Ankylosis of tarsometatarsal luxations using external fixation

Short-term outcome after treatment of talocrural instability in cats using modified type II transarticular external skeletal fixation

Transarticular external skeletal fixation (TESF) is repeatedly used for temporary stabilisation of tarsal joint in cats. Hence, this study aimed to evaluate the use of temporary modified type II TESF for management of talocrural instability (TCI) in cats without joint arthrodesis and to rate short-term outcomes and complications. Medical records of all cats treated for TCI between January 2012 and December 2021 were reviewed. Information was collected including signalment, degree of lameness, type of TCI, accompanying soft tissue and bone injuries, and post-operative follow-up assessment including time of frame removal, complications, degree of lameness, range of joint motion and ankylosis. Surgical management didn't involve debridement of the articular cartilage. Eighty-five percent of cats had satisfactory joint stability at the time of frame removal. Eighteen cats exhibited minor complications, six cats had major complications, and 8 cats showed persistent lameness. All cats showed reduction of joint motion range by 20°-30° directly after frame removal while returned to normal in 79% of cats 4 weeks later. Variable degrees of joint ankylosis were reported. In conclusion, this study supports the use of temporary modified type II TESF for management of TCI in cats without joint involvement as an excellent alternative to tarsal arthrodesis.

Description and outcome of prosthetic ligament placement for stabilization of medial or dorsomedial tarsometatarsal joint luxation in dogs and cats: 16 cases (2004-2017)

OBJECTIVE

To describe prosthetic ligament placement for reduction and stabilization of medial or dorsomedial tarsometatarsal joint luxation in dogs and cats and to report complications and postoperative outcomes for patients that underwent that procedure.

ANIMALS

14 dogs and 2 cats with medial or dorsomedial tarsometatarsal joint luxation.

PROCEDURES

The electronic database of a referral surgery practice was searched to identify records of dogs and cats with tarsometatarsal joint luxation that underwent prosthetic ligament placement between January 2004 and March 2017. For each study subject, information extracted from the medical record included signalment, a description of the tarsometatarsal joint injury, durations of anesthesia and surgery, and intraoperative and postoperative care and complications. Radiographic images were also reviewed. The long-term outcome for study subjects was assessed by administration of a standardized questionnaire to owners.

RESULTS

Prosthetic ligament placement successfully stabilized the luxated tarsometatarsal joint in all 16 patients. Six patients developed minor postoperative complications, which included bandage-associated dermatitis or ulceration (n = 5) and orthopedic wire failure (1). No major or catastrophic complications were reported. All 13 owners who completed the questionnaire perceived that the described technique resulted in satisfactory long-term function for their pets.

CONCLUSIONS AND CLINICAL RELEVANCE

Results suggested that prosthetic ligament placement was a technically simple procedure that achieved satisfactory long-term stabilization of the tarsometatarsal joint in small animal patients with medial or dorsomedial luxation of the joint. Prosthetic ligament placement may be an alternative to arthrodesis for tarsometatarsal joint stabilization in appropriate patients.

Management of traumatic tarsal luxations with transarticular external fixation in cats

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

Evaluation of the transarticular external skeletal fixator for the treatment of tarsocrural instability in 32 cats

The medical records of all cats with tarsocrural joint instability that were treated between June 2002 and December 2008 at the Royal Veterinary College were retrospectively reviewed. A total of 32 cats were identified. Information gathered included signalment, type of injury (subluxation or luxation), concurrent fractures, presence of soft tissue wounds, transarticular external skeletal fixation (TESF) type, configuration of TESF (number of pins proximal and distal to the joint), duration of hospitalisation, duration of TESF prior to removal, complications and cost. A significant association was identified between the length of hospitalisation and the presence of wounds. Similarly a significant association was present between wounds and final cost of treatment. Additionally, the authors found that a high number of implant related complications were present when only two pins were used proximal and distal to the tarsocrural joint, but this association was not significant.

Long-term outcomes after partial tarsal arthrodesis in working farm dogs in New Zealand

AIM

To report the long-term outcome (return to work and owner satisfaction) for working farm dogs in New Zealand after partial tarsal arthrodesis for proximal intertarsal and/or tarsometatarsal tarsal joint injury.

METHODS

Working farm dogs that underwent partial tarsal arthrodesis were identified by diagnosis and breed code via a search of the medical records of Massey University Veterinary Teaching Hospital (MUVTH) and Veterinary Specialist Orthopaedic Services (VetSOS). Fourteen dogs fulfilled the selection criteria and were all actively in work on farms at the time of injury. Data from case files were analysed, and the ability of the dog to work after surgery and owners' satisfaction were assessed using a questionnaire sent to owners at a median follow-up interval of 57 months.

RESULTS

Following partial tarsal arthrodesis, 7/14 (50%) dogs could perform normal work duties required while 4/14 (29%) dogs could perform most of the duties they had undertaken before injury, though some allowance had to be made for reduced performance. Thirteen owners were satisfied or very satisfied with the outcome of surgery and 12/14 thought the financial investment required for the surgery was worthwhile. Of the three dogs that did not return to work, infection requiring implant removal (one dog) and less than optimal post-operative limb alignment (two dogs) were assessed to contribute to the poor outcome. Two other dogs that required implant removal due to infection did successfully return to work.

CONCLUSIONS

In this limited cases series, partial tarsal arthrodesis in working dogs had a good prognosis for return to work. Any conclusion regarding the benefit of a particular surgical technique requires a prospective evaluation with a larger number of animals. It is important to minimise the risk of infection and optimally align the tarsus to avoid a poor outcome.

CLINICAL RELEVANCE

New Zealand veterinarians can now provide more accurate prognostic information to owners whose working dogs suffer tarsal trauma requiring partial arthrodesis.