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猫股骨骨折固定:有哪些选择?

Feline Femoral Fracture Fixation: What are the options?

机构信息

Pride Veterinary Centre, Derby, UK.

Department of Clinical Science and Services, Queen Mother Hospital for Animals, Royal Veterinary College, University of London, London, UK.

出版信息

J Feline Med Surg. 2022 May;24(5):442-463. doi: 10.1177/1098612X221090391. Epub 2022 Apr 11.

Abstract

PRACTICAL RELEVANCE

The femur is the most commonly fractured bone in cats. Femoral fractures usually result from high-velocity trauma such as a road traffic accident or fall from a height and, as such, are associated with a wide variety of concurrent injuries. The initial focus of treatment should always be on assessment and stabilisation of the major body systems. Once any concurrent injuries have been addressed, all femoral fractures need surgical stabilisation, with the notable exception of greenstick fractures in very young cats, which can heal with cage rest alone. A number of different surgical options are available depending on the fracture type, location, equipment, surgeon experience and owner finances.

CLINICAL CHALLENGES

Femoral fractures can vary hugely in complexity and the small size of feline bones can limit the choice of implants. Furthermore, cats can present unique challenges in the postoperative period due to their active nature and the limited means to control their exercise level.

AUDIENCE

This review is aimed at general and feline-specific practitioners who have some experience of feline orthopaedics, as well as those simply wishing to expand their knowledge.

AIMS

The aim of this review is to help clinicians assess, plan and manage feline femoral fractures. It provides an overview of diagnostic imaging and a discussion of a range of suitable surgical options, including the principles of different types of fixation. It also highlights cat-specific issues, approaches and implants pertinent to the management of these cases.

EVIDENCE BASE

A number of original articles and textbook chapters covering many aspects of femoral fractures in cats and dogs have been published. Where possible, this review draws on information from key feline research and, where necessary, extrapolates from relevant canine literature. The authors also offer practical guidance based on their own clinical experience.

摘要

实际意义

股骨是猫最常骨折的骨头。股骨干骨折通常由高速创伤引起,如交通事故或高处坠落,因此与各种并发伤有关。治疗的初始重点始终应放在评估和稳定主要身体系统上。一旦处理了任何并发伤,所有股骨干骨折都需要手术稳定,只有非常年轻的猫的青枝骨折除外,这些骨折仅通过笼内休息即可愈合。根据骨折类型、位置、设备、外科医生经验和所有者财务状况,有许多不同的手术选择。

临床挑战

股骨干骨折的复杂性差异很大,猫的骨骼较小,这会限制植入物的选择。此外,由于猫的活跃天性以及控制其运动水平的手段有限,它们在术后可能会带来独特的挑战。

听众

本文面向具有一定猫科骨科经验的普通和专门的兽医,以及那些希望扩大知识的兽医。

目的

本文旨在帮助临床医生评估、计划和管理猫的股骨干骨折。它提供了诊断成像的概述,并讨论了一系列合适的手术选择,包括不同类型固定的原则。它还强调了与这些病例管理相关的猫特有的问题、方法和植入物。

证据基础

已经发表了许多涵盖猫和犬股骨干骨折各个方面的原创文章和教科书章节。在可能的情况下,本文参考了来自猫科动物的关键研究信息,并在必要时从相关的犬科文献中推断。作者还根据自己的临床经验提供了实用的指导。

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本文引用的文献

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Acute hindlimb lameness in a 6-month-old cat.一只6个月大的猫出现急性后肢跛行。
J Feline Med Surg. 2019 May;21(5):449-451. doi: 10.1177/1098612X19843214.

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