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AbstractSimple femoral neck fractures in dogs and cats are rare in clinic. The cause of the fracture is that the pelvis or femur is directly or indirectly subjected to external force, and it often occurs secondarily to osteoporosis caused by dysplasia of the hip joint. This paper described the diagnosis and treatment of a blue cat with femora neck fracture.
Key wordsFemoral neck fracture; Diagnosis; Treatment; Postoperative care
Received: August 20, 2018Accepted: November 10, 2018
Supported by Topnotch Academic Programs Project of Jiangsu Higher Education Institutions (PPZY2015C230).
Shasha ZHAO (1980-), female, P. R. China, experimentalist, devoted to research about basic veterinary science.
*Corresponding author. Email: 641042228@qq.com.
Simple femoral neck fractures in dogs and cats are rare in clinic. The cause of the fracture is that the pelvis or femur is directly or indirectly subjected to external force, and it often occurs secondarily to osteoporosis caused by dysplasia of the hip joint. This paper described the diagnosis and treatment of a blue cat with femora neck fracture.
Introduction of the Case
Blue cat, male, 14 months old, had a weight of 7 kg. Complain: A week ago, he fell from the cabinet, the right hind limb limps then, and it is unwilling to walk; and when touching the right hind limb, it screams.
Clinical Examination
The dog had a body temperature at 38.9 ℃, and the heart rate was 127 times. The initial body surface examination showed no trauma, and the cats right hind limb was suspended. The palpation of the animal at the hip joint resulted in painful screaming and resistance. The "drawer check" showed bone friction sound［1-2］.
Blood Routine Examination and Biochemical Examination
Blood routine examination and biochemical examination were carried out on the blue cat. The results are shown in Tables 1 and Table 2. No obvious abnormalities were observed. The animal was subjected to preoperative blood routine examination, which was mainly to check red blood cells and white blood cell platelets to determine whether the animal suffered from anemia, dehydration or inflammation, so as to ensure the accuracy of intraoperative and postoperative medication. The biochemical examination was carried out to check the liver and kidney function of the animal, to avoid anesthesia metabolism abnormalities caused by hepatic and renal dysfunction as far as possible［3-4］. Table 1Blood routine examination
Test Test result Reference range
Red blood cell (RBC)11.23 M/μl6.54-12.20
Hematocrit (HCT)46.5%30.3-52.3
Hemoglobin (HGB)15.6 g/dl9.8-16.2
Mean corpuscular volume (MCV)41.4 fl35.9-53.1
Mean corpuscular hemoglobin (MCH)13.9 pg11.8-17.3
Mean corpuscular hemoglobinconcentration (MCHC)33.5 g/dl28.1-35.8
Red cell distribution width (RDW)25.0%15.0-27.0
Reticulocyte (RETIC)43.8 K/μl3.0-50.0
White blood cell (WBC)4.50 K/ml2.87-17.02
Neutrophil (NEU)2.46 K/ml1.48-10.29
Lymphocyte (LYM)1.53 K/μl0.92-6.88
Monocyte (MONO)0.16 K/μl0.05-0.67
Eosinophil (EOS)0.32 K/μl0.17-1.57
Basophil (BASO)0.03 K/μl0.01-0.26
Platelet (PLT)306.00 K/ml151-600
Table 2Biochemical examination
Test Test result Reference range
Blood urea nitrogen (BUN)26 mg/dl16-36
Creatinine (CREA)1.2 mg/dl0.8-2.4
Phosphonium (PHOS)7.0 mg/dl3.1-7.5
Calcium (CA)11.0 mg/dl7.8-11.3
Alanine transaminase (ALT)94 U/L12-130
Alkaline phosphatase (ALKP)60 U/L14-111
Xray Inspection
The results are shown in Fig. 1 and Fig. 2. It was diagnosed as the right femoral neck fracture, and it was recommended to perform femoral head removal surgery.
Operation Method
Preoperative preparation and anesthesia
Before the operation, 0.15 ml of Jinganshu was intravenously administrated for sedation; 0.5 ml of meloxicam was subcutaneously injected to relief pain; and 1 unit of hemocoagulase Bothrops atrox for injection was subcutaneously injected for hemostasis, followed by anesthesia induction with 2.5 ml propofol and inhalation anesthesia with isoflurane.
Fig. 1Ventrodorsal position
Fig. 2Left lateral position
Surgical procedure
Operative pathway
The dorsal operative pathway was adopted by gluteal myotenotomy［5］. The arcuate skin incision began from 1/3 of the dorsal rim behind the iliac bone, extended down to the greater trochanter and stopped at 1/3 of the thigh along the thighbone (Fig. 3).
