Perry Karen L, Adams Robert J, Woods Samantha, Bruce Mieghan
Michigan State University, East Lansing, Michigan.
Davies Veterinary Specialists, Higham, Gobion, United Kingdom.
Vet Surg. 2017 Jan;46(1):39-51. doi: 10.1111/vsu.12575. Epub 2016 Oct 12.
To estimate the prevalence of complications and describe the outcome associated with calcaneal fractures in non-racing dogs and in cats.
Retrospective multicenter clinical cohort study.
Medical records of client-owned dogs and cats (2004-2013).
Medical records were searched and 50 animals with calcaneal fractures were included for analysis. Complications were recorded and an outcome score applied to each fracture. Associations between putative risk factors and both major complications, and final outcome scores were explored.
Complications occurred in 27/50 fractures (61%) including 23 major and 4 minor complications. At final follow-up, 4 animals (10%) were sound, 27 (64%) had either intermittent or consistent mild weight-bearing lameness, 7 (17%) had moderate weight-bearing lameness, and 1 (2%) had severe weight-bearing lameness. Fractures managed using plates and screws had a lower risk of complications than fractures managed using pin and tension band wire, lag or positional screws or a combination of these techniques (Relative risk 0.16, 95% CI 0.02-1.02, P=.052). Non-sighthounds had reduced odds of a poorer outcome score than sighthounds (Odds ratio 0.11, 95% CI 0.02-0.50, P=.005) and fractures with major complications had 13 times the odds of a poorer outcome score (Odds ratio 13.4, 95% CI 3.6-59.5, P<.001).
This study reports a high occurrence of complications associated with calcaneal fracture stabilization in non-racing dogs and in cats, and a poorer outcome score was more likely in animals with complications. A more guarded prognosis should be given to owners of non-racing dogs or cats with calcaneal fractures than previously applied to racing Greyhounds with calcaneal fractures.
评估非赛犬和猫跟骨骨折的并发症发生率,并描述与之相关的预后情况。
回顾性多中心临床队列研究。
客户拥有的犬猫(2004 - 2013年)的病历。
检索病历,纳入50例跟骨骨折动物进行分析。记录并发症情况,并对每个骨折应用预后评分。探讨假定危险因素与主要并发症及最终预后评分之间的关联。
50处骨折中有27处(61%)发生并发症,包括23处主要并发症和4处次要并发症。末次随访时,4只动物(10%)恢复良好,27只(64%)有间歇性或持续性轻度负重跛行,7只(17%)有中度负重跛行,1只(2%)有重度负重跛行。使用钢板和螺钉治疗的骨折并发症风险低于使用克氏针和张力带钢丝、拉力或定位螺钉或这些技术组合治疗的骨折(相对风险0.16,95%可信区间0.02 - 1.02,P = 0.052)。非视觉猎犬比视觉猎犬预后评分较差的几率降低(优势比0.11,95%可信区间0.02 - 0.50,P = 0.005),发生主要并发症的骨折预后评分较差的几率是前者的13倍(优势比13.4,95%可信区间3.6 - 59.5,P < 0.001)。
本研究报告了非赛犬和猫跟骨骨折内固定术后并发症发生率较高,有并发症的动物预后评分更差。对于非赛犬或猫跟骨骨折的主人,应给予比先前用于赛犬跟骨骨折更保守的预后建议。