Comparison of post-operative outcomes after open or closed surgical techniques to stabilize metacarpal and metatarsal fractures in dogs and cats

Authors: 
Gabriel Carbonell Rosselló, Jasmin Carmel, Matthew Pead, Victor Vidal Lacosta, Pilar Lafuente
BMC Vet Res. 2022 Aug 4;18(1):300. doi: 10.1186/s12917-022-03404-3.

Background: Treatment options for metacarpal/metatarsal fractures include conservative and surgical management. The aim of this study is to determine whether there is any significant difference in healing and complication rates, between open and closed treatment. Medical records of dogs and cats with metacarpal/metatarsal fractures with complete follow-up were retrospectively reviewed. Patients were allocated in two groups: open or closed stabilization. Minor and major complications were recorded and compared. Fracture healing was classified as good, delayed and non-union, and it was statistically compared.

Results: Sixty-three patients (35 dogs and 28 cats) were included. Thirty-one were treated with an open approach and 32 by a closed stabilization. Regarding fracture healing a significantly higher proportion of delayed healing/non-union was found in the closed group (12/32 vs 2/31). Regarding postoperative complications, a significantly higher number of animals in the open group did not develop any complications (12/31 vs 3/32). A significantly higher proportion of minor complications were reported in the closed group (27/32 vs 12/31). However, a higher number of major complications was reported in the open group (7/31 vs 2/32) although this was not statistically significant. Fracture malalignment was significantly more prevalent in patients undergoing closed stabilization (11/32 vs 2/31).

Conclusion: According to the results, better healing, fracture alignment and a lower complication rate are found when fractures are stabilised with an open technique. However, other factors such as configuration of the fracture, soft tissue involvement, patient´s character and client´s situation would also need to be taken into account in the decision of stabilization technique.