fractures in total and of these 15 were treated with surgery, including 10 acetabular fractures, two ilial, two pubic and one ischial fracture. Screw loosening and loss of fracture reduction was seen in four of the surgically treated fractures (two pubic fractures, one ilial and one acetabular fracture). Fourteen cats were euthanased as a direct result of a fracture occurring. While most pelvic fractures healed uneventfully, some cats remained intermittently lame, but it was not always possible to determine the cause of the lameness from the information available and because all cats had concurrent patellar fractures. CONCLUSIONS AND RELEVANCE: Many of the pelvic fractures healed with conservative management. Fractures involving articular surfaces such as acetabular fractures may benefit from surgical stabilisation as surgery may offer the benefits of articular fracture repair with improved joint congruency and a faster return to normal activity.

Radiological Evaluation of Juvenile osteochondral Conditions in Brazilian Warmblood Horse.

The term juvenile osteochondral condition (JOCC) has been used to identify developmental changes in the growth plates. The condition is characterized by a set of changes with similar pathogenesis that affect the immature skeleton and joints of growing foals. The aim of the current study is to investigate the prevalence and degree of severity of osteochondral changes in Brazilian warmblood (BW) foals in two farms in the south of Brazil. Radiological evaluation was applied to the metacarpophalangeal (MCP), carpal (C), metatarsophalangeal (MTP), tarsal (T), and femorotibiopatellar (FTP) joints of 90 foals (47 females and 43 males) in the age group 16-36 months. The evaluation was made before the animals started their athlete performance. Changes were classified as a degree of severity 0 to 4. Changes were diagnosed in 56 foals (58%) that had 105 affected joints. Thirty-three (59%) out of the 56 animals had changes in more than one joint; 57% (19/33) of them had bilateral changes. MTP and MCP were the joints with the most severe changes, respectively (severity 2 and 3), followed by FTP, T, and C. Osteochondral fragments (59%), tarsal arthropathies (48%), irregularities and radiolucency in the FTP joint (7%), and subchondral cystic lesion in the FTP joint (1%), were the most observed changes. BW foals recorded the high prevalence of osteochondral alterations; although MTP and T were the most affected joints, MTP and MCP presented the most severe changes. The present study confirmed significant JOCC prevalence in BW. Further studies should be carried out in different properties.

Management of severe stifle trauma: 2. Periarticular fractures.

PRACTICAL RELEVANCE: Periarticular stifle fractures are uncommon but challenging injuries to treat. There may be concurrent damage to the ligaments and stabilising structures of the stifle joint itself, which should also be evaluated (see Part 1 of this article series). Improved knowledge of the fixation options and biomechanical challenges of these injuries will aid clinical decision-making and effective repair. CLINICAL CHALLENGES: Due to their nature, periarticular fractures may have small juxta-articular fragments, which require additional thought to address during stabilisation. In juvenile animals, these fractures typically involve the physis and often can be managed with cross pin fixation. In adult cats, locking fixation, specialised plates or external skeletal fixators can be utilised to address the juxta-articular fragments. Readers should also be aware of patellar fracture and dental anomaly syndrome (PADS), where cats develop insufficiency fractures affecting the patella and proximal tibia. A careful oral examination should be performed in affected patients, as these cats may have persistent deciduous teeth. Close attention should be paid to preoperative radiographs for evidence of chronicity of the injury including sclerosis of the patella, remodelling and blunting of the fracture lines. AIMS: The aims of the article are to review the current literature surrounding periarticular fractures of the stifle joint and to summarise the diagnosis, treatment, outcome and complications of each fracture type. As well as discussing general fracture fixation and biomechanical principles applicable to both dogs and cats, information is provided on specific issues facing cats, such as PADS. EVIDENCE BASE: Published data is limited, with reports including only a small number of cats. The information and recommendations in this article have therefore been drawn from a combination of the available literature and the authors' clinical experience.

Stabilisation of periarticular fractures and osteotomies with a notched head locking T-plate.

OBJECTIVE: To report the clinical outcomes and complications of small animals that had articular or periarticular fractures or osteotomies stabilised with a notched head locking T-plate. METHODS: Medical records were searched retrospectively to identify animals that had a notched head locking T-plate used to stabilise a small articular or periarticular bone fragment. RESULTS: Nine dogs and two cats had an articular or periarticular bone fragment stabilised with a 2.0- or 2.4-mm notched head locking T-plate (12 procedures). The median body weight was 4.7 kg. The plate was modified by removing holes in 10/12 procedures and a combination of locking and non-locking screws were used in 7/12 procedures. All fractures or osteotomies progressed to clinical union. There were two intraoperative complications (intra-articular screw placement and overlong screw) and two postoperative complications (skin necrosis and stress protection) CONCLUSIONS: This study reports the successful use of a 2.0- or 2.4-mm notched head locking T-plate for articular or periarticular fractures or osteotomies in a variety of small-breed dogs and cats. Care must be taken to prevent inadvertent penetration of the articular surface, particularly in regions such as the proximal tibia. The ability to modify the plate dimensions intraoperatively proved beneficial in most cases.

Minimally invasive osteosynthesis technique for articular fractures.

Articular fractures require accurate reduction and rigid stabilization to decrease the chance of osteoarthritis and joint dysfunction. Articular fractures have been traditionally repaired by arthrotomy and internal fixation. Recently, minimally invasive techniques have been introduced to treat articular fractures, reducing patient morbidity and improving the accuracy of reduction. A variety of techniques, including distraction, radiographic imaging, and arthroscopy, are used with the minimally invasive osteosynthesis technique of articular fractures to achieve a successful repair and outcome.