Cat, british shorthair Male castrated 2 years of age, presented in the emergency duty after falling from the 4th floor. Severe swelling at the level of the left tarsus. Radiograph of the left tarsus were taken Radiographic examination Lateromedial and dorsoplantar view of the left tarsus Radiographic examination
- There is a severe, extensive soft tissue swelling centred on the left tarsus of mild heterogenous opacity with multiple gas inclusions.
- There is a transverse fracture of the distal metaphysis of the tibia with angulation laterally (arrow)
- There is an articular fracture of the talus with severe dislocation laterally and probably rotation (arrow head)
- There is luxation of the other fragment of the talus medially with some small mineral opacities in the widened joint gap (empty arrows)
Radiographic diagnosis Open articular comminuted fracture and luxation of the left talus with fracture of the distal fibula. Accompanying lesion of the medial collateral ligament. Close up of the dorsoplantar view of the left tarsus The cat underwent surgical fixation. Lateromedial and dorsoplantar view directly post operative Radiographs of the tarsus were taken 2 and 4 months post OP. The last study is shown Lateromedial and dorsoplantar view 4 months post operative. A mild lucency around the cerclage of the tibia is visible, there is solid and smooth marked new bone proliferation dorsal to the distal plate and in the distal fibula. Considering the possibility of focal osteomyelitis, the implant was removed 5 months post operation. Lateromedial and dorsoplantar view after complete implant removal, 5 months post operation. Comments
- In the last clinical examination, the cat was only mildly lame on the left limb.
- Postoperative imaging is essential for proper evaluation of the reduction and alignment of the fracture as well as placement of orthopedic device. Radiographs should be repeated every 4 to 6 weeks unless clinical signs indicate a possible acute change in condition.
- The amount of callus is related to the type of the fracture, degree of reduction, fixation. Fractures that have large gaps either because of less-than-anatomic reduction or missing fragments will heal with a larger callus. Fractures with anatomic reduction and rigid fixation may heal with little or no visible callus.
- The time for removal of orthopedic devices varies with the device and each patient and the progression of the healing process. Methods have been explored to quantify measurement of fracture healing by using ultrasound, CT or radiography. However, the most used method to assess union remains radiographic examination and clinical assessment.
- Generally, fixation devices may be removed when radiographic evidence of bridging bony callus is present.
