Vet Comp Orthop Traumatol 2022; 35(06): 403-412
DOI: 10.1055/s-0042-1750430
Clinical Communication

Short-Term Clinical and Radiographic Outcome after Stabilization of Femoral Capital Physeal Fractures with Cortical Positional Screws in 39 Cats

Joris Johannes Wilhelmus Gerardus Vink
1   Department of Orthopaedic Surgery, Medisch Centrum Voor Dieren, Amsterdam, The Netherlands
,
Mike Willem Laurens Hubers
1   Department of Orthopaedic Surgery, Medisch Centrum Voor Dieren, Amsterdam, The Netherlands
,
Erik den Hertog
2   Hertog Veterinary Research Support, Amersfoort, The Netherlands
,
Ingrid Geraldine Fernanda Schaeffer
1   Department of Orthopaedic Surgery, Medisch Centrum Voor Dieren, Amsterdam, The Netherlands
,
Dick van Zuilen
1   Department of Orthopaedic Surgery, Medisch Centrum Voor Dieren, Amsterdam, The Netherlands
,
Roelof Jozef Maarschalkerweerd
1   Department of Orthopaedic Surgery, Medisch Centrum Voor Dieren, Amsterdam, The Netherlands
,
Nicolien Jacoba van Klaveren
1   Department of Orthopaedic Surgery, Medisch Centrum Voor Dieren, Amsterdam, The Netherlands
› Author Affiliations

Abstract

Objective The aim of this study was to report the short-term clinical and radiographic outcome for the treatment of femoral capital physeal fractures with cortical positional screws in cats.

Study Design Medical records and radiographs of cats with femoral capital physeal fractures stabilized with cortical positional screws were retrospectively reviewed. Signalment, bodyweight, femoral head affected, fracture classification, fracture reduction, implants, concurrent orthopaedic injuries, osteoarthritis, femoral neck osteolysis, complications and 6-week follow-up clinical results were recorded. A short- to long-term follow-up was performed by telephone questionnaire with the owners.

Results Forty-six fractures in 39 cats met the inclusion criteria. In 45/46 fractures, radiographic signs of bone healing were present and 35/39 cats were assessed as walking normally by a veterinarian at 6-week follow-up. There was a significant increase in radiographic signs of osteoarthritis (p=0.037) and femoral neck osteolysis (p=0.001) on 6-week follow-up radiographs. Pre- and postoperative osteoarthritis and femoral neck osteolysis were not associated with clinical outcome. The mean follow-up period for the telephone questionnaire was 48 months (range, 5–147 months). Seven out of 25 owners reported a gait abnormality in the short- to long-term.

Conclusion Femoral capital physeal fractures in cats can be treated successfully with the use of cortical positional screws. This technique may be considered as an alternative to other primary fixation techniques and salvage procedures for the treatment of femoral capital physeal injuries in cats. This technique seemed successful in cats with a low-grade preoperative femoral neck osteolysis.

Authors' Contributions

Joris Vink and Mike Hubers contributed to conception of study, study design, acquisition of data and interpretation of data. Erik den Hertog contributed to data analysis and interpretation. Nicolien Jacoba van Klaveren, Ingrid Schaeffer, Dick van Zuilen and Roelof Maarschalkerweerd contributed to acquisition of data and performed all surgeries. All authors drafted, revised and approved the submitted manuscript.


Supplementary Material



Publication History

Received: 24 August 2021

Accepted: 04 May 2022

Article published online:
08 September 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
  • References

