Nurra Genziana, Pilot Mariette, Grek-Fritzner Beatrice, Coppola Mario, Grierson James Michael, Langley-Hobbs Sorrel
Dick White Referrals, Six Mile Bottom, Cambridgeshire, UK.
Small Animal Referral Hospital Langford, University of Bristol, Bristol, UK.
J Feline Med Surg. 2025 Apr;27(4):1098612X241305918. doi: 10.1177/1098612X241305918. Epub 2025 Apr 3.
ObjectivesThe objectives of this study were to evaluate the population, concurrent injuries, best diagnostic radiographic projection, management and short-term outcome of cats presenting with a fracture of the greater trochanter.MethodsMedical records, imaging studies, methods of repair, complications and short-term outcome of cats that presented with a fracture of the greater trochanter were retrospectively reviewed at two referral institutions. Radiographs were evaluated using a quantitative scoring system. Short-term outcome (>3-6 months) and complications were determined at the follow-up appointment.ResultsSeventeen cats were included. The mean age was 10.5 months (range 3-16). All 17 cats exhibited concurrent orthopaedic injuries, with 5/17 (29%) presenting with multiple orthopaedic injuries. Coxofemoral luxation was the most common, representing more than half (58.8%) of the concurrent orthopaedic injuries identified, followed by pelvic/sacral fractures (52.9%). Further orthopaedic injuries such as sacroiliac luxation and femoral neck fractures were the least common and were present in 11.7% of the studied population. Greater trochanteric fractures were most easily identified on the ventrodorsal radiographic projection of the pelvis, with increased accuracy in the frog-leg ventrodorsal view. Most cats (94.4%) were managed surgically using two or three Kirschner (K)-wires and a tension band wire. Short-term follow-up was available for all 17 cats at a mean of 6.3 months (range 3-8). Major complications were seen in 4/17 (23.5%) patients. These included mild lameness and persistent discomfort due to periosteal reaction, which resolved following surgical or medical intervention. Short-term mobility was considered good in 58.8% of cats, acceptable in 29.5% and poor in the remaining 11.7%.Conclusions and relevanceCoxofemoral luxation was the most prevalent concurrent orthopaedic injury (58.8%). The majority of the greater trochanteric fractures (94.4%) were managed surgically with K-wires and a tension band wire. Ventrodorsal and specifically frog-leg radiographic projections of the pelvis enhance the diagnosis of greater trochanteric fractures. Specific outcomes of greater trochanteric fractures are uncertain because of the high occurrence of concurrent orthopaedic injuries.
目的
本研究的目的是评估出现大转子骨折的猫的种群、并发损伤、最佳诊断性放射学投照、治疗方法及短期预后。
方法
在两家转诊机构对出现大转子骨折的猫的病历、影像学检查、修复方法、并发症及短期预后进行回顾性研究。使用定量评分系统对X线片进行评估。在随访预约时确定短期预后(>3 - 6个月)及并发症。
结果
共纳入17只猫。平均年龄为10.5个月(范围3 - 16个月)。所有17只猫均伴有并发骨科损伤,其中5/17(29%)存在多处骨科损伤。髋股关节脱位最为常见,占已确定并发骨科损伤的一半以上(58.8%),其次是骨盆/骶骨骨折(52.9%)。其他骨科损伤如骶髂关节脱位和股骨颈骨折最不常见,在所研究的猫中占11.7%。大转子骨折在骨盆的腹背位放射学投照中最易识别,蛙腿腹背位视图的准确性更高。大多数猫(94.4%)采用两根或三根克氏针及张力带钢丝进行手术治疗。17只猫均进行了短期随访,平均随访时间为6.3个月(范围3 - 8个月)。4/17(23.5%)的患者出现了主要并发症。这些并发症包括因骨膜反应导致的轻度跛行和持续不适,但经手术或药物干预后症状缓解。58.8%的猫短期活动能力良好,29.5%的猫可接受,其余11.7%的猫较差。
结论及相关性
髋股关节脱位是最常见的并发骨科损伤(58.8%)。大多数大转子骨折(94.4%)采用克氏针及张力带钢丝进行手术治疗。骨盆的腹背位尤其是蛙腿位放射学投照可提高大转子骨折的诊断准确性。由于并发骨科损伤发生率高,大转子骨折的具体预后尚不确定。