References
Decision making in feline pelvic fracture repair
Abstract
Pelvic fractures are common in cats and are usually traumatic in origin. The box-like construction of the pelvis means that if a fracture is present in one region, other fractures are likely present elsewhere in the pelvis. Surgery is indicated for fractures of the weight-bearing axis (sacroiliac fracture or luxation, iliac body fractures, acetabular fractures), those resulting in pelvic narrowing, and those which result in neurological dysfunction or severe pain. Fractures of the pelvic floor and ischia are often treated conservatively. Challenges faced during feline pelvic fracture repair include difficulty securing implants in the thin bone of the iliac wing, the limited bone stock for implant placement, the need to avoid damage to the coxofemoral joint and the proximity of the lumbosacral trunk and sciatic nerves to the fracture site. A thorough understanding of the anatomy of the pelvis and careful pre-operative planning maximises the chance of a successful outcome following surgery.
Pelvic fractures are common injuries in cats, most frequently affecting young males following trauma, such as road traffic accidents (Bookbinder and Flanders, 1992). A wide variety of fracture patterns are seen in various combinations (Figure 1).
A thorough history and clinical examination are essential starting points in fracture assessment. Clinical examination should start with an assessment of the cardiovascular and neurological systems to identify any concomitant or life-threatening injuries that may have occurred (Box 1).
Assessment of the pelvis in the conscious, traumatised cat can be difficult. Palpation of the iliac crests and ischiatic tuberosities to determine whether they are aligned symmetrically as a rectangle allows assessment of the integrity of the pelvis with minimal patient discomfort. Similarly, the greater trochanter, ischiatic tuberosity and iliac crest should form a triangle on palpation and be symmetrical on each side. Finding crepitus or discomfort on manipulation of the hips is an indication of a probable injury of the coxofemoral joint.
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