title: 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.
  
  
  METHODS
  Case series.
  
  
  METHODS
  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.
authors.affiliation: Fitzpatrick Referrals, Halfway Lane, Eashing, UK. noelf@fitzpatrickreferrals.co.uk
authors.forename: Noel
authors.initials: N
authors.lastname: Fitzpatrick
authors.forename: Jerry O
authors.initials: JO
authors.lastname: Riordan
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Smith
authors.forename: Jola H
authors.initials: JH
authors.lastname: Modlinska
authors.forename: Russell
authors.initials: R
authors.lastname: Tucker
authors.forename: Russell
authors.initials: R
authors.lastname: Yeadon
mesh_terms: D000818:Animals; D002415:Cats / Q000293:injuries* / Q000601:surgery; D004285:Dogs / Q000293:injuries* / Q000601:surgery; D005260:Female; D005592:Fracture Fixation / Q000295:instrumentation / Q000379:methods / Q000662:veterinary*; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation / Q000379:methods / Q000662:veterinary; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000601:surgery / Q000662:veterinary*; D008297:Male; D050279:Metacarpal Bones / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D008682:Metatarsal Bones / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D011183:Postoperative Complications / Q000662:veterinary; D011859:Radiography; D012189:Retrospective Studies; D016896:Treatment Outcome