Comminuted tibial fracture in a cat repaired with IMPeek plate-rod

A 6 year old male neutered Maine Coon cat suffered an acute trauma to the proximal right tibia after falling from a height in the owner's home. Open reduction and internal fixation was performed via medial approach to the tibial shaft, using a 2.4mm 14 hole LCP from Synthes, combined with a 4mm IMPeek rod placed in the medullary canal via a proximal normograde approach. 

To facilitate insertion into the medulla, a 5/32" metallic pin was used to create an entry point in the cranial tibial plateau and path for the IMPeek rod to follow into the distal diaphysis. The IMPeek rod was then inserted slowly with a battery powered drill using the K-wire attachment. The blunt tip of the IMPeek rod helped to facilitate fracture distraction. A 14 hole LCP was then contoured to the medial aspect of the tibia and affixed with 3 screws into the proximal and distal fracture fragments in a far-near, near-far configuration to maximize construct strength whilst minimizing screw requirements. 5 of the 6 screws engaged the IMPeek rod to create an interlocking plate-rod construct.

A brand new drill bit was used along with a locking drill guide for the 5 locking screws. Extensive lavage and suction was utilized to minimize heat generation and to remove IMPeek debris. Due to the similar sensation of drilling through cortical bone and the IMPeek rod, gentle, consistent pressure was applied when engaging the rod to help prevent slippage off the side of the rod.

Once the holes were drilled, depth was measured with a gauge and screws inserted by hand. The sensation of screwing into the rod was similar to that of screw penetration into cortical bone. Lavage was again performed prior to cutting of the IMPeek rod with small double action wire cutters. Closure was routine. 

The day after surgery the cat was ambulatory and was toe touching lame on the right hind limb. 2 week post op recheck showed persistent weight bearing on the right hind limb with a healed surgical incision and no discomfort on palpation of the tibia. 

8 week post op radiographs will be posted when available.