MA, VetMB, PhD, MVetMed, DipECVS, FHEA, FRCVS, RCVS & ECVS Specialist Small Animal Surgery.
Department of Clinical Science and Services, Queen Mother Hospital for Animals, Royal Veterinary College, University of London, London, UK.
J Feline Med Surg. 2021 Jan;23(1):17-32. doi: 10.1177/1098612X20979508.
Traumatic joint luxations are usually associated with significant trauma and there may be concomitant systemic injury. Joints are unstable as a result of injury to one or more supporting structures and the clinician should aim to determine which structures are damaged with physical examination, diagnostic imaging and careful assessment under sedation/anaesthesia. The aim is to reduce the joint back to its anatomical position, and then to maintain this through repair of damaged structures. However, where this is not possible, replacement or removal (arthrodesis/excision arthroplasty) of the joint remain viable options.
Owing to the small size of feline joints and the severity of damage often seen, surgical management of these cases can be challenging. The first priority is to ensure the patient is systemically well before embarking on any specific surgical treatment of a luxated joint. Cats also present challenges in the postoperative period and a lack of patient and owner compliance can be detrimental to postoperative outcomes.
This article aims to help the reader diagnose joint luxations and to assist decision-making with an overview of the management and treatment options available.
There are a number of original articles and textbook chapters in the literature covering aspects of different joint luxations, particularly for the more common luxations. This article draws on information from key feline research and, where necessary, extrapolates from relevant canine research. The authors also offer practical guidance based on their own clinical experience.
创伤性关节脱位通常与明显的创伤有关,可能伴有全身损伤。由于一个或多个支撑结构受伤,关节不稳定,临床医生应通过体格检查、诊断影像学检查和镇静/麻醉下的仔细评估,确定哪些结构受损。目的是将关节恢复到解剖位置,然后通过修复受损结构来维持关节的位置。然而,如果无法做到这一点,关节的替代或切除(关节融合术/关节切除成形术)仍然是可行的选择。
由于猫关节的体积小,而且经常出现严重的损伤,这些病例的手术管理可能具有挑战性。首先,在开始任何特定的关节脱位手术治疗之前,必须确保患者全身状况良好。猫在术后也会带来挑战,如果患者和主人不配合,可能会对术后结果产生不利影响。
本文旨在帮助读者诊断关节脱位,并通过概述可用的管理和治疗选择来协助决策。
文献中有许多原创文章和教科书章节涵盖了不同关节脱位的各个方面,特别是更常见的脱位。本文参考了猫科动物研究的重要信息,并在必要时从相关的犬科动物研究中推断出结论。作者还根据自己的临床经验提供了实用的指导。