Use of combined transarticular pinning and external skeletal fixation for the reduction and stabilization of multiple metatarsophalangeal luxations in a cat

CASE SUMMARY: A 1-year-old spayed female domestic shorthair cat presented for evaluation of a non-weight bearing right pelvic limb lameness after falling from a 4 m height. On orthopedic examination there was substantial swelling and pain on manipulation of the right pes. Radiographs were obtained under sedation, and these revealed dorsoproximal luxations of the third, fourth and fifth metatarsophalangeal joints, and lateral rotation of the second digit. Closed manual reduction under sedation was unsuccessful and open reduction under general anesthesia was therefore performed. Combined transarticular pinning and external skeletal fixation were performed to maintain reduction of the third and fourth digits. Marked postoperative swelling of the distal pes and internal rotation of the third and fourth digits were noted within 24 h of surgery. Three weeks postoperatively, the cat had a persistent weight bearing right pelvic limb lameness and minor pin tract inflammation. All implants were removed and the limb was splinted for 1 week. Internal rotation and pin tract inflammation had resolved at the time of splint removal, and the lameness resolved within 6 weeks of surgery. The cat was not lame, but radiographs revealed mild-to-moderate degenerative osteoarthrosis when the cat was evaluated 6 months after surgery. RELEVANCE AND NOVEL INFORMATION: There are limited reports describing metatarsophalangeal luxations in cats. Although several surgical techniques have been advocated, specific outcomes in clinical cases have not been reported. This report describes the clinical application and outcome of combined transarticular pinning and external skeletal fixation for the management of multiple metatarsophalangeal luxations in a cat.