Surgical Fracture Repair in Cats

A broken bone (fracture) heals best when the broken ends are held close together but without movement across the fracture line. In the majority of cases when a cat breaks a bone, the best long-term results are obtained when the fracture is surgically repaired. This involves the use of implants such as pins, screws, plates, or wires to stabilize the break so that a bony callus can bridge the gap. 

Fractures usually result from trauma, such as a fall or traffic accident. Thus, the vet will stabilize the patient first, assess the injuries, and support the fracture with a dressing until the cat is well enough to undergo major surgery. 

Simple fractures are often repaired by vets in first opinion practice, but for more complex injuries referral to a veterinary orthopedic surgeon may be necessary. 

Although fractures look dramatic, they are usually not life-threatening. Thus the clinician's first priority is to stabilize the patient after a trauma, give pain relief, and support the fractured limb in a dressing. 

Once the risk of death from shock or other injuries has passed, the fracture is carefully assessed with the patient sedated or anesthetized. A series of radiographs are taken in order to see the exact nature of the fracture, where all the bone fragments are located, and decide on the surgical approach and appropriate sized implants. 

Once the clinician has planned their surgical approach, the cat is fully anesthetized, the area clipped and made surgically scrubbed. 

Under strict aseptic conditions the surgeon incises through the skin and muscle to expose the fracture site. A combination of plates, screws, pines, or wires is then used to stabilize the fracture so the broken ends are supported in a rigid manner. 

The operation site is flushed with saline, and the soft tissue closed. A supportive dressing may or may not be applied. 

Surgical fixation is extremely effective when performed by an experienced surgeon with the correct implants. There is much skill involved in assessing the best way to repair the fracture, gain sufficient access to the break, and having the range of different implant sizes available to effect an optimal repair. 

This being so, most fractures do exceedingly well, especially if post operative instructions are carried out with regard to rest. Occasionally, complications do occur such as implants working loose or infection. In these cases, repeat surgery to remove the metalwork and swab the area to culture the bacteria is necessary. Only once the infection has been brought under control is a new implant fitted. 

Other options to surgical fixation for simple fractures include immobilising the area with a cast or splint. The results are often disappointing, because it's important to restrict the joints above and below the fracture, which is often difficult. 

Bone healing across a fracture site takes around 4 - 12 weeks. This varies depending on the age of the cat and the location and nature of the fracture. Orthopedic surgery is painful, so for the first few days postoperatively the cat needs strong painkillers, and in some cases even sedation. 

The skin sutures are removed 7 - 14 days after surgery, but the cat needs to rest until fracture healing is evident on radiography. This means restricting the cat to a crate or a single small room for several weeks. 

Some implants are left permanently in place, whilst others are removed if they start to cause problems or there is easy access. 

Surgical fracture repair is costly, which is a reflection of the many processes required. Surgery is performed under anesthesia, often whilst the patient is on intravenous fluids and pain relief at around $100 - $300. Radiographs to assess the fracture would be around $140 upwards, with the actual fracture repair being anywhere from $850 upwards. For a basic fracture repair an average total bill is around the $1,500 mark, but for more complex surgery $4,000 plus is not unusual. 

Success of surgery depends, in part, on surgical planning and skill, but also on postoperative care. The patient who is rested as per post operative instructions is much more likely to make an uneventful recovery without complications. 

Sadly, even in the most experiences hands complications can arise, such as infections or implants loosening. This, in part, is a reflection of the traumatic nature of bone fractures resulting from a traffic accident, since bacteria easily track into open wounds. 

Whilst the majority of surgical fractures repairs are successful, occasionally unforeseen complications means a salvage procedure, such as limb amputation, may be necessary. 

Fractures usually arise as a result of trauma, thus prevention is about reducing the risk of a cat being involved in an accident. This means taking common sense actions such as netting of balconies, so the cat cannot fall from a height.

An important decision for any cat owner is whether to keep their cat indoors or not. So doing eliminates the risk of the pet being involved in a traffic collision or being attacked by other animals, resulting in a bite that breaks bone. 

Nobody intends for their cat to break a bone, therefore by their very nature these injuries are unexpected and unplanned for. In an ideal world, each owner would have financial provision in place to cover unexpected costs, such as that to repair a fractured leg.