Long bone fractures represented 16,9% of the total number of cats (n=41 of 243) and 13,28% of dogs (n=17 of 128) presented at the surgery Unit for examination. These results are slightly lower than in the world and even some North African surveys such as
Bennour et al. (2014), who found very high rates of fractures in companion animals but meet those of
Ben Ali (2013) who showed that fractures accounted for 17.8% of the total of presented cases. Cats were affected in 70,7% and dogs in 29,3% of all animals showing limb fractures (58 animals). A total number of 66 fractures was recorded. Some animals displayed more than one fracture (n=6 cats and n=2 dogs).
Ben Ali (2013) though, found that dogs were more prone to fractures than cats with dogs constituting 67% and cats 23% of the total in Egypt. Respective rates were 67.8% and 39.5% of the total surgical patients in Libya, for
Bennour et al. (2014) which also are the opposite of our findings. It also differs from
Libardoni et al. (2018), in which dogs were more represented. This could be linked to the fact that Algerian dog owners may avoid keeping dogs due to cultural considerations or preferring private practices over veterinary teaching hospitals, preventing students from handling their pets. The return to stability in Algeria may also explain the decreased need for watchdogs.
Our study showed male predominance in both cats and dogs (Table 1). Most available studies also registered higher rates for males: 57.45% for
Cardoso et al., (2016), 61.50% for
Shiju Simon et al. (2010) and 55.84% for
Kushwaha et al. (2011).
Keosengthong et al. (2019), however found that fractures in male dogs were predominant (58.4%) but similar proportions of males and females in cats (49.6% versus 50.4%). It is commonly admitted that males are more active and show more willingness to fight. The study’s findings may also be attributed to general owners’ preference for male companion animals to avoid unwanted pregnancies.
Miranda et al., (2020) found that female bone maturity is reached earlier than that of males which may potentially contribute to higher fracture incidence in young males.
Young cats and dogs were more saffected than adults (Table 1). These results corroborate the studies of
Cardoso et al. (2016);
Shiju Simon et al. (2010);
Vidane et al. (2014) and
Minar et al. (2013): Young animals are more prone to fractures due to bone fragility associated with the growth plate and incomplete mineralization. Their playful and curious behaviour, imperfect motor coordination and immature soft tissues also increase their vulnerability to trauma.
Most cats were European Short Hair (73,2%) and Siamese (22%). Angora and Chartreux reached 2,4% each. This matches the observations of
Libardoni et al. (2018) and of
Cardoso et al. (2016), where cats were mostly unde-fined breeds.In Dogs, German Shepherds represented 29,4%, followed by Malinois (17, 3%), then Belgian Sheperd and Pitt Bulls (11,8%, each). Other breeds represented 5,9%, each. Unlike
Shiju Simon et al. (2010), in our study, Purebred large animals were predominant. This could be an illustration of the fact that dogs, in Algeria; are mainly bred as watchdogs, needing to impress. Also, young large dogs may be more susceptible to fractures from trauma because of the extra weight exerted on their bones, temporarily fragile due to their rapid growth. Their predisposition to some bone diseases also increases the risk.
We found that nineteen cats and seven dogs were kept indoor. Three Indoor dogs were kept in “garages” and three others on “rooftops.”
Cardoso et al. (2016) reported that most fractured cats were indoor pets. Fall from a height was the major cause in both cats and dogs (Table 1). This contradicts
Keosengthong et al. (2019);
Libardoni et al. (2016); and
Miranda et al. (2020) who found that road accidents were the most frequent aetiology, but corresponds to
Ben Ali (2013);
Bennour et al. (2014);
Kushwaha et al. (2011) and,
Kumar et al., (2022) findings: where a fall accounted for 33,37% to 43,25% of causes. The low rates of road traffic accidents in our dogs may be due to their watchdog status and rooftop confinement, making them more susceptible to falls.
Eight cats (19.5%) suffered additional trauma: one spinal fracture, five pelvic fractures and diaphragmatic hernias accounted for 25% of these injuries. According to
Griffon et al., (1994), 38.7% of fractured cats exhibit thoracic injuries, with a higher rate for more cranial fractures. Diaphragmatic hernias were observed in our study, but not at a very high rate. This could reflect the fact that most fractures involved the hindlimb.
Fracture description and classification
We report 36 cats affected with single fractures and five with multiple fractures, representing 87.8% and 12.2% of animals, respectively. Simple fractures reached 88,2% in dogs (n=15) and two dogs suffered multiple fractures (11,8%). All animals suffering from multiple fractures displayed 2 fractures, except one cat, who had 3 fractures.
Keosengthong et al. (2019) found higher rates (44.1% of dogs and 37.8% of cats) in Thailand. The reason may be that in the latter, road traffic accidents are the main cause of fracture, which is not the case in our study.
Rear limb fractures were the most common in both our cats and dogs, accounting for 80.9% and 63.2%, respectively.
Minar et al., (2013) evaluated pelvic limb fractures at 37%, while
Elzomor et al., (2014) reported 69.39% in cats and 50.60% in dogs.