The subcutaneous tissue, the gluteal fascia, the tensor fascia lata muscle were cut from the anterior border of the biceps femoris muscle. The biceps femoris muscle was pulled backward, and the tensor fasciae muscle was pulled forward, to find the gluteus suferficidlis muscle, of which the sacral attachment was cut at the distal end of the greater trochanter, to separate the gluteus suferficidlis muscle towards the proximal end (Fig. 4).
Fig. 3Location of incision
Fig. 4Cutting off the tendon attachment of gluteus suferficidlis muscle
The gluteus medius was found and separated, and its tendon attachment was cut near the greater trochanter (Fig. 5). The gluteus medius muscle was pulled to the proximal end, to expose the deep gluteal muscle.
Fig. 5Cutting off the tendon attachment of gluteus medius
The deep gluteal muscle was found and separated, and its tendon attachment was cut near the greater trochanter (Fig. 6). The gluteus was pulled towards the proximal end to expose the hip joint capsule. The joint capsule was cut between the acetabular rim and the femoral neck where the joint capsule was attached (Fig. 7).
Taking out the femoral head
The femoral head fractured in the acetabular fossa was picked up, and the round ligament was cut off. Since the femoral neck of the cat had broken from the base part, the femoral head with dislocation fracture was removed (Fig. 8).
Fig. 6Cutting off the tendon attachment of deep gluteal muscle
Fig. 7Cut apart the joint capsule
Fig. 8Cut joint capsule
Reduction of the fracture ends
The fracture surfaces were smoothed with a rongeur and a bone file, the joint capsule was rinsed with warm metronidazole, and bone wax was heated and applied on the bleeding part of the bone.
Closure
Intermittent Lembert suture was performed on the incision of the joint capsule with No. 3 absorbable sutures. The cut gluteal muscle was restored to the normal position, and sewed. The gluteal fascia and the tensor fasciae latae were sutured at the leading edge of the biceps femoris muscle, the subcutaneous tissue layer was sutured, and the skin was interruptedly sutured with No. 3 sutures finally. After the operation was completed, the anesthesia was stopped, and the animal was supplied with oxygen, and subjected to transfusion after awakening.
Postoperative Care
There was no need to bandage the affected limb. 24 h later, the patient undergone rehabilitation exercises including stretching, abduction and adduction twice every day to prevent the formation of restrictive fibrosis, so as to ensure the formation of a full range of pseudarthrosis; and continuous antiinflammatory infusion was performed for 5 days, and the wound was cleaned every day. Within five days, the wound healed well without exudate, and the cat could walk. After 7 days, the wound of the cat healed well, and it could be known from further consultation that the cat had good appetite, and can walk well. After removal of the sutures, the owner was informed to continue to assist the rehabilitation for one week when avoiding strenuous exercise including climbing and jumping. Two weeks later, the owner brought the animal home, and it could be known from latter telephone interview that the affected limb was normal, and the cat had good appetite and can walk well. References
［1］ HAO YZ. Clinical application of femoral head resection for dogs and cats［D］. Yangling: Northwest Agriculture & Forestry University, 2013. (in Chinese)
［2］ XU GX. Fractures and operation of dogs and cats［J］. Journal of Cynology, 2011 (1): 22-26. (in Chinese)
［3］ YUAN ZK, CHEN HW, DONG YN, et al. Dog femoral head and femoral neck resection［J］. Chinese Journal of Veterinary Medicine, 2006, 42(5): 41-42. (in Chinese)
［4］ XIA N, JIANG XM, ZHANG ZW. Rehabilitation experience after dog femoral head and femoral neck resection［J］. Progress In Veterinary Medicine, 2008, 29(11): 115-117. (in Chinese)
［5］ DONG HJ, PENG GN. Atlas of small animal orthopedic surgery［M］. Beijing: China Agriculture Press, 2011. (in Chinese)
Editor: Yingzhi GUANGProofreader: Xinxiu ZHU
Agricultural Biotechnology2019
(Continued from page 89)
［14］ WANG C, HAO ZD. Effects of maturation mediums, temperature and culture durations on in vitro maturation of goats oocytes［J］. Acta Agriculturae BorealiOccidentalis Sinica, 2007, 16 (2): 7-9.
［15］ BAI JH. Advances in JIVET technique in prepubertal sheep and cattle［D］. Beijing: China Agricultural University, 2008.
［16］ WANG LQ, HE ZL, LIN JP, et al. Study on the induced development effect of Suffolk lamb follicular［J］. Journal of China Agricultural University, 2015, 20 (4): 141-146.
［17］ GUO H, WAN PC, SHI WY, et al. Study on in vitro production (IVP) of embryo utilizating superovulated oocytes from different breed lambs［J］. Animal Husbandry & Veterinary Medicine, 2012, 44 (10): 20-24.
