Combined physeal fractures of the distal radius and ulna: complications associated with K-wire fixation and long-term prognosis in six cats. Issue 8 (August 2017)

• Record Type: Journal Article
• Authors: Brioschi, Valentina; Langley-Hobbs, Sorrel J; Kerwin, Sharon; Meeson, Richard; Radke, Heidi
• Is Part Of: Journal of feline medicine and surgery. Volume 19:Issue 8(2017)
• Page Start: 907
• Page End: 914
• Publication Date: 2017-08
• Subjects: Cats -- Diseases -- Periodicals; Cats -- Surgery -- Periodicals; 636.8089
• DOI: 10.1177/1098612X16653644
• Languages: English
• ISSNs: 1098-612X

Abstract

Objectives: The objective was to describe the complications and long-term outcome associated with Kirschner (K)-wire fixation of combined distal radial and ulnar physeal fractures in six cats. Methods: Medical records (2002–2014) of six referral institutions were searched for cats with combined distal radial and ulnar physeal fractures. Cases with complete clinical files, radiographs and surgical records were retrospectively reviewed. Long-term outcome was assessed via telephone interviews using an owner questionnaire. Results: Complete files were available for 6/9 identified cases (cases 1–6). All fractures were classified as Salter–Harris type I or II. Five cases underwent open reduction and internal fixation via cross-pinning of the distal radius and intramedullary pinning of the ulna (cases 1–3); fixation of the distal radial and ulnar physes with one K-wire each (case 4); and K-wire fixation of the radial physis in combination with two transulnoradial K-wires (case 5). One case underwent closed reduction and percutaneous cross-pinning of the distal radius under fluoroscopic guidance (case 6). The complications encountered were: reduced radiocarpal range of motion (ROM) (cases 1, 3, 4, 5); implant loosening/migration (cases 1, 2, 5); and radioulnar synostosis (case 4). None of the cats developed angular limb deformity. Long-term outcome (12 months to 7 years after surgery) was graded as 'excellent' by the owners in all cases. Conclusions and relevance: Prognosis is favourable for feline combined distal radial and ulnar physeal fractures following K-wire fixation in cats over 7 months of age. Implant removal after bony union is recommended to minimise reduction in ROM and to prevent implant loosening/migration.