Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, NSW, Australia.
Southpaws Specialty, Emergency and Referral Hospital, Moorabbin, VIC, Australia.
J Feline Med Surg. 2024 Feb;26(2):1098612X231214930. doi: 10.1177/1098612X231214930.
The objectives of this study were to report the complications in radial and ulnar diaphyseal fractures in cats and to compare the differences in outcome between single and dual bone internal fixation.
Medical records between 2004 and 2022 were searched retrospectively for cats with antebrachial diaphyseal fractures treated with internal bone-plate fixation. In total, 49 cases were included from six referral hospitals, including one teaching hospital. Patient information was collated, including fracture configuration, location, repair method and clinical outcome as assessed by veterinary physical examination, radiography and owner questionnaire.
A total of 47 cats (mean age 4.2 years) were included. Fractures were located distally (24/49, 49%), proximally (13/49, 26.5%) and mid-diaphyseally (12/49, 24.5%). Dual bone fixation was used in 13/49 (26.5%) cases, with only 1/13 (7.7%) having major complications. By comparison, 4/36 (11.1%) of single plated fractures had major complications. Single bone fixation was 14.25 times more likely (95% confidence interval [CI] 2.07-97.99) to have a successful outcome (veterinarian-assigned score of 0) compared with dual bone fixation ( = 0.007). When evaluating owner-assessed outcomes, single bone fixation was 9.4 times more likely (95% CI 1.4-61.96) to have a successful outcome (owner score of 0) compared with dual bone fixation ( = 0.019).
Fractures that were repaired with single bone fixation had a greater chance of a better outcome. Although the difference was not significant, there was a higher major complication rate and a lower minor complication rate for cases treated with single bone fixation compared with dual bone fixation. The majority of fractures were located in the distal diaphysis. Comminution of the fracture and concurrent orthopaedic issues did not significantly affect the outcome. Further prospective studies with standardised follow-up, radiographic assessment, surgeon and implants are required to truly assess the difference between dual and single bone fixation.
本研究旨在报告猫桡骨和尺骨干骨折的并发症,并比较单骨和双骨内固定的结果差异。
回顾性检索 2004 年至 2022 年期间接受内置钢板固定治疗的前肢骨干骨折猫的病历。来自六家转诊医院(包括一家教学医院)的 49 例病例被纳入研究。收集患者信息,包括骨折形态、位置、修复方法和兽医体格检查、影像学检查以及主人问卷调查评估的临床结果。
共纳入 47 只猫(平均年龄 4.2 岁)。骨折位于远端(24/49,49%)、近端(13/49,26.5%)和骨干中段(12/49,24.5%)。双骨固定用于 13 例(26.5%)病例,其中只有 1 例(7.7%)发生严重并发症。相比之下,36 例单钢板固定骨折中有 4 例(11.1%)发生严重并发症。单骨固定的成功率(兽医评分 0)是双骨固定的 14.25 倍(95%置信区间 [CI] 2.07-97.99)(=0.007)。评估主人评估的结果时,单骨固定的成功率(主人评分 0)是双骨固定的 9.4 倍(95% CI 1.4-61.96)(=0.019)。
接受单骨固定修复的骨折更有可能获得更好的结果。虽然差异不显著,但与双骨固定相比,单骨固定的严重并发症发生率更高,轻微并发症发生率更低。大多数骨折位于骨干远端。骨折粉碎和并发骨科问题并未显著影响结果。需要进一步开展具有标准化随访、影像学评估、外科医生和植入物的前瞻性研究,以真正评估双骨和单骨固定之间的差异。