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联合经关节穿针与外骨骼固定术用于一只猫的多发跖趾关节脱位的复位与固定

Use of combined transarticular pinning and external skeletal fixation for the reduction and stabilization of multiple metatarsophalangeal luxations in a cat.

作者信息

Verpaalen Valentine D, Lewis Daniel D, Porter Erin G

机构信息

Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA.

出版信息

JFMS Open Rep. 2020 Feb 11;6(1):2055116920904465. doi: 10.1177/2055116920904465. eCollection 2020 Jan-Jun.

Abstract

CASE SUMMARY

A 1-year-old spayed female domestic shorthair cat presented for evaluation of a non-weight bearing right pelvic limb lameness after falling from a 4 m height. On orthopedic examination there was substantial swelling and pain on manipulation of the right pes. Radiographs were obtained under sedation, and these revealed dorsoproximal luxations of the third, fourth and fifth metatarsophalangeal joints, and lateral rotation of the second digit. Closed manual reduction under sedation was unsuccessful and open reduction under general anesthesia was therefore performed. Combined transarticular pinning and external skeletal fixation were performed to maintain reduction of the third and fourth digits. Marked postoperative swelling of the distal pes and internal rotation of the third and fourth digits were noted within 24 h of surgery. Three weeks postoperatively, the cat had a persistent weight bearing right pelvic limb lameness and minor pin tract inflammation. All implants were removed and the limb was splinted for 1 week. Internal rotation and pin tract inflammation had resolved at the time of splint removal, and the lameness resolved within 6 weeks of surgery. The cat was not lame, but radiographs revealed mild-to-moderate degenerative osteoarthrosis when the cat was evaluated 6 months after surgery.

RELEVANCE AND NOVEL INFORMATION

There are limited reports describing metatarsophalangeal luxations in cats. Although several surgical techniques have been advocated, specific outcomes in clinical cases have not been reported. This report describes the clinical application and outcome of combined transarticular pinning and external skeletal fixation for the management of multiple metatarsophalangeal luxations in a cat.

摘要

病例摘要

一只1岁已绝育的雌性家猫从4米高处坠落,因右后肢不能负重前来评估跛行情况。骨科检查发现右足操作时肿胀明显且疼痛。在镇静状态下拍摄X光片,结果显示第三、第四和第五跖趾关节背侧近端脱位,第二趾向外旋转。镇静下的闭合手法复位未成功,因此进行了全身麻醉下的切开复位。对第三和第四趾进行了经关节穿针固定和外骨骼固定相结合的操作以维持复位。术后24小时内发现右足远端明显肿胀,第三和第四趾内旋。术后三周,猫右后肢仍持续负重跛行,针道有轻度炎症。取出所有植入物,肢体用夹板固定1周。拆除夹板时,内旋和针道炎症已消退,跛行在术后6周内消失。这只猫不再跛行,但术后6个月评估时X光片显示有轻度至中度退行性骨关节炎。

相关性及新信息

描述猫跖趾关节脱位的报告有限。虽然已经提倡了几种手术技术,但尚未报道临床病例的具体结果。本报告描述了经关节穿针固定和外骨骼固定相结合在治疗猫多发性跖趾关节脱位中的临床应用及结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4acc/7013114/cf7409e391cc/10.1177_2055116920904465-fig1.jpg

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