Combined Intramedullary and External Skeletal Fixation of Metatarsal and Metacarpal Fractures in 12 Dogs and 19 Cats

Abstract

Objective: To report surgical technique, clinical experiences, and long-term outcomes of combined intramedullary/external skeletal fixation of metatarsal (MT) and metacarpal (MC) fractures in dogs and cats. Study Design: Case series. Animals: Dogs (n = 12); 19 cats. Methods: Clinical and radiographic records of animals managed by combined intramedullary/external fixation of MT/MC fractures were reviewed. Signalment, fracture configuration, complications, and subjective clinical findings were recorded. Surgical technique involved retrograde intramedullary pin placement into fractured MT/MC bones, and transverse pin placement in the base of the MT/MCs or tarsal/carpal bones. Contoured pin ends were enshrouded dorsally in epoxy resin and implants maintained until fracture union. Postoperative clinical and radiographic reassessment was performed where possible. Results: Small breed dogs (n = 12) and 19 cats were operated. Fixator removal occurred in < 10 weeks in all cases. Complications included synostosis (n = 2), pin tract discharge (7), excessive postoperative swelling (8), skin abrasions from the frame (2), and paw distortion associated with frame impingement (2). Long-term radiography documented degenerative changes associated with MT-phalangeal or MC-phalangeal joints in 2 dogs; 7 cats, but changes were typically graded mild or moderate and affected only 1 or 2 joints. Conclusions: Combined intramedullary/external fixation of MT/MC fractures is viable, particularly juxta-articular fractures. Pin penetration of MT-phalangeal or MC-phalangeal joints may cause morbidity and requires further study. © 2011 by The American College of Veterinary Surgeons.