Open Septic Tibial Fracture in a Cat Managed with Simini Lavage and Plate-Rod Fixation
Clinica Vezzoni · Cremona, Italy · Dr Aldo Vezzoni · Feline Tibial Fracture · Open Septic
Case Summary
Achille, a 5-year-old DSH cat weighing 5 kg, presented to Clinica Vezzoni one week after sustaining a Grade 1 open comminuted tibial fracture. On presentation, purulent material was visible at the fracture site. A sample was taken for culture and sensitivity testing.
Wound debridement and fracture fixation were performed using a plate-rod construct: a Vitcone 2.5 mm locking plate combined with a 1.6 mm intramedullary pin. Simini Protect Lavage was applied for 60 seconds and then rinsed. A gentamicin-impregnated collagen sponge (Gentacoll) was placed before closure.
Culture results confirmed Staphylococcus pseudintermedius, non-MDR. Cefazolin was prescribed at 20 mg/kg TID for one week. Skin sutures were removed at 10 days with no discharge. At one month post-operatively, there were no signs of infection and bone healing was progressing.
Clinical Presentation
Open Septic Fracture — 1 Week After Injury
Achille, a 5-year-old domestic shorthair cat, presented to Clinica Vezzoni one week after sustaining an open tibial fracture. The fracture was classified as Grade 1 open, comminuted. Critically, it had been open and exposed for one week prior to presentation, creating a high-risk infection environment.
On clinical examination, purulent material was visible at the fracture site, confirming active infection. A sample was taken for culture and sensitivity (C&S) testing prior to surgical debridement. The combination of open contamination, one week of exposure, and visible purulent discharge made this a challenging septic orthopaedic case.
Image 1 — Achille at presentation. 5-year-old DSH cat, 5 kg.
Image 2 — Pre-operative radiograph: open comminuted tibial fracture.
Image 3 — Intraoperative view of the open fracture site — one week old, contaminated.
Image 4 — Purulent material at the fracture site confirming active infection. Sample taken for C&S.
Surgical Protocol
Debridement, Plate-Rod Fixation, and Simini Lavage
Surgery involved thorough wound debridement followed by fracture fixation using a plate-rod construct. A Vitcone 2.5 mm locking plate was combined with a 1.6 mm intramedullary pin — a technique suited to feline tibial fractures providing rotational stability and biological fixation. Simini Protect Lavage was applied for 60 seconds and rinsed. A gentamicin-impregnated collagen sponge (Gentacoll) was placed at the fracture site before closure.
| Step | Description |
|---|---|
| 01 | General anaesthesia. Right hindlimb prepared and draped. |
| 02 | Wound debridement performed. All necrotic and contaminated tissue removed from fracture site. |
| 03 | Fracture reduced. 1.6 mm intramedullary pin placed retrograde. |
| 04 | Vitcone 2.5 mm locking plate applied and secured. Plate-rod construct confirmed stable. |
| 05 | SiminiSimini Protect Lavage applied for 60 seconds at the fracture and wound site, then rinsed. |
| 06 | Gentacoll gentamicin-impregnated collagen sponge placed at the fracture site before closure. |
| 07 | Layered closure. Post-operative radiographs taken to confirm implant position. |
Image 5 — Wound debridement. All contaminated and necrotic tissue removed.
Image 6 — Simini Protect Lavage applied for 60 seconds at the fracture site.
Image 7 — Wound appearance after Simini application and rinse.
Image 8 — Gentacoll gentamicin-impregnated collagen sponge placed before closure.
Image 9 — Wound closure complete. Layered sutures in place.
Image 10 — Post-operative radiograph (left projection): Vitcone locking plate and intramedullary pin in situ.
Image 11 — Post-operative lateral radiograph: plate-rod construct confirming fracture reduction.
Image 12 — Post-operative radiograph (right projection): implant position and fracture alignment confirmed.
This case represents one of the most challenging infection scenarios in small animal orthopaedics: an open fracture with a one-week delay to presentation, active purulent discharge confirmed at surgery, and culture-positive for Staphylococcus pseudintermedius. Simini Protect Lavage was applied for 60 seconds at the fracture site prior to closure, followed by a saline rinse. In combination with a Gentacoll collagen sponge and a one-week antibiotic course, no signs of infection were present at 10 days or 1 month post-operatively.
Outcomes and Follow-Up
Culture Result, Antibiotic Course, and Recovery
Culture and sensitivity results confirmed Staphylococcus pseudintermedius — non-MDR, susceptible to cephalosporins. Cefazolin was prescribed at 20 mg/kg TID for one week. Skin sutures were removed at 10 days post-operatively with no discharge noted. At one month, there were no signs of infection and radiographic bone healing was progressing.
Staphylococcus pseudintermedius — Non-MDR
Culture confirmed S. pseudintermedius, not multidrug resistant. Cefazolin 20 mg/kg TID prescribed for one week based on sensitivity results.
Suture Removal — No Discharge
Skin sutures removed at 10 days post-operatively. No discharge, no signs of wound breakdown or infection.
No Infection — Bone Healing Progressing
One-month post-operative recheck: no signs of infection. Radiographs confirmed bone healing in progress.
Image 13 — 10-day follow-up. Sutures removed, no discharge, wound healed.
Image 14 — 1-month radiograph: bone healing in progress. No periimplant lucency or infection signs.
Image 15 — 1-month follow-up, additional view: fracture callus forming, no signs of implant infection.
This case demonstrates Simini use in a contaminated open fracture with delayed presentation (one week from injury), active purulent discharge at surgery, and a culture-positive result — conditions representing the high end of infection risk in feline orthopaedics. The outcome at 10 days and 1 month showed no infection.
Clinical Timeline
Post-Operative Course
Injury — Open Tibial Fracture
Grade 1 open comminuted tibial fracture sustained. One week of open wound exposure prior to presentation.
Presentation — Active Infection
Purulent material at fracture site confirmed. Sample taken for C&S. Surgery performed: debridement, plate-rod fixation, Simini 60 s, Gentacoll sponge, closure.
C&S Result — S. pseudintermedius
Culture confirmed Staphylococcus pseudintermedius, non-MDR. Cefazolin 20 mg/kg TID started for 1 week.
Suture Removal — No Discharge
Skin sutures removed. No discharge, no infection signs. Antibiotic course complete.
1-Month Follow-Up — Healing Confirmed
No signs of infection. Bone healing progressing on radiographs.