Feline Trochanter Fractures: Rare, Traumatic, and Often Missed on Standard Radiographs

Fracture of the Greater Trochanter of the Femur in 17 Cats: Imaging, Clinical Features and Concurrent Injuries

Genziana Nurra, Mariette Pilot, Beatrice Grek-Fritzner, Mario Coppola, James Michael Grierson, Sorrel Langley-Hobbs

Background:
Fractures of the greater trochanter are a rare subset of proximal femoral injuries in cats, typically affecting young animals with open growth plates and often caused by trauma. These fractures are frequently associated with other orthopaedic injuries, such as coxofemoral luxation and pelvic fractures. This study aimed to characterize the clinical and radiographic presentation, concurrent injuries, management strategies, and short-term outcomes of greater trochanteric fractures in cats.

Methods:
A retrospective review was conducted of 17 cats presenting with greater trochanteric fractures to two UK referral institutions between 2009 and 2023. Data collected included signalment, injury cause, imaging modality, concurrent injuries, surgical treatment, complications, and follow-up outcomes. Radiographs were evaluated using a quantitative scoring system to determine which views best visualized the fracture. CT was also assessed where available. Surgical stabilization was performed using K-wires and tension band wiring when indicated.

Results:
All 17 cats had concurrent orthopaedic injuries, with coxofemoral luxation (58.8%) and pelvic/sacral injuries (52.9%) being most common. Fractures were most reliably detected using frog-leg ventrodorsal pelvic radiographs. CT, performed in four cats, confirmed the diagnosis in all cases. Surgical fixation was employed in 94.4% of cats, primarily using two or three K-wires and a tension band wire. Short-term follow-up (mean 6.3 months) showed a good outcome in 58.8% of cats, acceptable in 29.5%, and poor in 11.7%. Major complications requiring intervention occurred in 23.5% of cases, with persistent lameness being the most common issue.

Limitations:
This study was limited by its small sample size and retrospective design. Variability in imaging and surgical approaches across institutions may have influenced outcomes. The universal presence of concurrent injuries made it difficult to isolate the impact of the greater trochanteric fracture itself on clinical outcomes.

Conclusions:
Greater trochanteric fractures in cats are always associated with trauma and frequently occur alongside multiple other orthopaedic injuries. Surgical repair using pins and tension band wiring is common and often successful. Frog-leg ventrodorsal pelvic radiographs and CT are the most effective imaging modalities for detecting these fractures. Despite concurrent injuries, short-term outcomes are generally favorable with appropriate management.

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