Management and Long-Term Outcome of Acetabular Fractures in Dogs: A Retrospective Study of 49 Dogs

Abstract

Objective The aim of this study was to categorize the presentation, management, complications and long-term outcome of canine acetabular fractures, and to determine the factors affecting outcome. Materials and Methods Case records and imaging for dogs with acetabular fractures were reviewed with long-term follow-up via canine brief pain inventory (CBPI) and owner questionnaires. Results The majority of fractures were in the mid-third (36/52) and caudal-third (13/52) with few in the cranial-third of the acetabulum (3/52). Concurrent injuries were diagnosed in 47/49 dogs; 10/34 dogs had neurological deficits on presentation. Forty-seven fractures received treatment: 25/47 had direct surgical repair (DSR), 10/47 had salvage surgery (SS) and 12/47 had conservative management (CM). Fracture location significantly affected treatment group (p = 0.001). New neurological deficits were documented after DSR in 5/24 dogs and SS in 2/10 dogs. Short-term complications occurred after DSR in 10/18 dogs (five minor, five major) and CM in 1/8 dogs (major). Long-term complications occurred after DSR in 2/15 dogs (major) and CM in 2/7 dogs (catastrophic). Conservative management dogs had worse average owner-reported CBPI scores than DSR or SS dogs. Clinical Significance Acetabular fractures predominate in the mid and caudal acetabulum, with high levels of concurrent injuries. Fracture location significantly influenced the treatment approach taken. Postoperative neurological deficits are common following SS and DSR.

Retrospective Assessment of Thirty-Two Cases of Pelvic Fractures Stabilized by External Fixation in Dogs and Classification Proposal

“…Seventy-five percent of the patients have graded a mean of 9.25 with comfort VAS. These results were considered satisfactory due to the specific features of the treated fractures and the reported critical management of acetabular fractures and their complications [28,30].…”

“…Most veterinary literature for the treatment of acetabular fractures in dogs reports the use of plates for stabilization [28,29]. Only Graville et al (2018) described the use of EF for the stabilization of this type of fracture [11], suggesting that it was a viable option for the treatment of acetabulum fractures despite some limitations, such as challenging the reduction in the fracture site or pin loosening in some cases [5].…”

A Bilateral Acetabular Physeal Fracture Treated with External Fixation in an Immature Cat

“…Clinical signs compatible with 'Patellar Fracture and Dental Anomaly Syndrome (PADS)' were not detected in the patient, as this syndrome is characterised by dental abnormalities, patellar fractures, and other non-traumatic fractures [17,30]. Typically, internal fixation methods dominate the resolution of acetabular fractures [4,[12][13][14][15]17]. In human medicine, the use of EF in pelvic fractures at certain stages of treatment has been described [31][32][33][34][35][36] due to its structural advantages [32][33][34][35][36][37][38][39][40], including for acetabular fractures in particular [34][35][36].…”

“…Piana et al suggest that displacements of more than 3 mm in fracture reduction are associated with a higher risk of osteoarthritis in the affected joint [12]. However, other authors argue that this decision is more of a biomechanical matter, where factors such as the patient's level of activity and body weight are important factors for deciding between conservative or surgical treatment [13]. Other complications observed in displaced, non-reduced acetabular fractures include narrowing of the pelvic canal with subsequent constipation, neurological deficits, and pain [4].…”

“…Different techniques are described for the treatment of acetabular fractures, with the most commonly used being small fragment plates or locking plates [4,[12][13][14][15][16][17] and the combination of screws with polymethyl methacrylate or cerclage wire [1,4,[18][19][20]. In cases where surgical repair is not feasible, salvage procedures such as femoral head and neck ostectomy can provide pain relief and preserve limb function [21].…”