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猫头部创伤:75只猫颅骨骨折的CT分析及其处理

Feline head trauma: a CT analysis of skull fractures and their management in 75 cats.

作者信息

Knight Rebekah, Meeson Richard L

机构信息

Department of Clinical Sciences and Services, The Royal Veterinary College, Hatfield, UK.

出版信息

J Feline Med Surg. 2019 Dec;21(12):1120-1126. doi: 10.1177/1098612X18819183. Epub 2018 Dec 20.

Abstract

OBJECTIVES

The aim of this study was to describe and evaluate the configurations and management of feline skull fractures and concurrent injuries following head trauma.

METHODS

Medical records and CT images were reviewed for cats with skull fractures confirmed by CT that were managed conservatively or with surgery. Details of signalment, presentation, skull fracture configuration, management, re-examination, and complications or mortality were recorded and analysed.

RESULTS

Seventy-five cats (53 males, 22 females) with a mean age of 4.8 ± 3 years met the inclusion criteria. Eighty-nine percent of cats had fractures in multiple bones of the skull, with the mandible, upper jaw (maxilla, incisive and nasal bones) and craniofacial regions most commonly affected. Temporomandibular joint injury occurred in 56% of cats. Road traffic accidents (RTAs) were the most common cause of skull fractures, occurring in 89% of cats, and caused fractures of multiple regions of the skull. RTAs were also associated with high levels of concurrent injuries, particularly ophthalmic, neurological and thoracic injuries. A more limited distribution of injuries was seen in non-RTA cats. Equal numbers of cats were managed conservatively or surgically (47%). Mortality rate was 8% and complications were reported in 22% of cats. Increasing age at presentation and presence of internal upper jaw fractures were risk factors for development of complications. No risk factors were identified for mortality.

CONCLUSIONS AND RELEVANCE

RTAs were the most common cause of feline skull fractures and resulted in fractures in multiple regions of the skull and concurrent injuries occurred frequently. Problems with dental occlusion were uncommon post-treatment. An increased risk of implant loosening and malocclusion was seen with palatine and pterygoid bone fractures and hard palate injuries. This study provides useful additional information regarding feline skull fractures, concurrent injuries and management techniques following head trauma.

摘要

目的

本研究旨在描述和评估猫头部外伤后颅骨骨折及并发损伤的形态及处理方法。

方法

回顾经CT确诊为颅骨骨折且接受保守治疗或手术治疗的猫的病历及CT图像。记录并分析动物特征、临床表现、颅骨骨折形态、治疗方法、复查情况以及并发症或死亡率等细节。

结果

75只猫(53只雄性,22只雌性)符合纳入标准,平均年龄为4.8±3岁。89%的猫颅骨多块骨头发生骨折,下颌骨、上颌(上颌骨、切齿骨和鼻骨)及颅面部区域最常受累。56%的猫发生颞下颌关节损伤。道路交通事故(RTA)是颅骨骨折最常见的原因,89%的猫因RTA导致颅骨多处骨折。RTA还常伴有高水平的并发损伤,尤其是眼部、神经和胸部损伤。非RTA猫的损伤分布较为局限。接受保守治疗和手术治疗的猫数量相等(47%)。死亡率为8%,22% 的猫出现并发症。就诊时年龄增加和上颌骨内部骨折是发生并发症的危险因素。未发现与死亡率相关的危险因素。

结论及意义

RTA是猫颅骨骨折最常见的原因,导致颅骨多处骨折且并发损伤频繁发生。治疗后牙合问题不常见。腭骨和翼状骨骨折及硬腭损伤会增加种植体松动和错牙合的风险。本研究为猫颅骨骨折及头部外伤后的并发损伤和处理技术提供了有用的补充信息。

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