https://www.vetsurgeon.org/f/non-clinical-questions/18081/plantar-metatarsal-lesion-question Hi I would be really grateful for some advice on what to do for one of our nurses cats - he came in tonight with a plantar metatarsal laceration. I can see that at least one, but I think two, of his digital flexor tendons has been severed completelyen-USTelligent Community 10https://www.vetsurgeon.org/thread/109509?ContentTypeID=1Mon, 03 Mar 2014 20:40:09 GMT146601cc-3922-4be7-9974-7e1d4e45a66b:152b5e54-eb45-483e-91a4-b7c91f52dc89Sarah Bolt<p>Thank you very much for the advice, it was treally helpful in my discussing it with the nurse. She decided she&#39;d like to at least try to repair the tendons, but having not seen one and as the cat was stable, we decided to wait for a more experienced colleague to help. The op went fairly well today so we&#39;ll wait ti see how it goes from here!</p> <p>Many thanks again :-)</p><div style="clear:both;"></div>https://www.vetsurgeon.org/thread/109383?ContentTypeID=1Sun, 02 Mar 2014 11:31:56 GMT146601cc-3922-4be7-9974-7e1d4e45a66b:b5535090-aadd-4971-ac2e-18ec886af7d6Malcolm Ness<p>These are challenging cases. Your options are to effectively do nothing - ie suture the skin wounds and accept the inevitable cosmetic imperfection and disability that will accompany the dysfunctional digital flexion. The other option is definitive repair, and as indicated (and as you can see) that is technically difficult and might well fail leaving you with a more costly and invasive version of the outcome in option one! Before surgery check to ensure that an adequate blood supply and functioning sensory nerve perception is retained distal to the injury.</p> <p>Extend the existing wound to expose the plantar tendons. Identify the intact sup and deep dig flexors for all 4 digits. If you can&#39;t identify the intact tendon then you need to go looking for the severed ends which might have retracted a considerable distance. Suture each severed tendon individually - I would use 2m monofilament nylon in a locking loop or 3-way pulley pattern. This is the first hard bit as you have remarkably little tissue to play with. Hold the paw in flexion to reduce strain. Once you have re-apposed all the damaged tendon ends, close the skin and then carefully apply a dressing that maintains the paw in some flexion - that is the second difficult bit. The third difficult bit is maintaining the flexion throughout a four week healing period. There is a high risk that the repair will partially or totally fail - hence the implication earlier that your nurse might be best advised to learn to live with a cat with a floppy paw.</p><div style="clear:both;"></div>