A comparison between fixation methods of femoral diaphyseal fractures in cats – a retrospective study

Konning, Tessa; Maarschalkerweerd, Roelof; Endenburg, Nienke; Theyse, L. F. H.

doi:10.1111/jsap.12061

Cited by 16 publications

(27 citation statements)

References 17 publications

(37 reference statements)

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“…Neste estudo, todas as fraturas foram diafisárias, sendo este pré-requisito importante para estabilização com PPIM [1]. A associação PPIM é indicada principalmente para fraturas cominutivas, quando não é possível obter redução anatômica dos fragmentos [10], como ocorreu em 9 pacientes deste trabalho (Figura 2), mas pode ser utilizada também para estabilizar fraturas simples ou múltiplas [15], mantendo as vantagens biológicas desta técnica [1].…”

Section: Discussionunclassified

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Plate-Rod Osteosynthesis in Dogs and Cats

Souza

Ferreira

Amadori

et al. 2019

Acta Scientiae. Vet.

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Background: Most fractures are caused by traumatic processes due to car accidents, but they can also occur due to bullets, fights and falls. Surgical stabilization is often necessary and shows high rates of bone healing when its basic concepts are followed. The objective of this study is to report cases of shaft fracture in long bones stabilized with intramedullary pin and plate (IMPP) in order to evaluate pre- and postoperative clinical and radiographic signs, correlating the ideal surgical technique described on recent studies with complications resulting from the surgical procedure.Cases: This study includes patients undergoing osteosynthesis with intramedullary pin and plate from January 2015 to December 2016 at the Veterinary Medical Teaching Hospital of UFRGS. During this period, 13 animals (five cats and eight dogs) with long bone fractures were treated with the abovementioned association. Information on breed, age, sex, etiology of the fracture, affected bone, clinical signs, osteosynthesis technique, clinical progress, fracture healing, and postoperative complications was collected for the study. Late postoperative recovery was evaluated by telephone contact with owners. The mean age was 5.4 years (3 months - 15 years) and body weight 17.66 kg (3 - 28.4 kg). The fractures were due to being hit by a vehicle (5), bites (1), accident with a toy (1), and unknown (6).Discussion: All cases included in this study were in the femur, humerus or tibia. Fractures in the radius are also frequent in small animal traumatology, but in this case the use of an intramedullary pin is not recommended. All animals had diaphyseal fractures, which is an important prerequisite for IMPP stabilization. The IMPP association is mainly indicated in cases of comminuted fractures, when it is anatomically impossible to reduce fracture fragments, as occurred with nine patients in this study. The plate did not break of fail in any of the cases, as the association of an intramedullary pin with the plate significantly reduces tension on the plate, increasing bending strength up to ten times. One of the animals presented severe postoperative pain and could not adequately lean on the operated limb. Orthopedic and neurological evaluation led to the conclusion that the long pin in the region of the subtrochanteric fossa could be injuring the sciatic nerve and the animal was reoperated to cut the pin shorter. Pain stopped and after seven months the animal could lean on the limb and move normally, being proprioceptive and showing no pain on palpation and manipulation. The pin used in the IMPP technique should fill 30 to 40% of the diameter of the intramedullary canal at its narrowest portion. Of the 13 patients included in this study, six received pins within the recommended diameter, one received a pin larger than recommended, and five received pins smaller than recommended. The mean diameter of the pin related to the diameter of the medullary canal was 32.3% (19% - 54.8%). The bone healing rate described for IMPP is high (98%), three patients returned for this study reevaluation and all of them presented visible radiographic bone healing. We concluded that osteosynthesis associated with the use of intramedullary pin and plate resulted in adequate stabilization of fractures in the femur, tibia and humerus, allowing fast functional recovery with low complication rates.

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“…A placa, sem associação, pode ser suscetível a falha por carga cíclica, principalmente arqueamento, e esta é uma das causas da falha deste implante [17]. Quando ambos são associados a placa e o pino intramedular trabalham em sinergia [10].…”

Section: Introductionunclassified

Plate-Rod Osteosynthesis in Dogs and Cats

Souza

Ferreira

Amadori

et al. 2019

Acta Scientiae. Vet.