  • 1 Borak D, Wunderlin N, Brückner M, Schwarz G, Klang A. Slipped capital femoral epiphysis in 17 Maine Coon cats. J Feline Med Surg 2017; 19 (01) 13-20
  • 2 Craig LE. Physeal dysplasia with slipped capital femoral epiphysis in 13 cats. Vet Pathol 2001; 38 (01) 92-97
  • 3 Lafuente P. Young, male neutered, obese, lame? Non-traumatic fractures of the femoral head and neck. J Feline Med Surg 2011; 13 (07) 498-507
  • 4 McNicholas Jr WT, Wilkens BE, Blevins WE. et al. Spontaneous femoral capital physeal fractures in adult cats: 26 cases (1996–2001). J Am Vet Med Assoc 2002; 221 (12) 1731-1736
  • 5 Queen J, Bennett D, Carmichael S. et al. Femoral neck metaphyseal osteopathy in the cat. Vet Rec 1998; 142 (07) 159-162
  • 6 Fischer HR, Norton J, Kobluk CN, Reed AL, Rooks RL, Borostyankoi F. Surgical reduction and stabilization for repair of femoral capital physeal fractures in cats: 13 cases (1998-2002). J Am Vet Med Assoc 2004; 224 (09) 1478-1482
  • 7 Culvenor JA, Black AP, Lorkin KF, Bradley WA. Repair of femoral capital physeal injuries in cats-14 cases. Vet Comp Orthop Traumatol 1996; 9 (04) 182-185
  • 8 Jeffery ND. Internal fixation of femoral head and neck fractures in the cat. J Small Anim Pract 1989; 30 (12) 674-677
  • 9 Gibson KL, vanEe RT, Pechman RD. Femoral capital physeal fractures in dogs: 34 cases (1979-1989). J Am Vet Med Assoc 1991; 198 (05) 886-890
  • 10 DeCamp CE, Probst CW, Thomas MW. Internal fixation of femoral capital physeal injuries in dogs: 40 cases (1979-1987). J Am Vet Med Assoc 1989; 194 (12) 1750-1754
  • 11 Grayton J, Allen P, Biller D. Case report: proximal femoral physeal dysplasia in a cat and a review of the literature. Isr J Vet Med 2014; 69: 40-44
  • 12 Nappier M, Robertson B, LeRoith T. Acute hindlimb lameness in a 6-month-old cat. J Feline Med Surg 2019; 21 (05) 449-451
  • 13 Rahal SC, Mesquita LR, Kano WT. et al. Clinical outcome and gait analysis of a cat with bilateral slipped capital femoral epiphysis following bilateral ostectomy of the femoral head and neck. Vet Q 2016; 36 (02) 115-119
  • 14 Berzon JL, Howard PE, Covell SJ, Trotter EJ, Dueland R. A retrospective study of the efficacy of femoral head and neck excisions in 94 dogs and cats. Vet Surg 1980; 9 (03) 88-92
  • 15 Yap FW, Dunn AL, Garcia-Fernandez PM, Brown G, Allan RM, Calvo I. Femoral head and neck excision in cats: medium- to long-term functional outcome in 18 cats. J Feline Med Surg 2015; 17 (08) 704-710
  • 16 Schnabl-Feichter E, Schnabl S, Tichy A, Gumpenberger M, Bockstahler B. Measurement of ground reaction forces in cats 1 year after femoral head and neck ostectomy. J Feline Med Surg 2021; 23 (04) 302-309
  • 17 Off W, Matis U. Excision arthroplasty of the hip joint in dogs and cats. Clinical, radiographic, and gait analysis findings from the Department of Surgery, Veterinary Faculty of the Ludwig-Maximilians-University of Munich, Germany. 1997. Vet Comp Orthop Traumatol 2010; 23 (05) 297-305
  • 18 Witte PG, Scott HW, Tonzing MA. Preliminary results of five feline total hip replacements. J Small Anim Pract 2010; 51 (07) 397-402
  • 19 Liska WD, Doyle N, Marcellin-Little DJ, Osborne JA. Total hip replacement in three cats: surgical technique, short-term outcome and comparison to femoral head ostectomy. Vet Comp Orthop Traumatol 2009; 22 (06) 505-510
  • 20 Salter RB, Harris WR. Injuries involving the epiphyseal plate. J Bone Joint Surg 1963; 45 (03) 587-622
  • 21 Johnson KA. Piermattei's Atlas of Surgical Approaches to the Bones and Joints of the Dog and Cat. Fifth edition. Missouri: Elsevier Saunders; 2014. :328–332
  • 22 Guiot LP, Déjardin LM. Fractures of the femur. In: Johnston SA, Tobias KM. eds. Veterinary Surgery: Small Animal. Missouri: Elsevier Saunders; 2018: 1019-1071
  • 23 Hardie EM, Roe SC, Martin FR. Radiographic evidence of degenerative joint disease in geriatric cats: 100 cases (1994–1997). J Am Vet Med Assoc 2002; 220 (05) 628-632
  • 24 Keller GG, Reed AL, Lattimer JC, Corley EA. Hip dysplasia: a feline population study. Vet Radiol Ultrasound 1999; 40 (05) 460-464
  • 25 Cook JL, Evans R, Conzemius MG. et al. Proposed definitions and criteria for reporting time frame, outcome, and complications for clinical orthopedic studies in veterinary medicine. Vet Surg 2010; 39 (08) 905-908
  • 26 Hulse D, Kerwin S, Mertens D. Fractures of the proximal femur. In: Johnson AL, Houlton JE, Vanini R. eds. AO Principles of Fracture Management in the Dog and Cat. Stuttgart: Thieme; 2005: 272-285
  • 27 Tillson DM, Roush JK, McLaughlin RM, Gaughan EM, DeBowes RM. Biomechanical comparison of three repair methods for proximal femoral physeal fractures in shear and tension. Vet Comp Orthop Traumatol 1994; 7 (04) 136-139
  • 28 Belkoff SM, Millis DL, Probst CW. Biomechanical comparison of 1-screw and 2-divergent pin internal fixations for treatment of slipped capital femoral epiphysis, using specimens obtained from immature dogs. Am J Vet Res 1993; 54 (10) 1770-1773
  • 29 Khanna A, Plessas SJ, Barrett P, Bainbridge LC. The thermal effects of Kirschner wire fixation on small bones. J Hand Surg [Br] 1999; 24 (03) 355-357
  • 30 Franssen BB, Schuurman AH, Van der Molen AM, Kon M. One century of Kirschner wires and Kirschner wire insertion techniques: a historical review. Acta Orthop Belg 2010; 76 (01) 1-6
  • 31 Beale B. Orthopedic clinical techniques femur fracture repair. Clin Tech Small Anim Pract 2004; 19 (03) 134-150
  • 32 Smith RN. Fusion of ossification centres in the cat. J Small Anim Pract 1969; 10 (09) 523-530
  • 33 Perry KL, Fordham A, Arthurs GI. Effect of neutering and breed on femoral and tibial physeal closure times in male and female domestic cats. J Feline Med Surg 2014; 16 (02) 149-156
  • 34 Daly WR. Femoral head and neck fractures in the dog and cat: a review of 115 cases. Vet Surg 1978; 7 (02) 29-38
  • 35 Otani T, Kawaguchi Y, Marumo K. Diagnosis and treatment of slipped capital femoral epiphysis: recent trends to note. J Orthop Sci 2018; 23 (02) 220-228
  • 36 Roaten J, Spence DD. Complications related to the treatment of slipped capital femoral epiphysis. Orthop Clin North Am 2016; 47 (02) 405-413
  • 37 Lehmann CL, Arons RR, Loder RT, Vitale MG. The epidemiology of slipped capital femoral epiphysis: an update. J Pediatr Orthop 2006; 26 (03) 286-290