Metatarsal fractures - conservative management?

RE: Metatarsal fractures - conservative management?

Will McMullan — Fri, 29 Jul 2016 10:55:21 GMT

Sorry, forgot some vital info! 8 year old Jack Russell, o confident they can restrict her very well. Bit of a debate with his ex-wife as to whether or not they go for surgery but I think the case may have been taken back to his vets so might be out of my hands anyway.

RE: Metatarsal fractures - conservative management?

Tiago Cardoso — Thu, 28 Jul 2016 23:09:36 GMT

Hi,

I'm happy to be corrected here but believe the rule is that surgical repair should be advised if both weight-bearing metacarpals are fractured. Otherwise, conservative treatment should achieve a similar result.

If all 4 metatarsals are fractured, healing may (and probably will) occur but conservative management will give a higher chance of malunion, delayed union and non-union.

Hope this helps,

Tiago

RE: Metatarsal fractures - conservative management?

Anthony Todd — Thu, 28 Jul 2016 23:05:41 GMT

Never internally fixed these and must have seen a few.

We made sure the foot was off the ground with an aluminium rocker splint and a POP cast after reduction under GA/Xray as necessary.

Can't remember a failure.

Restrict activity!!!

RE: Metatarsal fractures - conservative management?

David Mills — Thu, 28 Jul 2016 22:50:56 GMT

Case selection important, esp age and activity.

If young, it is reasonable - will form a fibrous callus in 2w which will help hugely, and unlikely to be bearing much weight on them. Big, active, older dog and would normally be pinning the two central ones - this is someone who hates these sxx so do what I can to avoid.

If you're dressing/splinting weekly for 6-8 weeks (and you're not lucky enough to have a client whose a vet nurse!) then can work out cheaper to operate and dress for a couple of weeks only.

RE: Metatarsal fractures - conservative management?

Joyce Whitehead — Thu, 28 Jul 2016 22:45:04 GMT

One of our ex VNs, who now works in a referral practice, brought her farm Border Collie to us after he got a foot trapped in a gate. He had fractured all four metatarsals with minimal displacement. The referral vets wanted to operate as this would give the best chance of recovery but the owners couldn't afford to do this as he wasn't insured. I don't want to get into a big surgery/conservative/cast argument but on this occasion we used a splint and bandaging. The VN did regular dressing changes and he recovered very well and is back to full working strength now. Sorry, anecdotal evidence but it worked for him.

RE: Metatarsal fractures - conservative management?

Beats — Thu, 28 Jul 2016 19:45:35 GMT

cat or dog? Young or old?