Surgical Pins and Plates in Cats
What is a fracture?
Fracture is the term used to describe a broken bone. There are many different types of fractures, named according to the location of the fracture, how complex the injury is, and whether or not the pieces pierce through the skin.
How are fractures treated?
A better understanding of the theory and practice of fracture repair has resulted in an improved level of care for the cat with a fractured (broken) leg.
"The main objectives of fracture repair are to promote rapid healing of the fracture and to get the cat using its leg as quickly as possible."
It is now possible to repair the vast majority of fractures that a cat may suffer as the result of a traumatic incident. The main objectives of fracture repair are to promote rapid healing of the fracture and to get the cat using its leg as quickly as possible. In most cases, this involves rebuilding the broken bone and fixing it in that position with metallic implants.
The most common methods of fixation of fractures include:
1) placing a stainless steel pin in the marrow cavity of the affected bone,
2) plating the bone in position with a plate screwed to the outside of the bone OR
3) using an external fixator, which involves placing several short stainless steel pins vertically into the bone fragments, and connecting these pins on the outside of the leg using metal bars and clamps.
The decision as to which technique is used depends on a number of factors:
- the type of fracture your cat has suffered
- what equipment your veterinarian or surgeon has available
- other injuries your cat may have suffered to other limbs
- the age of your cat
- the temperament of your cat
- financial considerations
How are fractures diagnosed?
If your cat has sustained a fracture, it will normally be unable to bear weight or stand on the affected limb. Usually, a fracture is painful. There may be soft tissue swelling in the region of the fracture.
"An x-ray will be used to confirm the diagnosis and search for additional injuries."
Your veterinarian will be able to detect if there is a fracture by looking for pain, swelling and a grinding sensation between the ends of the broken bones. An x-ray will be used to confirm the diagnosis and search for additional injuries.
If there are no additional injuries, your veterinarian will use the x-ray of the fractured limb to determine which method of fixation to use. After the fracture has been repaired, another x-ray will be taken to assess how well the pieces of bone have been rejoined. The x-ray will also document the exact placement of all of the pins and/or plates.
What post-operative care does my cat need?
After a fracture has been repaired, your veterinarian will normally hospitalize your cat for a few days to ensure that there are no immediate post-operative complications such as surgical site infections, movement of the surgical implants or other problems. Immediately after the fracture has been repaired a soft bandage may be placed on the fractured limb to provide a small degree of additional support and to minimize any swelling of the soft tissues surrounding the fracture. On rare occasions, it may be necessary to put the limb in a rigid cast; however, this is generally avoided.
"...pain relief medications will be used during the postoperative period."
Antibiotics will often be prescribed to help prevent infection in the fracture site. In addition to this, since fractures and the repair associated with them will give the cat a degree of pain and discomfort, pain relief medications will be used during the postoperative period.
Some cats will not eat very well while hospitalized and can lose weight. Inadequate nutrition can lead to slow fracture healing. To promote optimal healing, your veterinarian will discharge your cat as soon as it is safe to do so.
For the first several days, your cat may need to have strict cage rest. Depending on the actual fracture repair, your veterinarian may recommend confinement in a small area such as a bedroom to allow your cat some limited mobility. In general, it is more desirable to let the cat exercise in a small room while closely supervised as opposed to strict immobilization in a cage. Physical activity minimizes muscle loss on the fracture limb, reduces the chance of long-term joint immobility and speeds healing of the fracture.
The length of time your cat will require confinement and activity restriction depends on the following factors:
- the age of your cat - younger cats heal more quickly than older cats
- if your cat has a pre-existing illness that may delay healing, such as chronic kidney disease, hyperthyroidism, etc.
- the type of fracture your cat has suffered
- the type of fixation used
- how quickly your cat starts to use its leg effectively after surgery
- the x-ray appearance of the fracture after a period of time has elapsed
"It may be necessary to remove some or all of the metal implants used in the fracture repair once healing is fully complete."
Once your veterinarian is satisfied that the fracture has healed adequately, you will be advised that exercise restriction is no longer required. It may be necessary to remove some or all of the metal implants used in the fracture repair once healing is fully complete. Your veterinarian will decide if this is necessary. Most pins and plates can safely remain in the cat for life if the situation requires that they be left in place.
What is the long-term prognosis for my cat?
Most fractures can be repaired very effectively and in many cases, your cat will resume normal activity levels within three to four months after repair. However, if the original fracture involved a joint, some lameness, decreased range of motion (ROM), stiffness, or arthritis may develop over time.