Alza Salvatierra Diego N, Witte Philip G, Scott Harry W, Catchpole Clare
1 Southern Counties Veterinary Specialists, Ringwood, UK.
2 Churchtown Dairy, St Keyne, UK.
J Feline Med Surg. 2018 Jan;20(1):45-54. doi: 10.1177/1098612X17698264. Epub 2017 Mar 15.
Case series summary Pantarsal arthrodesis (PTA) was performed in seven tarsi of six cats, using orthogonal (dorsal and medial) veterinary cuttable plates (VCPs) without postoperative external coaptation. Short-term outcomes, arthrodesis progression and complications were assessed using a retrospective review of case notes (veterinary examination) and radiographs. Long-term outcomes were assessed via owner questionnaire (Feline Musculoskeletal Pain Index [FMPI]). Mean angle of PTA was 136° (range 116-166°). Intraoperative complications were recorded in two cases, both involving failure of the drill bit during drilling for calcaneotibial screws. Postoperative complications were encountered in a case of bilateral single-session PTA. These included gastrocnemius myotendinopathy on the right, and long-term protrusion of a screw head from the skin on the left. Both complications were resolved surgically, through resection of the implicated gastrocnemius tendon of insertion and removal of the plate, respectively. FMPI assessment was performed for all six cats a mean of 8.8 months (range 6-16 months) following surgery. Mean score for the first part (assessing ability to perform normal activities) was 92.2% (range 80.9-97.1%). Mean score for the second part (owner perception of pain) was 95.8% (range 87.5-100%). Mean overall score (mean score for parts 1 and 2 combined) was 92.3% (range 81.6-97.4%). PTA may be performed in cats using orthogonal VCPs to treat severe tarsal injuries. It may be prudent to avoid single-session bilateral PTA in cats. Relevance and novel information This case series documents a novel technique as an alternative for PTA in cats with talocrural injuries. Long-term outcome and complications presented in this case series are evaluated and discussed.
对6只猫的7个跗骨进行了全跗关节融合术(PTA),使用正交(背侧和内侧)兽医可切割钢板(VCPs),术后未进行外部固定。通过回顾病例记录(兽医检查)和X光片评估短期结果、关节融合进展和并发症。通过主人问卷(猫肌肉骨骼疼痛指数[FMPI])评估长期结果。PTA的平均角度为136°(范围116 - 166°)。2例记录了术中并发症,均涉及在钻入跟骨胫骨螺钉时钻头失败。双侧单次PTA病例出现了术后并发症。这些包括右侧腓肠肌肌腱病,以及左侧螺钉头部长期从皮肤突出。两种并发症均通过手术解决,分别切除受累的腓肠肌插入肌腱和取出钢板。在手术后平均8.8个月(范围6 - 16个月)对所有6只猫进行了FMPI评估。第一部分(评估正常活动能力)的平均得分是92.2%(范围80.9 - 97.1%)。第二部分(主人对疼痛的感知)的平均得分是95.8%(范围87.5 - 100%)。总体平均得分(第1部分和第2部分得分总和)是92.3%(范围81.6 - 97.4%)。可以使用正交VCPs对猫进行PTA来治疗严重的跗骨损伤。在猫中避免单次双侧PTA可能是谨慎的做法。相关性和新信息:本病例系列记录了一种新技术,作为猫距小腿关节损伤PTA的替代方法。对本病例系列中呈现的长期结果和并发症进行了评估和讨论。