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Tarsometatarsal stabilization after metatarsal bone amputation for treatment of an aneurysmal bone cyst in a cat

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  • 1 From Diagnostica Piccoli Animali, Clinica Veterinaria Pedrani, 36030 Zugliano, Italy (Nicetto, Coltro); and Clinica Veterinaria Nervianese, 20014 Nerviano, Milan, Italy (Massari).

Abstract

CASE DESCRIPTION

A 5-year-old 4.0-kg (8.8-lb) castrated male domestic shorthair cat was referred because of grade 4/5 left hind limb lameness and swelling in the region of the second metatarsal bone of that limb.

CLINICAL FINDINGS

Computed tomography revealed an expansile osteolytic lesion of the second metatarsal bone associated with a periosteal reaction on the third metatarsal bone. There was no evidence of metastases.

TREATMENT AND OUTCOME

Amputation of the second and third metatarsal bones was performed but resulted in medial instability of the remaining metatarsal bones. The instability was treated by placing a loop of 2-0 monofilament, nonabsorbable suture from a screw placed in the distal row of the tarsal bones to a tunnel in the proximal metaphysis of the fourth metatarsal bone. Clinical reevaluation of the cat 7, 15, 30, 60, 90, and 210 days after surgery and radiographic reevaluation 90 and 210 days after surgery showed complete recovery of the cat. The implants were removed at the time of the 7-month reevaluation. Clinical evaluation 18 months after implant removal showed the treated joint to be stable.

CLINICAL RELEVANCE

The surgical stabilization technique described here provided medial stability of the tarsometatarsal joint after amputation of the second and third meta-tarsal bones. This method may be an alternative to arthrodesis while maintaining articular function in cats. (J Am Vet Med Assoc 2021;259:294–299)

Abstract

CASE DESCRIPTION

A 5-year-old 4.0-kg (8.8-lb) castrated male domestic shorthair cat was referred because of grade 4/5 left hind limb lameness and swelling in the region of the second metatarsal bone of that limb.

CLINICAL FINDINGS

Computed tomography revealed an expansile osteolytic lesion of the second metatarsal bone associated with a periosteal reaction on the third metatarsal bone. There was no evidence of metastases.

TREATMENT AND OUTCOME

Amputation of the second and third metatarsal bones was performed but resulted in medial instability of the remaining metatarsal bones. The instability was treated by placing a loop of 2-0 monofilament, nonabsorbable suture from a screw placed in the distal row of the tarsal bones to a tunnel in the proximal metaphysis of the fourth metatarsal bone. Clinical reevaluation of the cat 7, 15, 30, 60, 90, and 210 days after surgery and radiographic reevaluation 90 and 210 days after surgery showed complete recovery of the cat. The implants were removed at the time of the 7-month reevaluation. Clinical evaluation 18 months after implant removal showed the treated joint to be stable.

CLINICAL RELEVANCE

The surgical stabilization technique described here provided medial stability of the tarsometatarsal joint after amputation of the second and third meta-tarsal bones. This method may be an alternative to arthrodesis while maintaining articular function in cats. (J Am Vet Med Assoc 2021;259:294–299)

Contributor Notes

Address correspondence to Dr. Nicetto (tommaso.nicetto@gmail.com).