Type II Monteggia Lesion with Complete Elbow Dislocation in a Cat

Abstract

A 2-year-old neutered male cat was presented for right forelimb non-weight-bearing lameness. A fracture of the proximal third of the ulna (associated with a caudal radio-humeral and humero-ulnar dislocations and a radio-ulnar dislocation) was radiographically identified, leading to a diagnosis of type II Monteggia lesion with complete elbow joint dislocation. The ulnar fracture was reduced and stabilized using an intramedullary pin. During surgery, the lateral collateral ligament and the annular ligament appeared disrupted. The radio-ulnar dislocation was reduced and stabilized, using a double-loop suture prosthesis passing through the metaphysis of the ulna and around the radial head. The radio-humeral dislocation was reduced and stabilized using a lateral collateral suture prosthesis. No postoperative complications were observed and the patient regained good elbow joint range of motion, with no significant lameness at 8 postoperative months.

Keywords

Monteggia fracture - elbow joint dislocation - cat - prosthesis

Animal Care

Client consent obtained.

Publikationsverlauf

Eingereicht: 17. Dezember 2020

Angenommen: 07. November 2021

Artikel online veröffentlicht:
02. März 2022

• References

• 1 Hill FWG. A survey of bone fractures in the cat. J Small Anim Pract 1977; 18 (07) 457-463
• 2 Phillips IR. A survey of bone fractures in the dog and cat. J Small Anim Pract 1979; 20 (11) 661-674
• 3 Nolte DM, Fusco JV, Peterson ME. Incidence of and predisposing factors for nonunion of fractures involving the appendicular skeleton in cats: 18 cases (1998-2002). J Am Vet Med Assoc 2005; 226 (01) 77-82
• 4 Bado JL. The Monteggia lesion. Clin Orthop Relat Res 1967; 50 (50) 71-86
• 5 Jupiter JB, Leibovic SJ, Ribbans W, Wilk RM. The posterior Monteggia lesion. J Orthop Trauma 1991; 5 (04) 395-402
• 6 Schwarz PD, Schrader SC. Ulnar fracture and dislocation of the proximal radial epiphysis (Monteggia lesion) in the dog and cat: a review of 28 cases. J Am Vet Med Assoc 1984; 185 (02) 190-194
• 7 Blieux V. Des fractures de Monteggia chez le chien et le chat: études anatomique, clinique et rétrospective de 59 cas de fractures de l'ulna avec luxation de la tête radiale [Monteggia fractures in dogs and cats: Anatomical, clinical and retrospective study of 59 cases of ulnar fractures with radial head dislocation]. 2005 Available at: http://hdl.handle.net/10068/765467
• 8 Konrad GG, Kundel K, Kreuz PC, Oberst M, Sudkamp NP. Monteggia fractures in adults: long-term results and prognostic factors. J Bone Joint Surg Br 2007; 89 (03) 354-360
• 9 Bush M, Owen M. Type-IV variant Monteggia fracture with concurrent proximal radial physeal fracture in a Domestic Shorthaired Cat. Vet Comp Orthop Traumatol 2009; 22 (03) 225-228
• 10 Irubetagoyena I, Lopez T, Autefage A. Type IV Monteggia fracture in a cat. Vet Comp Orthop Traumatol 2011; 24 (06) 483-486
• 11 Fox D. Radius and ulna. In: Johnston SA, Tobias KM. eds. Veterinary Surgery Small Animal. 2nd edition. Saint Louis: Elsevier GmbH; 2018: 918-919
• 12 Vallone L, Schulz K. Repair of Monteggia fractures using an Arthrex Tightrope system and ulnar plating. Vet Surg 2011; 40 (06) 734-737
• 13 Voss K, Langley-Hobbs S, Montavon P. Elbow joint. In: Montavon P, Voss K, Langley-Hobbs S. eds. Feline Orthopaedic Surgery and Musculoskeletal Disease. 1st ed.. Philadelphia: Elsevier; 2009: 354-356
• 14 Fernandez-Sanchez A, Calvo I, Farrell M. Articular type II Monteggia fracture with concurrent humeroulnar luxation in a Bengal cat. Vet Rec Case Rep 2019; 7 (01) 7-10
• 15 DeCamp CE, Johnston SA, Déjardin LM, Schaefer SL. Type A1, ulnar fracture. In: Brinker WO, Piermattei D, Flo G. eds. Small Animal Orthopedics and Fracture Repair. 5th edition. Saint Louis: Elsevier GmbH; 2016: 372-378
• 16 Autefage A. Fracture of the ulna. In: Johnson A, Houlton J, Vannini R. eds. AO Principles of Fracture Management in the Dog and Cat. Nex York: Thieme; 2005: 260-272
• 17 Boudrieau R. Fractures of the radius and ulna. In: Slatter D. ed. Textbook of Small Animal Surgery. 3rd edition. Philadelphia: W.B. Saunders; 2003: 1955-1973
• 18 Campbell JR. Luxation and ligamentous injuries of the elbow of the dog. Vet Clin North Am 1971; 1 (03) 429-440
• 19 Mitchell KE. Traumatic elbow luxation in 14 dogs and 11 cats. Aust Vet J 2011; 89 (06) 213-216
• 20 Billings L, Vasseur P, Todoroff R, Johnson W. Clinical results after reduction of traumatic elbow luxations in nine dogs and one cat. J Am Anim Hosp Assoc 1992; 28: 137-142
• 21 O'Brien MG, Boudrieau RJ, Clark GN. Traumatic luxation of the cubital joint (elbow) in dogs: 44 cases (1978-1988). J Am Vet Med Assoc 1992; 201 (11) 1760-1765
• 22 Williams H, Calvo I, Gaines A. et al. Multi-centre retrospective study of the long-term outcome following suspected traumatic elbow luxation in 32 cats. J Small Anim Pract 2020; 61 (06) 354-362
• 23 Farrell M, Thomson DG, Carmichael S. Surgical management of traumatic elbow luxation in two cats using circumferential suture prostheses. Vet Comp Orthop Traumatol 2009; 22 (01) 66-69
• 24 Bordelon JT, Reaugh HF, Rochat MC. Traumatic luxations of the appendicular skeleton. Vet Clin North Am Small Anim Pract 2005; 35 (05) 1169-1194
• 25 Schmiedt CW. Suture material, tissue staplers, ligation devices, and closure methods. In: Johnston SA, Tobias KM. eds. Veterinary Surgery Small Animal. 2nd ed. Saint Louis: Elsevier GmbH; 2018: 214-218