The metacarpal bones are the bones on the forelimb of the cat that connect the “wrist” (the carpus) to the toes (the phalanges). There are five metacarpal bones on each limb, with the major weight bearing bones being the central metacarpal bones three and four.
A fracture of the bone is when the normal architecture of the bone is disrupted. This can occur due to a variety of reasons (trauma, disease, etc) and as such can present in a number of ways. Most commonly there will be complete fractures where a clean break is present or comminuted fractures where there are multiple fragments of bone present.
The most common signs that accompany a metacarpal fracture are sudden onset non-weight bearing in one of the limbs, often accompanied by a painful swelling in the distal limb.
In order for the veterinary surgeon to get a definitive diagnosis and formulate a proper treatment plan, x rays under sedation will often be necessary to see the extent of the fractures.
There are multiple treatment options available for the treatment of fractures of the metacarpal bones. Management of fractures can be non-surgical or surgical.
Non-surgical treatment can be used when:
Non-surgical treatment is often via splinting or cage rest alone with no dressing. With splinting/dressing the limb, complications are not uncommon and relate to soft tissue injury when the dressing slips. This can be severe if the blood supply is cut off to the foot. These dressing require diligent monitoring at home.
Surgical treatment should be considered in the following:
Several techniques for surgical treatment are available. These include:
Animals that undergo surgery to treat fractured metacarpals will need to be rested for as much as possible initially. Regular check-ups with the surgeon will be needed in order to assess how healing is going. X-rays may be needed in order to evaluate healing fracture and external skeletal fixator frames can be removed once adequate healing has occurred.
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