［18］ WU WW, XU XM, ZHANG TH, et al. Study on the factors affecting Xinjiang fine wool lamb JIVET［J］. China Animal Husbandry & Veterinary Medicine, 2011, 38 (4): 144-147.
Key wordsFemoral neck fracture; Diagnosis; Treatment; Postoperative care
Received: August 20, 2018Accepted: November 10, 2018
Supported by Topnotch Academic Programs Project of Jiangsu Higher Education Institutions (PPZY2015C230).
Shasha ZHAO (1980-), female, P. R. China, experimentalist, devoted to research about basic veterinary science.
*Corresponding author. Email: 641042228@qq.com.
Simple femoral neck fractures in dogs and cats are rare in clinic. The cause of the fracture is that the pelvis or femur is directly or indirectly subjected to external force, and it often occurs secondarily to osteoporosis caused by dysplasia of the hip joint. This paper described the diagnosis and treatment of a blue cat with femora neck fracture.
Introduction of the Case
Blue cat, male, 14 months old, had a weight of 7 kg. Complain: A week ago, he fell from the cabinet, the right hind limb limps then, and it is unwilling to walk; and when touching the right hind limb, it screams.
Clinical Examination
The dog had a body temperature at 38.9 ℃, and the heart rate was 127 times. The initial body surface examination showed no trauma, and the cats right hind limb was suspended. The palpation of the animal at the hip joint resulted in painful screaming and resistance. The "drawer check" showed bone friction sound［1-2］.
Blood Routine Examination and Biochemical Examination
Blood routine examination and biochemical examination were carried out on the blue cat. The results are shown in Tables 1 and Table 2. No obvious abnormalities were observed. The animal was subjected to preoperative blood routine examination, which was mainly to check red blood cells and white blood cell platelets to determine whether the animal suffered from anemia, dehydration or inflammation, so as to ensure the accuracy of intraoperative and postoperative medication. The biochemical examination was carried out to check the liver and kidney function of the animal, to avoid anesthesia metabolism abnormalities caused by hepatic and renal dysfunction as far as possible［3-4］. Table 1Blood routine examination
Test Test result Reference range
Red blood cell (RBC)11.23 M/μl6.54-12.20
Hematocrit (HCT)46.5%30.3-52.3
Hemoglobin (HGB)15.6 g/dl9.8-16.2
Mean corpuscular volume (MCV)41.4 fl35.9-53.1
Mean corpuscular hemoglobin (MCH)13.9 pg11.8-17.3
Mean corpuscular hemoglobinconcentration (MCHC)33.5 g/dl28.1-35.8
Red cell distribution width (RDW)25.0%15.0-27.0
Reticulocyte (RETIC)43.8 K/μl3.0-50.0
White blood cell (WBC)4.50 K/ml2.87-17.02
Neutrophil (NEU)2.46 K/ml1.48-10.29
Lymphocyte (LYM)1.53 K/μl0.92-6.88
Monocyte (MONO)0.16 K/μl0.05-0.67
Eosinophil (EOS)0.32 K/μl0.17-1.57
Basophil (BASO)0.03 K/μl0.01-0.26
Platelet (PLT)306.00 K/ml151-600
Table 2Biochemical examination
Test Test result Reference range
Blood urea nitrogen (BUN)26 mg/dl16-36
Creatinine (CREA)1.2 mg/dl0.8-2.4
Phosphonium (PHOS)7.0 mg/dl3.1-7.5
Calcium (CA)11.0 mg/dl7.8-11.3
Alanine transaminase (ALT)94 U/L12-130
Alkaline phosphatase (ALKP)60 U/L14-111
Xray Inspection
The results are shown in Fig. 1 and Fig. 2. It was diagnosed as the right femoral neck fracture, and it was recommended to perform femoral head removal surgery.
Operation Method
Preoperative preparation and anesthesia
Before the operation, 0.15 ml of Jinganshu was intravenously administrated for sedation; 0.5 ml of meloxicam was subcutaneously injected to relief pain; and 1 unit of hemocoagulase Bothrops atrox for injection was subcutaneously injected for hemostasis, followed by anesthesia induction with 2.5 ml propofol and inhalation anesthesia with isoflurane.
Fig. 1Ventrodorsal position
Fig. 2Left lateral position
Surgical procedure
Operative pathway
The dorsal operative pathway was adopted by gluteal myotenotomy［5］. The arcuate skin incision began from 1/3 of the dorsal rim behind the iliac bone, extended down to the greater trochanter and stopped at 1/3 of the thigh along the thighbone (Fig. 3).
The subcutaneous tissue, the gluteal fascia, the tensor fascia lata muscle were cut from the anterior border of the biceps femoris muscle. The biceps femoris muscle was pulled backward, and the tensor fasciae muscle was pulled forward, to find the gluteus suferficidlis muscle, of which the sacral attachment was cut at the distal end of the greater trochanter, to separate the gluteus suferficidlis muscle towards the proximal end (Fig. 4).
