Ziya YURTAL, Cafer Tayer İŞLER, Muhammed Enes ALTUĞ, Ömer KIRGIZ, İbrahim ALAKUŞ, Halil ALAKUŞ, Mehmet Zeki Yılmaz DEVECİ, Eren CEYLAN

Kedi ve Köpeklerde Metakarpal ve Metatarsal Kırıkların Tedavisi (32 Vakada Retrospektif Değerlendirme)

Küçük hayvan hekimliğinde kedi ve köpeklerde metakarpal (MK) ve metatarsal (MT) kırıklarla sık karşılaşılmaktadır. Tedavide konservatif ve cerrahi yöntemler tanımlanmıştır. Bu çalışmada MK/MT kırık belirlenen 32 vakanın (22 kedi, 10 köpek) tanı, tedavi ve prognoz süreçlerinin değerlendirilmesi amaçlandı. Hastaların demografik ve diyagnostik bilgileri, yapılan preoperatif ve perioperatif işlemler, uygulanan tedaviler, postoperatif işlemler ve prognoz süreci çalışma kapsamındadır. MK/MT toplam 97 kırık kemikte en çok diyafizer 1/3 (43 kemik) ve distal 1/3 (48 kemik) lokalizasyonlarda kırıklar belirlendi. En çok görülen kırık şekilleri transversal (65) ve oblik (27) olarak belirlendi. Toplam 39 ekstremitenin %25.64’ünde bir kemik, %20.51’inde iki kemik, %33.33’ünde üç kemik, %20.51’inde dört kemiğin kırıldığı belirlendi. Tedavide MK/MT kırığı olan 39 ekstremiteden 11 ekstremitede eksternal koaptasyon, 23 ekstremitede açık cerrahi redüksiyon ile osteosentez, 4 ekstremitede kafes istirahati ve 1 ekstremitede amputasyon uygulandı. Kedi ve köpeklerin toplamında cerrahi osteosentez uygulanan 23 ekstremiteden 19’unda prognoz çok iyi, 3’ünde iyi olduğu ve bir vakada postoperatif ölüm şekillendiği belirlendi. Eksternal koaptasyon uygulanan 11 ekstremitenin 6’sında çok iyi, 5’inde iyi; kafes istirahati uygulanan 4 ekstremiteden 2’sinde çok iyi, birinde iyi ve birinde orta olarak belirlendi. Bu çalışmayla kedi ve köpeklerin metakarpal ve metatarsal kırıklarının tedavi süreci, tanı ve klinik sonuçlar ile birlikte değerlendirilerek özgün veriler sunuldu. Kapalı, disloke olmamış, MK ve MT kemiklerin yük binmeyen veya tek kemiğinde olan kırıklarda konservatif tedavinin başarılı olabildiği; ancak, iki veya daha fazla kemiğin etkilendiği, disloke olmuş ve yük verilen MK/MT kırıklarda cerrahi osteosentez uygulamasının elzem olduğu kanısına varıldı.

Anahtar Kelimeler:

Ekstremite, intramedüller pin, ortopedi, osteosentez, veteriner

Treatment of Metacarpal and Metatarsal Fractures in Cats and Dogs (Retrospective Evaluation of 32 Cases)

Metacarpal (MC) and metatarsal (MT) fractures are common in small animal medicine in cats and dogs. Conservative and surgical methods have been described for treatment. This study was aimed to evaluate the diagnosis, treatment, and prognosis of 32 cases (22 cats, 10 dogs) with MC/MT fractures. The demographic and diagnostic information of the patients, procedures (before, during and after the operation), treatments applied, and prognosis findings are within the scope of the study. Ninety-seven bones with MC/MT fractures were most at diaphyseal 1/3 (43 bones) and distal 1/3 (48 bones) localizations. The most common fracture types were transverse (65) and oblique (27). The fractures of 39 extremities were single bone fractures in 25.64%, two bones in 20.51%, three bones in 33.33%, and four bones in 20.51%. Treatment methods were external coaptation in 11 extremities, surgical osteosynthesis in 23 extremities, cage rest in four extremities, and amputation in one extremity. It was determined that the prognosis was excellent in 19 of 23 extremities that underwent surgical osteosynthesis, good in three, and postoperative death occurred in one case. Out of 11 extremities with external coaptation, six were excellent, and five were good. It was determined that two of the four extremities treated with cage rest were very good, one was good, and one was moderate. This study has evaluated the treatment of metacarpal and metatarsal fractures in cats and dogs in terms of diagnostic and clinical results, and original data were presented. Conservative treatment is considered successful in fractures if closed, not dislocated, without weight-bearing bones on the metacarpal and metatarsal bones or if only one MC/MT bone is fractured. However, it was shown that surgical osteosynthesis is essential if the fractures are dislocated, and the two or more weight-bearing bones are affected.