Harasen (2003) suggested that front limb fractures might be more fatal due to their proximity to vital organs, such as the head and thorax, which may not be captured in survey studies. Alternatively, we propose that animals trying to escape trauma may leave their rear limbs more vulnerable.
The distribution of long bone fracture is summarised in Fig 1. The femur was most affected in both cats and dogs. Tibial fractures were ranked second in cats and third in dogs.
Elzomor et al., (2014),
Cardoso et al. (2016) and
Libardoni et al. (2016) have stated that the femur and tibia were the most involved long bones. Our study revealed that dogs’ radius/ulna and humerus were affected in second and fourth place, only partially aligning with previous research findings: respectively reaching 17,6% and 7,5% for
Vidane et al. (2014) in Brazil and 12,01% and 6,91% for
Libardoni et al. (2016) in Mozambique, but matching
Vani et al. (2022) who found that in dogs, radius/ulna was the second more frequently affected bone. Most of the body weight being applied on the forelimb in animal and large heavy dogs being overrepresented in our study may explain this higher rate. Metacarpal, metatarsal and, phalanx fractures where rare, which matches the results of
Bennour et al. (2014) and
Ben Ali (2013).
Table 2 summarizes fracture locations in dogs and cats. In cats, femoral head and neck fractures were highly represented, similar to findings of
Cardoso et al., (2016) where they reached 42.86%. In dogs, contrary to
Minar et al., (2013) and
Libardoni et al., (2018), both proximal and distal fractures were equally common. Unlike in most studies, the major cause for fracture in both cats and dogs was a fall from a height: The vertical overloading force on limbs at the reception could explain the high rate of this fracture pattern (head and/r neck fractures) in our study, as proposed by
Matis and Waibl (1985).
Anggoro et al., (2024) finds that miniature dogs are more susceptible to distal fractures compared to larger dogs (our population), potentially explaining the difference with our results: We observed that most physeal fractures were noted on the femur, as did
Rubinos and Meeson (2022). In our cats, diaphyseal tibial fractures were predominant.
Abo Soleiman et al.’s (2020) findings align with this.
Shiju Simon et al. (2010) declares that avulsion fractures in dogs were common in the tibia. We found that they were as represented as diaphyseal and distal ones.
Gall et al. (2022) found that humeral and,
Cardoso et al., (2016) that radial fractures were mainly diaphyseal, which matches our observations. Single ulnar fractures are rare according to
Makar et al., (2024). Our results are consistent with that.
Comminuted fractures represented 12.2% to 17.8% for
href="#keosengthong_2019">Keosengthong et al., (2019) and, 8.1% to 18.6% for
href="#abo-soliman_2020">Abo-Soliman et al., (2020) We found similar results (Table 3). Open fractures in our study were predominantly found in the tibia and paw bones (Table 3).
Cardoso et al., (2016) found that open fractures reached (11.12%), the tibia being involved in 70% of cases. Low amounts of surrounding tissue in these bones are likely to be the cause.
Treatment and outcome
Fractures were treated from day 0 up to 52 days, (median time 7 days), due to late case presentation.
Kushwaha et al., (2011) experienced the same issue in India. Table 4 lists the different types of treatment used. Pins were mostly used. Intramedullary pins associated with cerclages are a suitable option when applied per the indications
(Aithal et al., 2023; Sodhi et al., 2021). Multiple other devices are commonly used nowadays, such as plates, plates and rods, external fixators
(Gall et al., 2022), but pinning is still considered an acceptable option to treat fractures
(Kushwaha et al., 2011; Priyanka et al., 2019; Kumar et al., 2023).
Femoral osteotomy may be used in chronic head/Neck fractures (
Beale, 2004;
Aithal et al., 2023), which was the case in our study. In open fractures, Intramedullary pinning was only applied when complete immobilization could be achieved, as recommended by
Glyde and Arnett (2006). External fixators are more indicated when available, as stated by
Aithal et al., (2023) and
Singh et al., (2023), which was not the case in our study.
Eccles et al., (2020) declares that amputating a leg may be beneficial for cats with significant soft tissue or neurovascular damage and when early treatment cannot be achieved.
Beale (2004) and
Aithal et al., (2023) consider cross pins -which were used in our study- as a good choice for Salter-Harris fractures.
Casts were applied on minimally displaced fractures. External coaptation can be considered for minimally displaced radial fractures when plating or external fixation is unavailable or refused by the owner (
Palmer and Goh, 2020).
The study evaluated outcomes of 28 cats and nine dogs after osteosynthesis surgery. Cats had good outcomes (96.43%). One poor result was noted in a distal humerus (cross pins and an intercondylar pin). Optimal immobilisation of separated condyles is best achieved through a lag screw an Kirshner wires as shown by
Beale (2004). In dogs, we registered good outcomes (77.78%), fairness (11.11%) and poor outcome (11.11%) for one intramedullary nail placement in the humerus. It is worth noting that we registered no non-unions.
