title: Combined physeal fractures of the distal radius and ulna: complications associated with K-wire fixation and long-term prognosis in six cats.
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.
authors.affiliation: 1 Department of Veterinary Medicine, University of Cambridge, Cambridge, UK.
authors.forename: Valentina
authors.initials: V
authors.lastname: Brioschi
authors.affiliation: 1 Department of Veterinary Medicine, University of Cambridge, Cambridge, UK.|2 Department of Clinical Veterinary Sciences, University of Bristol, Bristol, UK.
authors.forename: Sorrel J
authors.initials: SJ
authors.lastname: Langley-Hobbs
authors.affiliation: 3 Department of Veterinary Small Animal Clinical Sciences, Texas A&M University, College Station, TX, USA.
authors.forename: Sharon
authors.initials: S
authors.lastname: Kerwin
authors.affiliation: 4 The Department of Clinical Science and Services, The Royal Veterinary College, London University, Hatfield, UK.
authors.forename: Richard
authors.initials: R
authors.lastname: Meeson
authors.affiliation: 1 Department of Veterinary Medicine, University of Cambridge, Cambridge, UK.
authors.forename: Heidi
authors.initials: H
authors.lastname: Radke
mesh_terms: D000818:Animals; D001864:Bone Wires / Q000662:veterinary*; D002415:Cats / Q000293:injuries* / Q000601:surgery; D005260:Female; D005593:Fracture Fixation, Internal / Q000662:veterinary*; D015601:Injury Severity Score; D008297:Male; D011379:Prognosis; D011884:Radius / Q000002:abnormalities; D011885:Radius Fractures / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery / Q000662:veterinary*; D013580:Synostosis; D016896:Treatment Outcome; D014457:Ulna / Q000002:abnormalities; D014458:Ulna Fractures / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery / Q000662:veterinary*