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“…However, the most fragmented fractures were repaired with the use of bridging plate associated with the intramedullary pin, external skeletal fixator Tie-In configuration, and association of intramedullary pins with cerclage. Therefore, stating that the complication rate is due to the attachment method, fracture, and patient characteristics is impossible (JACKSON & PACCHIANA, 2004;KÖNNING, 2013).…”

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confidence: 99%

Classification, fixation techniques, complications and outcomes of femur fractures in dogs and cats: 61 cases (2015-2016)

et al. 2018

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The aim of this study was to retrospectively evaluate the frequency of femur fractures in dogs and cats in the routine of a school hospital, determining their classification, fixation methods, complications, and outcomes. A total of 61 animals, 50 (82.0%) dogs and 11 (18.0%) cats, had femoral fractures that were submitted to osteosynthesis. Sixty-two femoral fractures were evaluated. Single fractures in the distal epiphysis (n=25) were the most frequent (P=0.0001). Intramedullary pins were used in association with cerclage and tension band for osteosynthesis in proximal fractures. In diaphyseal fractures, bone plates and screws, two intramedullary pins (insulated or with cerclage) and Tie-In configuration were used. In distal fractures, modified Rush intramedullary pins, cross pins and Tie-In configuration were used. Comparing complication frequencies at fracture sites that required reintervention after osteosynthesis, a significant difference was observed (P=0.0253) between the diaphyseal (31.25%) and distal (7.14%) fractures independent of the technique used. We concluded that distal epiphyseal fractures were the most frequent in the routine of a school hospital. Distal epiphyseal fractures presented a lower frequency of complications for consolidation when treated with modified Rush intramedullary pins or crossed pins.

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“…7 In a plate-rod construct the intramedullary pin resistance to bending loads and the axial and torsional support of the bone plate are combined. [2][3][4]8,9 Advantages of the plate-rod construct over a bone plate alone include simplifying fracture reduction, maintaining spatial alignment, reducing plate strain across the fracture gap, and increasing the stiffness, load to failure, and fatigue life of the construct. 5,6,10 For each 10% increase in pin diameter, strain in the plate is reduced by $20%.…”

Section: Introductionmentioning

confidence: 99%

Veterinary Cuttable Plate in a Plate-Rod Construct for Repair of Diaphyseal Femoral Fractures in the Cat

Védrine¹,

Gérard²

2018

Vet Comp Orthop Traumatol

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Objective This study evaluated retrospectively the effectiveness of the veterinary cuttable plate (VCP) in a plate-rod construct, for the treatment of diaphyseal femoral fractures in cats. Materials and Methods A total of 29 cats with diaphyseal femoral fracture underwent stabilization with a VCP-rod construct. Results Fractures were classified as type A (7/29), type B (11/29) and type C (11/29) following the AO classification. Biological osteosynthesis was elected in three type B and 10 type C fractures, and open approach in the other cases. Pin diameter was 2 mm (n = 16) or 2.5 mm (n = 13); this corresponded to a percentage of pin occupation of 39.9 and 53.0% of the intramedullary cavity respectively. The 2.0/2.7-mm VCP and 2-mm screws were used in all cases. The median length of the VCP was 12 holes, and the median number of screws placed in the plate was 6. The median number of cortices engaged per fragment was 6. Ninety-nine percent of the screws were bicortical. Quadriceps contracture was an unacceptable functional outcome in one cat. Follow-up was available in 20 cases. Complete bone healing was assessed in 16/20 cases with a functional outcome considered as full in 17/20, acceptable in 2/20, and unacceptable in 1/20. Telephonic owner outcome assessment was available for five more cats and was considered as full in all cases. Clinical Significance The VCP-rod construct is effective to manage all configurations of diaphyseal femoral fracture in cats. The high amount of screw holes per unit length of a VCP allows bicortical screws placement without interfering with the intramedullary rod.

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A comparison between fixation methods of femoral diaphyseal fractures in cats – a retrospective study

Abstract: There was no statistically significant difference in the time to achieve bone healing but there was a significant difference in categorized complication rates between the groups.

Cited by 16 publications

References 17 publications

Plate-Rod Osteosynthesis in Dogs and Cats

Plate-Rod Osteosynthesis in Dogs and Cats

Classification, fixation techniques, complications and outcomes of femur fractures in dogs and cats: 61 cases (2015-2016)

Veterinary Cuttable Plate in a Plate-Rod Construct for Repair of Diaphyseal Femoral Fractures in the Cat

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