Subscribe to RSS
Management of Feline Femoral, Tibial and Humeral Fractures Using a 3.5 mm Titanium Interlocking NailFunding None.
Objective Our objectives were to report complications associated with stabilization of long-bone fractures in cats using a 3.5-mm titanium interlocking nail and to examine the influences of signalment, fracture type and fixation evaluations on the occurrence of complications.
Study Design Retrospective clinical study.
Material and Methods Medical and radiographic records of cats with long-bone fractures treated with an interlocking nail were reviewed. Data included age, sex, weight, cause of the fracture, fractured bone(s) and fracture type. Complications were classified as minor and major complications. Fisher's exact tests and logistic regression analysis were used to test whether certain variables of signalment and interlocking nail configuration had an effect on the occurrence of complications.
Results Sixty-seven fractures of 67 cats were examined in this study. Forty-eight femora, sixteen tibiae and three humeri were included. Complications occurred in 11/67 fractures. Major complications occurred in 8/67 fractures and included screw breakage (n = 3), nail breakage (n = 2), nail bending (n = 1), screw loosening (n = 1), non-union (n = 1). Statistical analysis showed a significant difference between fracture types and the occurrence of major complications (p = 0.02).
Conclusion In conclusion, use of this commercially available standard 3.5-mm titanium interlocking nail for stabilization of comminuted and oblique humeral, femoral and tibial fractures in cats is feasible.
G.M.M. and C.F. contributed to conception of study, study design, acquisition of data and data analysis and interpretation. T.B. contributed to study design and acquisition of data. T.C.B. contributed to study design and data analysis and interpretation. M.G. contributed to conception of study. All authors drafted and revised and approved the submitted manuscript.
Received: 14 August 2021
Accepted: 06 July 2022
Article published online:
23 September 2022
© 2022. Thieme. All rights reserved.
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
- 1 Johnston S, vonPfeil D, Déjardin L, Roe SC, Weh J. Internal fracture fixation. In: Veterinary Surgery: Small Animal. Vol 1. Saunders; 2018: 654-90
- 2 Déjardin LM, Perry KL, von Pfeil DJF, Guiot LP. Interlocking nails and minimally invasive osteosynthesis. Vet Clin North Am Small Anim Pract 2020; 50 (01) 67-100
- 3 Dueland RT, Berglund L, Vanderby Jr R, Chao EY. Structural properties of interlocking nails, canine femora, and femur-interlocking nail constructs. Vet Surg 1996; 25 (05) 386-396
- 4 Muir P, Johnson KA, Markel MD. Area moment of inertia for comparison of implant cross-sectional geometry and bending stiffness. Vet Comp Orthop Traumatol 1995; 8 (03) 146-152
- 5 Bernarde A, Diop A, Maurel N, Viguier E. An in vitro biomechanical study of bone plate and interlocking nail in a canine diaphyseal femoral fracture model. Vet Surg 2001; 30 (05) 397-408
- 6 Scotti S, Klein A, Pink J, Hidalgo A, Moissonnier P, Fayolle P. Retrograde placement of a novel 3.5 mm titanium interlocking nail for supracondylar and diaphyseal femoral fractures in cats. Vet Comp Orthop Traumatol 2007; 20 (03) 211-218
- 7 Díaz-Bertrana MC, Durall I, Puchol JL, Sánchez A, Franch J. Interlocking nail treatment of long-bone fractures in cats: 33 cases (1995-2004). Vet Comp Orthop Traumatol 2005; 18 (03) 119-126
- 8 Duhautois B. Use of veterinary interlocking nails for diaphyseal fractures in dogs and cats: 121 cases. Vet Surg 2003; 32 (01) 8-20
- 9 Dueland RT, Johnson KA, Roe SC, Engen MH, Lesser AS. Interlocking nail treatment of diaphyseal long-bone fractures in dogs. J Am Vet Med Assoc 1999; 214 (01) 59-66
- 10 Endo K, Nakamura K, Maeda H, Matsushita T. Interlocking intramedullary nail method for the treatment of femoral and tibial fractures in cats and small dogs. J Vet Med Sci 1998; 60 (01) 119-122
- 11 Brückner M, Unger M, Spies M. Early clinical experience with a newly designed interlocking nail system-Targon(®) Vet. Vet Surg 2016; 45 (06) 754-763
- 12 Moses PA, Lewis DD, Lanz OI, Stubbs WP, Cross AR, Smith KR. Intramedullary interlocking nail stabilisation of 21 humeral fractures in 19 dogs and one cat. Aust Vet J 2002; 80 (06) 336-343
- 13 Marturello DM, Perry KL, Déjardin LM. Clinical application of the small I-Loc interlocking nail in 30 feline fractures: a prospective study. Vet Surg 2021; 50 (03) 588-599
