Comparing postoperative complications of internal versus external fixation for closed diaphyseal tibial fractures in cats.

PICO question: In cats with closed diaphyseal tibial fractures, does internal fixation, when compared to external fixation, result in a lower postoperative complication rate? Clinical bottom line: Category of research: Treatment. Number and type of study designs reviewed: There were no publications that directly answered the PICO question. Strength of evidence: Zero. Outcomes reported: Both internal and external fixation are published techniques deployed in tibial fracture fixation in cats, however no study has directly compared the postoperative complications in these groups for closed diaphyseal tibial fractures. Conclusion: Given the lack of evidence to answer the PICO question, the veterinarian should consider their choice of stabilisation technique on the methods available and their personal experience. Both internal and external skeletal fixation (ESF) are published methods of feline tibial fracture fixation. A related study demonstrated that ESF has a high risk of complication for feline tibial fracture repair but given the absence of evidence for exclusively closed fracture types, this conclusion cannot be drawn for the PICO. How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient's circumstances and owners' values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources.Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.