Malleolus: fracture in Cats (Felis) | Vetlexicon
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Malleolus: fracture

ISSN 2398-2950


Introduction

  • Affects articular surface and disrupt origin of collateral ligaments.
  • Cause: trauma.
  • Signs: valgus (if medial malleolar fracture); varus (if lateral malleolar fracture).
  • Treatment: open reduction and fixation; if open, may need to be treated as a 'shearing injury'   Malleolus: shearing injury.
  • Prognosis: fair - osteoarthritis a common sequel.

Presenting signs

  • Acute onset, non-weight bearing, hindlimb lameness with valgus or varus of hock.

Pathogenesis

Etiology

  • Trauma.

Pathophysiology

  • Traumatic fracture of malleolus of hock.
  • Medial and lateral malleolar fractures permit valgus and varus deformity of hock respectively.

Diagnosis

Presenting problems

  • Hindlimb lameness.

Client history

  • Acute onset, non-weight bearing hindlimb lameness following trauma, with varus or valgus deformity of hock joint.

Clinical signs

  • Pain.
  • Swelling.
  • Crepitus.
  • Instability deformity.

Diagnostic investigation

Radiography - medial and lateral stressed views

  • Fracture site(s) evident.
Talocrural subluxation may not be evident on neutral studies, stressed views may be required.

Careful manipulation of talocrural joint

  •  Can disclose involvement of long and short collateral ligament components, in extension and flexion respectively.

Definitive diagnostic features

  • Radiographic findings.

Treatment

Initial symptomatic treatment

Standard treatment

  • Very small fragments - excize fragments and repair soft tissue/reattach soft tissues to bone.
  • Small origin avulsions - capture by wire cerclage anchored in a malleolar tunnel.
    K wires may be used in association with cerclage wire.
  • Lateral malleolar fractures involving a significant length of distal fibula - transverse screw fixation to distal tibia.

Prevention

Outcomes

Prognosis

  • Fair - joint involvement always carries risk of subsequent clinically significant osteoarthritis.

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Roch S P, Störk C K, Gemmill T J et al (2009) Treatment of fractures of the tibial and/or fibular malleoli in 30 cats. Vet Rec 165 (6), 165-170 PubMed.