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Fracture of the Carpus and Tarsus in Cats

By: Dr. David Diamond

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Isolated fractures of the bones of the carpus (wrist) or tarsus (ankle) are not frequently encountered in veterinary medicine. More commonly these fractures are found in conjunction with other fractures or shearing injuries (where the tissues are ground off on a hard surface) of the legs.

These fractures are usually the result of trauma and often cause a severe lameness of the affected limb. The lameness may improve with time and rest such that it becomes obvious only with exercise.

The potential long-term effects of these fractures range from none to severe, debilitating arthritis in the joint.

Diagnosis

Diagnostic tests are necessary to determine the presence of the fracture and assess its location and severity concerning how many fragments are present and association of the fracture with the joint and/or ligaments. In addition to obtaining a complete medical history and performing a thorough physical examination, tests that your veterinarian may wish to perform include:

  • Chest radiographs to rule out injury to the lungs caused by the trauma

  • Complete orthopedic examination to evaluate your pet for the presence of other fractures or joint injuries

  • Radiographs of the affected joint to determine the severity of the fracture and help determine the appropriate repair

  • Laboratory tests are not required to make the diagnosis; however, some tests may be done to assess your pet's risk for anesthesia if surgery is being considered. Blood work may also be necessary if there is concurrent trauma to internal structures or if there is evidence of hemorrhage.

    Treatment

    There are many bones that make up both the carpus and tarsus. Depending on the nature of the specific fracture, management may be different for each case. Treatment of these fractures may include the following:

  • Emergency treatment. If your dog has suffered trauma, emergency treatment may be necessary for concurrent injuries. This may include fluid administration, oxygen support and other supportive treatments. Repair and even assessment of the fractures will be delayed until your cat is stable. Injectable analgesics (pain medications) may be given to your cat while he is being treated in the hospital, and they may be continued orally once he is discharged to your care.

  • Immobilization of the affected joint. Initially, the affected joint will be immobilized in a splint or a cast until definitive repair can be done. This will help prevent further damage to the bones or associated soft tissues. Depending on the nature of the fracture, a splint or cast may be left on until the fracture heals or surgery is performed.

  • Surgery. These fractures often require surgery. An incision is made to visualize the fracture and then the fragments of bone are repositioned and stabilized using screws, plates, pins and/or wires.

    Home Care and Prevention

    If immobilization of the joint in a split or a cast is the sole form of treatment for these fractures, you will need to restrict your cat's activity for several weeks. The toes will be visible at the bottom of the splint or cast and you will need to touch and squeeze them daily to make sure they are warm, non-painful and not excessively swollen. The splint will need to be redressed or changed approximately every two weeks (or sooner if it becomes wet or soiled, or if your cat develops any rub sores at the top or bottom of the splint). Contact your veterinarian if you have any questions or concerns regarding your cat's splint or cast.

    Regardless of whether the affected leg is placed in a cast or repaired by surgery, your cat needs to be kept restricted from activity for several weeks. Depending on the type of surgery, a skin incision may be visible. Monitor the incision for swelling, redness or discharge. Stitches or staples will need to be removed in 10-14 days after the surgery.

    A re-check appointment with your veterinarian will usually be scheduled for several weeks after your cat was released from the hospital. Your veterinarian will perform radiographs to evaluate how the bone is healing and will monitor your cat's progress before allowing you to increase his activity level.

    Many traumatic events are true accidents and thus unavoidable; however, you can avoid the risk of having your pet sustain motor vehicle trauma by keeping cats at home where it is safe.

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