Fig. 3Location of incision
Fig. 4Cutting off the tendon attachment of gluteus suferficidlis muscle
The gluteus medius was found and separated, and its tendon attachment was cut near the greater trochanter (Fig. 5). The gluteus medius muscle was pulled to the proximal end, to expose the deep gluteal muscle.
Fig. 5Cutting off the tendon attachment of gluteus medius
The deep gluteal muscle was found and separated, and its tendon attachment was cut near the greater trochanter (Fig. 6). The gluteus was pulled towards the proximal end to expose the hip joint capsule. The joint capsule was cut between the acetabular rim and the femoral neck where the joint capsule was attached (Fig. 7).
Taking out the femoral head
The femoral head fractured in the acetabular fossa was picked up, and the round ligament was cut off. Since the femoral neck of the cat had broken from the base part, the femoral head with dislocation fracture was removed (Fig. 8).
Fig. 6Cutting off the tendon attachment of deep gluteal muscle
Fig. 7Cut apart the joint capsule
Fig. 8Cut joint capsule
Reduction of the fracture ends
The fracture surfaces were smoothed with a rongeur and a bone file, the joint capsule was rinsed with warm metronidazole, and bone wax was heated and applied on the bleeding part of the bone.
Closure
Intermittent Lembert suture was performed on the incision of the joint capsule with No. 3 absorbable sutures. The cut gluteal muscle was restored to the normal position, and sewed. The gluteal fascia and the tensor fasciae latae were sutured at the leading edge of the biceps femoris muscle, the subcutaneous tissue layer was sutured, and the skin was interruptedly sutured with No. 3 sutures finally. After the operation was completed, the anesthesia was stopped, and the animal was supplied with oxygen, and subjected to transfusion after awakening.
Postoperative Care
There was no need to bandage the affected limb. 24 h later, the patient undergone rehabilitation exercises including stretching, abduction and adduction twice every day to prevent the formation of restrictive fibrosis, so as to ensure the formation of a full range of pseudarthrosis; and continuous antiinflammatory infusion was performed for 5 days, and the wound was cleaned every day. Within five days, the wound healed well without exudate, and the cat could walk. After 7 days, the wound of the cat healed well, and it could be known from further consultation that the cat had good appetite, and can walk well. After removal of the sutures, the owner was informed to continue to assist the rehabilitation for one week when avoiding strenuous exercise including climbing and jumping. Two weeks later, the owner brought the animal home, and it could be known from latter telephone interview that the affected limb was normal, and the cat had good appetite and can walk well. References
［1］ HAO YZ. Clinical application of femoral head resection for dogs and cats［D］. Yangling: Northwest Agriculture & Forestry University, 2013. (in Chinese)
［2］ XU GX. Fractures and operation of dogs and cats［J］. Journal of Cynology, 2011 (1): 22-26. (in Chinese)
［3］ YUAN ZK, CHEN HW, DONG YN, et al. Dog femoral head and femoral neck resection［J］. Chinese Journal of Veterinary Medicine, 2006, 42(5): 41-42. (in Chinese)
［4］ XIA N, JIANG XM, ZHANG ZW. Rehabilitation experience after dog femoral head and femoral neck resection［J］. Progress In Veterinary Medicine, 2008, 29(11): 115-117. (in Chinese)
［5］ DONG HJ, PENG GN. Atlas of small animal orthopedic surgery［M］. Beijing: China Agriculture Press, 2011. (in Chinese)
Editor: Yingzhi GUANGProofreader: Xinxiu ZHU
Agricultural Biotechnology2019
(Continued from page 89)
［14］ WANG C, HAO ZD. Effects of maturation mediums, temperature and culture durations on in vitro maturation of goats oocytes［J］. Acta Agriculturae BorealiOccidentalis Sinica, 2007, 16 (2): 7-9.
［15］ BAI JH. Advances in JIVET technique in prepubertal sheep and cattle［D］. Beijing: China Agricultural University, 2008.
［16］ WANG LQ, HE ZL, LIN JP, et al. Study on the induced development effect of Suffolk lamb follicular［J］. Journal of China Agricultural University, 2015, 20 (4): 141-146.
［17］ GUO H, WAN PC, SHI WY, et al. Study on in vitro production (IVP) of embryo utilizating superovulated oocytes from different breed lambs［J］. Animal Husbandry & Veterinary Medicine, 2012, 44 (10): 20-24.
［18］ WU WW, XU XM, ZHANG TH, et al. Study on the factors affecting Xinjiang fine wool lamb JIVET［J］. China Animal Husbandry & Veterinary Medicine, 2011, 38 (4): 144-147.