Cat - Care following fractures repaired with Pins or Plates

What is a fracture?

This is the term used to describe a broken bone.

How are fractures treated?

In recent years, the use of modern veterinary equipment and a better understanding of the theory and practice of fracture repair, has resulted in an improved level of treatment for the cat with a fractured (broken) leg. It is now possible to repair the vast majority of fractures that a cat may suffer as the result of a traumatic incident, most commonly a road traffic accident. The main aims of fracture repair are to get a fracture to heal as quickly as possible and 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 (using metallic implants).

The commonest methods of fixation of fractures are: placing a stainless steel pin in the marrow cavity of the affected bone, plating the bone in position with a plate screwed to the outside of the bone or, lastly, by the use of pins that project out of the cat's leg that are connected with a metal bar and clamps (the last are called external fixators).

The decision as to which implants are used depends on a number of factors:

• The type of fracture your cat has suffered
• What equipment your veterinary surgeon has available
• Other injuries your cat may have suffered to other limbs
• The age of your cat
• Financial considerations
• The temperament of your cat

How are fractures diagnosed?

Your cat may have been missing from home for a number of days. If it has a fracture it will normally not be able to weight bear on the affected limb. Your cat will be experiencing a degree of discomfort or pain. There may be a degree of soft tissue swelling in the region of the fracture. Your vet will be able to detect if there is a fracture by looking for pain, swelling and a grinding sensation (crepitus) between the ends of the broken bones.

Before repairing a fracture your vet will give your cat a thorough examination to ensure that there are no other injuries, and it may also be necessary to take radiographs (x-rays) of the cat's chest and abdomen to make absolutely sure that there are no life threatening internal injuries before anaesthetising your cat to repair its fracture.

If there are no additional injuries your vet will take a radiograph (x-ray) of the fractured limb before the fracture is repaired to help to decide which method of fixation to use. After the fracture has been repaired another radiograph (x-ray) will usually be taken to assess how well the pieces of bone have come back together and so that the exact position of all of the pins/plates can be determined. If there is a lot of soft tissue injury, your vet may decide to keep your cat hospitalised for a few days on pain relief to allow the soft tissue swelling to settle down, this will make fracture repair easier and more reliable.

What post-operative care does my cat need?

After a fracture has been repaired your veterinary surgeon will normally keep your cat in the veterinary practice for a few days to ensure that there are no immediate post operative complications such as wound problems, movement of implants or infection. Immediately after the fracture has been repaired a soft dressing may be placed on the fractured limb to provide a small degree of additional support and to minimise any swelling of the soft tissues surrounding the fracture. Occasionally it may be necessary to put the limb in a rigid cast, however this is generally avoided.

Usually antibiotics will be prescribed to 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 may be provided for the post operative period.

Some cats will not eat very well if hospitalised and can lose significant amounts of weight. This situation can lead to slow fracture healing. In most cases your vet will discharge your cat as soon as they feel it is safe to do so.

Initially your cat will have to be prevented from going outdoors. Depending on how happy your vet is with the fracture repair he may suggest that the cat is confined to one room of the house. However if there are concerns about how stable the fracture is, the cat may have to be confined to a large cage. In general it is more desirable to let the cat exercise itself around one room in a controlled manner, this minimises muscle wastage on the fractured limb, minimises any chance of long term limb stiffness and can help healing of the fracture.

The length of time your cat is confined depends on the following factors:

• The age of your cat - young cats heal more quickly than older cats
• If your cats has already got any other illness, if this is the case fracture healing may be delayed
• The type of fracture your cat has suffered
• The type of fixation used
• How quickly your cat starts to use its leg effectively
• The radiographic (x-ray) appearance of the fracture after a period of time has elapsed

Once your vet is happy the fracture has healed adequately they will allow you to let your cat go outside. Before your cat goes outside it may be necessary to remove some or all of the metal implants used in the fracture repair. Your vet will decide if this is necessary.

What is the long-term outlook for my cat?

Most fractures can be repaired very effectively and in many cases your cat will not be left with a permanent stiffness or lameness. However if the original fracture involved a joint, some lameness and/or stiffness may result at some stage after the fracture has been repaired.