Traumatic physeal fractures in cats: a review of 36 cases (2010–2020)

2021 ◽  
pp. 1098612X2110058
Author(s):  
Carlos Rubinos ◽  
Richard L Meeson
Keyword(s):  
Distal Tibia ◽  
Fracture Repair ◽  
Implant Removal ◽  
Type I ◽  
Physeal Fracture ◽  
Physeal Closure ◽  
Femoral Physis ◽  
Clinical Records ◽  
Physeal Fractures

Objectives The aim of this study was to describe the demography, aetiology, location and classification of physeal fractures in cats, and to describe their management and outcomes. Methods Clinical records and radiographs of cats referred for management of physeal fractures were retrospectively reviewed. Fractures of the proximal femoral physis were excluded. Descriptive statistics were used to describe signalment, cause of injury, presence of concurrent injuries, fracture description, treatment modality, complications, follow-up, physeal closure, implant removal and outcome. Results Thirty-four cats with 36 fractures were included, of which 17 affected the distal femur, 11 the distal tibia and fibula, five the distal radius and ulna, two the proximal tibia and one the distal humerus. Salter–Harris classification was type I in 14, type II in 16, type III in two and type IV in four fractures. Thirty-four fractures were treated with primary fixation, and the most common method was crossed Kirschner wires (24/34 fractures). Complications were observed in 14 fractures, of which 12 were minor. At radiographic follow-up, physeal closure was reported in 23 fractures, of which 15 were considered premature. Implant removal was performed in three fractures. Outcome was good in 28, fair in four and poor in two fractures. Conclusions and relevance Fracture of the distal femoral physis was the most common physeal fracture seen. Cats presenting with physeal fractures may be skeletally immature or mature with delayed physeal closure. The rate of physeal closure after fracture repair was relatively high but without apparent impact. The frequency of implant removal was very low, indicating that despite having a physeal fracture repair, most cats did not require a second procedure to remove implants. Overall, internal fixation provided a good outcome in most fractures.

Percutaneous tibial physeal fracture repair in small animals: technique and 17 cases

2017 ◽  
Vol 30 (04) ◽  
pp. 1-9
Author(s):  
Dirsko von Pfeil ◽  
Mathieu Glassman ◽  
Meaghan Ropski
Keyword(s):  
Avulsion Fracture ◽  
Skin Irritation ◽  
Distal Tibia ◽  
Case Series ◽  
Fracture Repair ◽  
Tibial Tuberosity ◽  
Avulsion Fractures ◽  
Physeal Fracture ◽  
Physeal Fractures

SummaryObjectives: To retrospectively describe cases treated via percutaneous tibial physeal fracture repair (PTPFR), using intra-operative fluoroscopy (IFL) or digital radiography (DR). To describe a technique (“spiking”), used to treat tibial tuberosity avulsion fractures.Methods: Clinical data of 14 dogs and three cats were included. The “spiking” technique was described.Results: Intra-operative fluoroscopy (n = 11) and DR (n = 6) were successfully used in 11 tibial tuberosity avulsion fractures, one combined proximal physeal and tibial tuberosity avulsion fracture, and five distal tibial/fibular physeal fractures. Surgery times ranged from eight to 54 minutes. The “spiking” technique was successfully applied in six tibial tuberosity avulsion fracture cases. Return to function was at a mean (± standard deviation) of 1.9 (± 1.6) weeks. Long-term (>12 months; n = 17) follow-up was available at a mean of 40.6 (± 13.4) months. Major complications consisted of skin irritation from a pin (distal tibia / fibula physeal fracture case; 8 weeks post-PTPFR), and a bilateral grade II medial patella luxation (tibial tuberosity avulsion fracture case; 1.5 years post-PTPFR). One case developed a mild tibial tuberosity avulsion fracture re-avulsion. All conditions in these three cases were not of clinical concern at follow-up and final outcome was graded as good in these and excellent in the other 14 cases.Clinical significance: Percutaneous tibial physeal fracture repair can be considered as a technique to treat tibial physeal fractures. The “spiking” technique was successfully applied in six dogs. A larger, prospective case series is indicated to provide additional clinical information.Supplementary Material to this article is available online at https://doi.org/10.3415/VCOT-16-07-0102

