Summary
Objectives: Lameness after metacarpal and metatarsal fractures in dogs is reported to occur with
an incidence of 18% to 70%. On the basis of long-term results, the prognosis of these
injuries was re-evaluated retrospectively.
Methods: Medical records of 100 dogs with complete clinical and radiographic follow-up examinations
after an average of four years (4 months – 14 years) were evaluated. According to
their treatment, patients were allocated to three groups (Group 1 = conservative,
Group 2 = surgical, Group 3 = combined). Assessment included complications during
the healing period and the final radiographic and functional outcome, which was statistically
compared for differences between groups (Fisher exact test, exact Wilcoxon-Mann-Whitney
test). Further, risk factors for each bone were analyzed (stepwise, multiple logistic
regression model). In 15 dogs, kinetic data (relative stance phase, peak vertical
force and impulse) were investigated by computed gait analysis.
Results: Complications were observed in 11 of 67 (16%) conservatively, in three of 25 (12%)
surgically, and in three of eight (37%) conservatively and surgically treated dogs.
Overall frequency of lameness evaluated by visual clinical assessment was three percent.
Frequency of osteoarthritis and nonunion was also low, accounting for three percent
and one percent respectively, although healing of mainly single-bone fractures resulted
in malunions in 14% radiographically. Synostoses were found in 19% of patients, and
significantly more frequent in surgically treated dogs. A higher risk of complications
was identified for metatarsal compared to metacarpal fractures. Further, an increased
risk for complications was detected for a higher degree of displacement and instability.
Clinical significance: According to the longterm results found in this study, the prognosis for metacarpal
and metatarsal fractures is better than reported in the literature to date. With the
reservation that more severe injuries are generally treated surgically, and these
fractures more frequently developed synostosis, no significant difference could be
detected between conservative and surgical treatment.
Keywords
Dog - fracture - metacarpus - metatarsus - conservative treatment - surgical treatment
- prognosis