Cat Shorthair Male, castrated 2 years of age. Jump from a window, crepitation and pain on the right elbow. Radiographs of the region were taken. Mediolateral (on the left) and craniocaudal view of the right elbow Radiographic findings and diagnosis
- There is a complete, oblique fracture of the ulna at the level of the proximal third with one cortical fragment and multiple, additional smaller fragments (arrow).
- Complete luxation of the ulna with dislocation caudomedial (empty arrow).
- There is mild malalignment of the distal ulna cranially and severe rotation in supination of the distal limb.
- Moderate soft tissue swelling, very likely lesion of the collateral ligaments.
- The cat underwent surgery, the annular ligaments and the collateral ligaments were torn.
- Post OP radiographs were taken.
Lateromedial (on the left) and craniocaudal (on the right) of the right elbow view post OP.
- Two months later the cat was presented for a re-check. He was lame 2-3/4 with moderate muscle atrophy of the right front limb.
- Radiographs were taken.
Lateromedial (on the left) and craniocaudal (on the right) of the right elbow view 2 months post OP. Radiographic diagnosis
- The elbow joint was reluxated laterally.
- There are signs of healing of the tibial fracture and severe degenerative changes in the elbow joint.
- The cat underwent a second operation, radiographs are shown.
Lateromedial (on the left) and craniocaudal (on the right) of the right elbow view after the surgical revision. The cat was sent home with prescription of cage rest and weekly session of physiotherapy. Ten days later he was presented at the emergency duty because the owner noticed movement of the implant. Lateromedial (on the left) and craniocaudal (on the right) view of the right elbow. There is severe dislocation of both the fix ex proximally with bend of the distal pins. The diagnosis is implant failure of the fix ex. The fix ex were removed. Lateromedial (on the left) and craniocaudal (on the right) of the right elbow view after removal of the fix ex. The elbow joint is caudally subluxated. Comments
- At this time and together with the owner, it was decided to opt for a conservative therapy .
- The luxation of the radius with fracture of the proximal one third of the ulna is commonly referred to as a Monteggia‘s fracture. The radial head may be displaced in any one of four directions (lateral, medial, cranial or caudal) but it has been reported that usually it luxates cranially.
- The radiographic diagnosis in this case was clear, the course of the surgery unexpected, with an unusual caudomedial radial luxation and reluxation lateral and caudal.