Tension band stabilisation of acetabular physeal fractures in four kittens

2007 ◽  
Vol 9 (3) ◽  
pp. 177-187 ◽  
Author(s):  
S.J. Langley-Hobbs ◽  
T.R. Sissener ◽  
C.J. Shales
Keyword(s):  
Surgical Repair ◽  
Fracture Repair ◽  
Tension Band ◽  
Implant Removal ◽  
Acetabular Bone ◽  
Excellent Outcome ◽  
Good For ◽  
Physeal Closure ◽  
Tension Band Technique ◽  
Physeal Fractures

The surgical repair of acetabular physeal fractures in four kittens using a screw and tension band technique is reported. This was an appropriate method for restoring articular congruency and improving pelvic alignment. All cases had an excellent outcome and full limb use following fracture repair. In kittens younger than 12 weeks, there is a possibility of premature fusion of the acetabular bone resulting in development of a deformed, shallow acetabulum and hip subluxation. However, surgery is still justified when there is pelvic canal narrowing to decrease the risk of future defecatory problems. Early implant removal in such young kittens may decrease the severity of deformity caused by premature physeal closure. In kittens of 16 weeks or older, the prognosis is good for normal acetabular development and implant removal is not necessary.

scholarly journals The Mid-term outcomes of ankle Dias-Tachdjian PEER physeal fracture in children treat by ORIF with One-stage medial-lateral combined incision

2020 ◽  
Author(s):  
Feng XIANG ◽  
Bo LI ◽  
Sheng XIAO ◽  
Jie Wen ◽  
Hong LIU ◽  
...  
Keyword(s):  
External Rotation ◽  
Distal Tibia ◽  
Angular Deformity ◽  
X Rays ◽  
Physeal Fracture ◽  
One Stage ◽  
Lateral Incision ◽  
Post Operation ◽  
Physeal Closure

Abstract Objectives: To report the mid-term outcomes and complications of ankle Dias-Tachdjian pronation-eversion external rotation (PEER) physeal fracture in children treat by ORIF with combined medial and lateral incision. Materials and Methods: A total of 21 children (12 male and 9 female patients with ankle Dias-Tachdjian PEER physeal fracture, underwent open reduction treatment with combined medial and lateral incision between Jan, 2015 and Oct, 2017. The surgical outcomes were assessed by X-ray film after operation. The lateral distal tibia angle (LDTA) was measured to evaluate angular deformity and the X rays was taken to evaluate the premature physeal arrest. Result: All the patients were followed up for an average time of 20.1 months (ranging from 17 to 25 months). Bone healing was achieved in all cases. American Orthopedic Foot and Ankle Society-Ankle and Hindfoot score(AOFAS-AH) of the patients improved from median 31(11,38) before operation to median 68(63,73) post-operation, median score 91(87,96) at last follow-up. Lateral distal tibia angle (LDTA) of the patients improved from 70.5±4.9 before operation to 90.0±1.2 post-operation, measure 90.6±3.7 at last follow-up. The differences between pre and post operation and the differences between pre-operation and last follow-up in both findings were statistically significant (P<0.05). There is no premature physeal closure, ankle deformity in 19 cases. They could normally exercise and take part in normal sport activities. The remaining 2 cases had physeal bone bridge and premature physeal closure but could still carry on daily activities and thus were categorized as good. Conclusion: ORIF with one-stage medial-lateral combined incision for ankle Dias-Tachdjian PEER physeal fracture in children can decrease the rate of premature physeal closure and has excellent efficacy for fracture union and the recovery of ankle functions.