- 14 Larin A, Eich CS, Parker RB, Stubbs WP. Repair of diaphyseal femoral fractures in cats using interlocking intramedullary nails: 12 cases (1996-2000). J Am Vet Med Assoc 2001; 219 (08) 1098-1104 https://avmajournals.avma.org/view/journals/javma/219/8/javma.2001.219.1098.xml [Internet]
- 15 Fauron AH, Déjardin LM, Phillips R, Gazzola KM, Perry KL. Clinical application of the I–LOC angle-stable interlocking nail in 100 traumatic fractures of the humerus, femur and tibia. Vet Comp Orthop Traumatol 2018; 31 (S02): A3642
- 16 Basinger RR, Suber JT. Two techniques for supplementing interlocking nail repair of fractures of the humerus, femur, and tibia: results in 12 dogs and cats. Vet Surg 2004; 33 (06) 673-680
- 17 Lorinson D, Grosslinger K, Vidoni B. Anwendung des Verriegelungsnagels bei Frakturen langer Röhrenknochen von Hund und Katze. Wien Tierärztl Monat - Vet Med Austria 2000; 87: 278-283
- 18 Schwarz T, Crawford PE, Owen MR, Störk CK, Thompson H. Fatal pulmonary fat embolism during humeral fracture repair in a cat. J Small Anim Pract 2001; 42 (04) 195-198
- 19 Bong MR, Kummer FJ, Koval KJ, Egol KA. Intramedullary nailing of the lower extremity: biomechanics and biology. J Am Acad Orthop Surg 2007; 15 (02) 97-106
- 20 Durall I, Diaz-Bertrana MC, Puchol JL, Franch J. Radiographic findings related to interlocking nailing: windshield-wiper effect, and locking screw failure. Vet Comp Orthop Traumatol 2003; 16 (04) 217-222
- 21 Suber JT, Basinger RR, Keller WG. Two unreported modes of interlocking nail failure: breakout and screw bending. Vet Comp Orthop Traumatol 2002; 15 (04) 228-232
- 22 Horstman CL, Beale BS. Long bone fracture repair using the interlocking nail in a minimally invasive surgical procedure in cats and dogs: 65 cases (1994–2001). Vet Comp Orthop Traumatol 2002; (15) A6
- 23 Radasch RM. Biomechanics of bone and fractures. Vet Clin North Am Small Anim Pract 1999; 29 (05) 1045-1082 , v–vi
- 24 Perren SM, Mathys R, Pohler O. Implants and materials in fracture fixation. In: Johnson AL, Houlton J, Vannini R, eds. AO Principles of Fracture Management in the Dog and Cat. Thieme; New York: 2005: 477-88
- 25 Niinomi M, Liu Y, Nakai M, Liu H, Li H. Biomedical titanium alloys with Young's moduli close to that of cortical bone. Regen Biomater 2016; 3 (03) 173-185
- 26 Brumback RJ. The rationales of interlocking nailing of the femur, tibia, and humerus. Clin Orthop Relat Res 1996; (324) 292-320
- 27 Kaur M, Singh K. Review on titanium and titanium based alloys as biomaterials for orthopaedic applications. Mater Sci Eng C 2019; 102: 844-862
- 28 Gielen I. Radiology of Fractures-Classification, Healing, Complications. In 2014. p. 325–237. (World Small Animal Veterinary Association, 39th Congress, Proceedings).
- 29 Cook JL, Evans R, Conzemius MG. et al. Proposed definitions and criteria for reporting time frame, outcome, and complications for clinical orthopedic studies in veterinary medicine. Vet Surg 2010; 39 (08) 905-908
- 30 von Pfeil DJF, Déjardin LM, DeCamp CE. et al. In vitro biomechanical comparison of a plate-rod combination-construct and an interlocking nail-construct for experimentally induced gap fractures in canine tibiae. Am J Vet Res 2005; 66 (09) 1536-1543
- 31 Moreno M, Zambrano S, Déjardin L. Bone Biomechanics and Fracture Biology. In: Veterinary Surgery: Small Animal. Saunders; Philadelphia: 2018: 613-49
- 32 Durall I, Diaz M, Morales I. Interlocking nail stabilisation of humeral fractures. Initial experience in seven clinical cases. Vet Comp Orthop Traumatol 1994; 7 (01) 3-8
- 33 Knudsen CJ, Grobler GP, Close RE. Inserting the distal screws in a locked femoral nail. J Bone Joint Surg Br 1991; 73 (04) 660-661
- 34 Wheeler JL, Stubbs WP, Lewis DD, Cross AR, Guerin SR. Intramedullary interlocking nail fixation in dogs and cats: biomechanics and instrumentation. Compend Contin Educ Vet 2004; 26 (07) 531-544
- 35 Horstman CL, Beale BS, Conzemius MG, Evans R R. Biological osteosynthesis versus traditional anatomic reconstruction of 20 long-bone fractures using an interlocking nail: 1994-2001. Vet Surg 2004; 33 (03) 232-237
- 36 Ting D, Cabassu JB, Guillou RP. et al. In vitro evaluation of the effect of fracture configuration on the mechanical properties of standard and novel interlocking nail systems in bending. Vet Surg 2009; 38 (07) 881-887
- 37 Dueland RT, Vanderby R, McCabe RP. Fatigue study of six and eight mm diameter interlocking nails with screw holes of variable size and number. Vet Comp Orthop Traumatol 1997; 10 (04) 194-199
- 38 Langley-Hobbs SJ, Straw M. The feline humerus. An anatomical study with relevance to external skeletal fixator and intramedullary pin placement. Vet Comp Orthop Traumatol 2005; 18 (01) 1-6