Keywords:

Extremity, intramedullary pin, orthopedics, osteosynthesis, veterinary,

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Aker L, 1998: Evcil karnivorlarda metakarpus ve metatarsus kırıklarının sağaltım yöntemlerine ilişkin klinik değerlendirilmesi. Yüksek Lisans Tezi, Ankara Üniversitesi Sağlık Bilimleri Enstitüsü, Ankara.
Altuğ ME, Deveci MZY, İşler CT, Yurtal Z, Gönenci R, 2017: Mustafa Kemal Üniversitesi Veteriner Fakültesi Cerrahi Kliniği’ne getirilen ortopedi olgularının genel değerlendirilmesi: 564 olgu (2009-2014). Harran Üniv Vet Fak Derg, 6 (2), 158-162.
Baroncelli AB, Peirone B, Winter M, Reese D, Pozzi A, 2012: Retrospective comparison between minimally invasive plate osteosynthesis and open plating for tibial fractures in dogs. Vet Comp Orthop Traumatol, 25 (05), 410-417.
Candaş A, Sağlam M, 1990: Köpeklerde Metacarpus Ve Metatarsus Kiriklarinin Transartiküler İntramedüller Pin Uygulamalariyla Sagaltimi. Ankara Üniv Vet Fak Derg, 37 (1), 147-155.
De La Puerta B, Emmerson T, Moores A, Pead M, 2008: Epoxy putty external skeletal fixation for fractures of the four main metacarpal and metatarsal bones in cats and dogs. Vet Comp Orthop Traumatol, 21 (05), 451-458.
Degasperi B, Gradner G, Dupre G, 2007: Intramedullary pinning of metacarpal and metatarsal fractures in cats using a simple distraction technique. Vet Surg, 36 (4), 382-388.
Deveci MZY, Gönenci R, Canpolat İ, Kanat Ö, 2020: In vivo biocompatibility and fracture healing of hydroxyapatite-hexagonal boron nitridechitosan-collagen biocomposite coating in rats. Turk J Vet Anim Sci, 44 (1), 76-88.
Fitzpatrick N, Riordan JO, Smith TJ, Modlinska JH, Tucker R, Yeadon R, 2011: Combined intramedullary and external skeletal fixation of metatarsal and metacarpal fractures in 12 dogs and 19 cats. Vet Surg, 40 (8), 1015-1022.
Gomaa M, El Seddawy F, Behery A, Youssef W, 2016; Different modalities of metacarpal fracture fixation in mongrel dogs: An experimental study. Adv Anim Vet Sci, 4 (2), 107-113.
İşler CT, Altuğ ME, Deveci MZY, Gönenci R, Yurtal Z, 2015: Mustafa Kemal Üniversitesi Veteriner Fakültesi cerrahi kliniği’ne getirilen olguların değerlendirilmesi, 1293 olgu (2009-2013). FÜ Sağ Bil Vet Derg, 29 (2), 97-102
Kapatkin A, Howe-Smith R, Shofer F, 2000: Conservative versus surgical treatment of metacarpal and metatarsal fractures in dogs. Vet Comp Orthop Traumatol, 13 (03), 123-127.
Kornmayer M, Failing K, Matis U, 2014: Long-term prognosis of metacarpal and metatarsal fractures in dogs. Vet Comp Orthop Traumatol, 27 (01), 45-53.
Kornmayer M, Matis U. 2017: Dowel pinning for metacarpal and metatarsal fractures in dogs. Tierarztl Prax Ausg, 45 (3), 154-162.
Libardoni RDN, Costa DD, Menezes FB, Cavalli LG, Pedrotti LF, Kohlrausch PR, Minto BW, Silva, MAM, 2018: Classification, fixation techniques, complications and outcomes of femur fractures in dogs and cats: 61 cases (2015-2016). Cienc Rural, 48 (6), e20170028.
Minar M, Hwang Y, Park M, Kim S, Oh C, Choi S, Kim G, 2013: Retrospective study on fractures in dogs. J. Biomed. Res, 14 (3), 140-144.
Muir P, Norris J, 1997: Metacarpal and metatarsal fractures in dogs. J Small Anim Pract, 38 (8), 344-348.
Okumura M, Watanabe K, Kadosawa T, Fujinaga T, 2000: Surgical salvage from comminuted metatarsal fracture using a weight‐bearing pin‐putty apparatus in a dog. Aust Vet J, 78 (2), 95-98.
Pozzi A, Hudson CC, Gauthier CM, Lewis DD, 2013: Retrospective comparison of minimally invasive plate osteosynthesis and open reduction and internal fixation of radius‐ulna fractures in dogs. Vet Surg, 42 (1), 19-27.
Seibert R, Lewis D, Coomer A, Sereda C, Royals S, Leasure C, 2011: Stabilisation of metacarpal or metatarsal fractures in three dogs, using circular external skeletal fixation. N Z Vet J, 59 (2), 96-103.
Wernham BG, Roush JK, 2010: Metacarpal and metatarsal fractures in dogs. Compend Contin Educ Vet, 29, E1-7.
Zahn K, Kornmayer M, Matis U, 2007: ‘Dowel’pinning for feline metacarpal and metatarsal fractures. Vet Comp Orthop Traumatol, 20 (04), 256-263.