Complete vastus release to repair complex proximal femoral fractures: description and follow-up in four cats

Abstract

Case series summary: Four domestic cats treated surgically for complex fractures of the proximal femur were included in this retrospective case series. Medical records from October 2021 to January 2023 were reviewed for cats presenting with high-energy trauma resulting in comminuted proximal femoral fractures. All cats underwent surgical stabilisation using a lateral approach extended by complete release of the vastus lateralis muscle to improve visualisation and access. Follow-up included physical and radiographic evaluation and completion of the Feline Musculoskeletal Pain Index (FMPI). The modified approach facilitated better visualisation and implant placement. The mean surgical time was 76 mins. Bone healing was observed in three cases with available follow-up, with FMPI scores indicating complete recovery. One case required revision surgery. Minor complications were resolved. Two cats died later from unrelated trauma. Relevance and novel information: Complete release of the vastus lateralis muscle enhanced exposure and facilitated successful treatment of complex proximal femoral fractures in cats without direct approach-related complications. This technique may be beneficial when standard exposure is insufficient in feline proximal femoral fractures.