Meeson Richard L, Geddes Alex T
The Royal Veterinary College, Department of Clinical Sciences and Services, Hatfield, UK.
J Feline Med Surg. 2017 Jan;19(1):36-41. doi: 10.1177/1098612X15606958. Epub 2016 Jul 10.
Objectives The aim of the study was to evaluate the management and long-term outcome of cats with pelvic fractures. Methods Cats with pelvic fractures had their records and radiographs reviewed. Radiographs were reviewed for fracture configuration, implants and pelvic canal narrowing. Owners were contacted for long-term follow-up. Results Forty-three cats met the criteria (mean follow-up 24 months [range 6-45 months]). The majority (93%) had more than one orthopaedic pelvic injury, with sacroiliac fracture luxations seen most commonly; 23% had presurgical neurological deficits. Most cats (74%) were managed surgically; 60% of sacroiliac fracture luxations, 82% of ilial fractures and 50% of acetabular fractures received surgery. The complication rate was 22%, most commonly sciatic neurapraxia (13%). Seventy-nine percent of all neurological deficits resolved and the remainder improved. Mean pelvic canal narrowing after trauma was -15% in surgical and -16% in conservatively managed cats. Canal width was improved postoperatively (-8%) but mildly narrowed further by follow-up (-12%); however, these changes were not significant. Nineteen percent of cats had constipation postsurgery; none developed megacolon. There was no clear correlation between the degree of narrowing of the pelvic canal up to -50%, or whether conservative treatment was opted for, and the development of constipation. Long-term mobility was not impaired in 86% of cats, and 84% did not have any lameness detectable. Conclusions and relevance The majority of cats were managed surgically, with a 22% complication rate; the most common being transient sciatic neurapraxia. Long-term outcome was generally excellent and most had a full recovery. Constipation/obstipation was very uncommon and no clear relationship with pelvic canal narrowing could be found when considering narrowing of up to -50% in both surgical and conservative groups. As no cats in this cohort had narrowing greater than -50%, the current recommendation of surgery to improve the canal width if narrowing is greater than -45% to -50% should remain.
目的 本研究旨在评估骨盆骨折猫的治疗及长期预后。方法 回顾骨盆骨折猫的病历及X光片。对X光片进行骨折形态、植入物及骨盆管狭窄情况的评估。联系猫主人进行长期随访。结果 43只猫符合标准(平均随访24个月[范围6 - 45个月])。大多数(93%)存在不止一处骨盆骨科损伤,最常见的是骶髂关节骨折脱位;23%术前存在神经功能缺损。大多数猫(74%)接受了手术治疗;60%的骶髂关节骨折脱位、82%的髂骨骨折和50%的髋臼骨折接受了手术。并发症发生率为22%,最常见的是坐骨神经失用(13%)。所有神经功能缺损中有79%得到恢复,其余有所改善。手术治疗的猫创伤后骨盆管平均狭窄率为 - 15%,保守治疗的猫为 - 16%。术后管腔宽度有所改善( - 8%),但随访时进一步轻度狭窄( - 12%);然而,这些变化并不显著。19%的猫术后出现便秘;无一例发展为巨结肠。骨盆管狭窄达 - 50%的程度,或是否选择保守治疗,与便秘的发生之间无明显相关性。86%的猫长期活动能力未受损害,84%未发现有跛行。结论及意义 大多数猫接受了手术治疗,并发症发生率为22%;最常见的是短暂性坐骨神经失用。长期预后总体良好,大多数猫完全康复。便秘/肠梗阻非常少见,在手术组和保守组中,当考虑狭窄达 - 50%时,与骨盆管狭窄无明显关系。由于该队列中没有猫的狭窄程度大于 - 50%,如果狭窄程度大于 - 45%至 - 50%,目前关于手术改善管腔宽度的建议应继续保留。