Authors of section

Author

Tomas Guerrero

Executive Editor

Amy Kapatkin

General Editor

Noel Moens

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Combined treatment options

1. Principles

B3 fractures are fixed with a combination of the methods used to treat A1, B1, B2 and Salter-Harris type I fractures.

In this type of fracture, the femoral neck fracture (B1, B2, Salter-Harris type I) is treated first, followed by reconstruction of the greater trochanter.

2. Patient positioning and approach

This procedure is performed with the patient in lateral recumbency.

One of the following approaches are used:

combined treatment options

3. Surgical technique

Combined treatment options

For a detailed description of the surgical techniques please see:

combined treatment options

  • Parallel K-wires fixation method for Salter-Harris type I fracture in immature animals and Lag screw and K-wire fixation for B2 fractures (neck fractures or more mature animals with minimal growth potential remaining).

combined treatment options

4. Aftercare

Activity restriction is indicated until radiographs indicate bone healing of the fracture.

Phase 1: 1-3 day after surgery

Aim is to reduce the edema, inflammation and pain.

Integrative medical therapies, anti-inflammatory and analgesic medications.

Note: Nonsteroidal anti-inflammatory medications can be toxic in the cat and should only be used as labeled for the cat.

Phase 2: 4-10 days after surgery

Aim is to resolve the hematoma, edema and control pain, and prevent muscle contracture.

Anti-inflammatory (see nonsteroidal warning) and analgesic medications may still be needed. Rehabilitation and integrative medical therapies can be used.

Special attention should be given to patients less than 1 year of age with a femoral fracture. Rehabilitation is strongly recommended to help prevent quadriceps muscle contracture.

If the cat is not starting to use the limb within few days after surgery, a careful evaluation is recommended.

10-14 days after surgery the sutures are removed.

Radiographic assessment is performed every 4-8 weeks until bone healing is confirmed.

Implant removal

Implants may cause discomfort of the adjacent soft tissue. If this occurs, implants can be removed after bone healing is observed. In case of infection, implants must be removed after healing.

If there is no implant failure or infection, there is no need for implant removal.