scholarly journals Routine radiographic follow-up is not necessary after physeal fractures of the distal tibia in children

2019 ◽  
Vol 90 (6) ◽  
pp. 610-613 ◽  
Author(s):  
Antti Stenroos ◽  
Jussi Kosola ◽  
Jani Puhakka ◽  
Topi Laaksonen ◽  
Matti Ahonen ◽  
...  
Keyword(s):  
Distal Tibia ◽  
Physeal Fractures

Premature Physeal Closure Following Distal Tibia Physeal Fractures

2003 ◽  
Vol 23 (6) ◽  
pp. 733-739 ◽  
Author(s):  
Adam Barmada ◽  
Tracey Gaynor ◽  
Scott J. Mubarak
Keyword(s):  
Distal Tibia ◽  
Physeal Closure ◽  
Physeal Fractures

Feline Distal Tibial Physeal Fracture Repair Using a Modified Cross-Pin Technique with Four Pins

2020 ◽  
Vol 33 (03) ◽  
pp. 220-226
Author(s):  
Diogo Miraldo ◽  
Bettina Salmelin ◽  
Russell Yeadon
Keyword(s):  
Kirschner Wire ◽  
Subjective Assessment ◽  
Fracture Repair ◽  
Excellent Outcome ◽  
Post Surgery ◽  
Retrospective Clinical Study ◽  
The Mean ◽  
Type Of Fracture ◽  
Physeal Fractures

Abstract Objective The aim of this article was to report the surgical technique and clinical outcome of a modified cross-pin technique for the treatment of distal tibial physeal fractures in cats without postoperative external coaptation. Study Design This study was a retrospective clinical study. Animals A total of 9 cats were presented with fracture of the distal tibial physis. Materials and Methods Medical records from July 2014 to September 2018 were reviewed. In all cases, a second medial and a craniolateral Kirschner wires were added to the traditional cross-pin technique. Information reviewed included orthogonal radiographs pre- and post-surgery and at subsequent re-examinations, subjective assessment of lameness and passive range of motion, veterinary clinical assessment and completion of a functional questionnaire (feline musculoskeletal pain index) at the time of writing this report. Eight owners completed the questionnaire. The mean questionnaire follow-up time was 12.7 months. Results Uncomplicated fracture healing occurred in all patients. Two patients required implant removal due to Kirschner wire migration and protrusion through the skin at 5 and 12 months post-surgery. No other complications were noticed. Eight patients had an excellent outcome, and one patient had a good outcome. Conclusion Distal tibial physeal fractures in cats can be treated successfully with the use of a modified cross-pin technique and without the use of external coaptation. Prognosis should be considered favourable for this type of fracture.

scholarly journals Premature Physeal Closure after a Non-Displaced Physeal Fracture of Distal Fibula

2021 ◽  
pp. 1-3
Author(s):  
Antti Stenroos ◽  
Topi Laaksonen ◽  
Jussi Kosola ◽  
Yrjänä Nietosvaara ◽  
Antti Stenroos
Keyword(s):  
Corrective Osteotomy ◽  
Distal Tibia ◽  
Angular Deformity ◽  
Leg Length ◽  
Post Injury ◽  
Distal Fibula ◽  
Physeal Fracture ◽  
Clinically Significant ◽  
Physeal Closure ◽  
Displaced Fracture

Premature physeal closure (PPC) may lead to clinically significant progressive angular deformity or leg length discrepancy. Many variables seem to play a role in determining which injuries result in PPC. A 8- year-old boy sustained a non-displaced physeal fracture of distal tibia and fibula. He showed no signs of PPC at 7 months post-injury. Seven years later, his ankle became painful. He had developed PPC of distal fibula causing angular ankle deformity, which was treated successfully by corrective osteotomy. To our knowledge, this is the first reported case of a non-displaced fracture of the distal fibula leading to PPC several years after the initial injury, which in our understanding was impossible to predict.

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