Minimally invasive application of a pre-contoured angle-stable interlocking nail in cats

Abstract

Objectives

The objective of this study was to record cases of cats that underwent long-bone fracture stabilisation using minimally invasive nail osteosynthesis with a pre-contoured titanium interlocking nail (Surg’X), and to report outcomes and associated complications.

Methods

Cats treated with a pre-contoured angle-stable interlocking nail at a single hospital centre between June 2022 and September 2024 were retrospectively enrolled. Collected data included the signalment, fracture characteristics, cause of trauma, concomitant injuries, implant size, as well as intraoperative and postoperative complications and outcomes.

Results

A total of 26 cats were included in this study (mean age 63.3 months). One cat died of concomitant injuries. All fractures but one were successfully treated using a minimally invasive approach. One cat required conversion to an open approach owing to a propagation of a fissure through the fracture line during nail insertion. Among the 25 cats available for follow-up, two (8%) minor postoperative complications were noted: one nail flexion and one opening of a fissure line, without affecting the implants. In addition, one (4%) major complication occurred, involving nail fracture. Long-term functional outcomes were evaluated for each patient (12–83 weeks postoperatively) through a questionnaire, demonstrating full functional recovery in all cats. No implant removal was needed.

Conclusions and relevance

Minimally invasive nail osteosynthesis of a pre-contoured angle-stable interlocking nail is feasible in cats and associated with a low complication rate and excellent clinical outcomes.

Keywords

Fracture interlocking nail angle-stable internal fixation minimally invasive osteosynthesis

Introduction

Interlocking nails (ILNs) are a commonly used method for internal fixation of fractures, particularly in human traumatology, and were first applied in dogs in 1986.¹ ILNs are indicated for the treatment of long-bone fractures, the revision of non-unions or malunions, and angular deformity corrections.^1,2 From a biomechanical perspective, ILNs offer several benefits. Positioned near the bone’s neutral axis, they provide greater stability in flexion compared with plates.^1,3
–5 In addition, they have a higher moment of inertia than plates of the same diameter, making them more rigid. However, early generation ILNs had some mismatch, or ‘slack’, between the screws and nail holes, which hindered optimal bone healing. To resolve this, angle-stable ILNs have been developed.^{1
–3,6
–11} These new models feature threaded screws or tapered bolts that lock securely into the nail, eliminating angular and rotational instability, or ‘slack’.^2,6
–8,12 In a clinical study of dogs treated with an angle-stable ILN, the rate of major complications was approximatively 10%.^4,12 In a clinical study of 30 cats, no major complications were encountered.¹³

Recently, pre-contoured angle-stable interlocking nails (CAS-ILNs) have been developed. These nails are designed with a curved shape, which prevents over-reduction, improves endocortical contact and allows for the insertion of longer nails that follow the bone’s anatomical curvature. This design expands their use beyond diaphyseal fractures to also include metaphyseal fractures. The curved shape further enables proximal tibial insertion at a more cranial position relative to the insertion of the cranial cruciate ligament. In addition, this implant allows for multiplanar locking. The biomechanical superiority of angle-stable ILNs over same-diameter plates has already been demonstrated, but clinical studies on this new implant are limited to a single recent multi-institutional study that reported the first clinical use of CAS-ILN in dogs and cats.^3,14 That multi-institutional retrospective study found a major complication rate of 11.5% and a functional recovery rate of 97%.¹⁴ This implant was specifically designed for minimally invasive placement, without requiring intraoperative fluoroscopy. It featured a cannulated design, allowing a pin to be inserted inside the implant to confirm proper screw positioning within the nail.¹⁴

The aim of the present study was to document cases of cats that underwent long-bone fracture stabilisation using minimally invasive nail osteosynthesis (MINO) with a CAS-ILN (Surg’X), highlighting the outcomes and any associated complications. Our hypothesis is that most fractures can be treated using a minimally invasive approach and that this implantation technique is safe, as proven by a low complication rate.

Materials and methods

This retrospective study focused on cats treated with a CAS-ILN at a single hospital centre between June 2022 and September 2024. The inclusion criteria required that cats had undergone stabilisation of a long-bone fracture using a pre-contoured ILN using MINO, with at least 12 weeks of follow-up. In addition, a questionnaire assessing long-term functional recovery was completed with the owners on the telephone for each patient (see the supplementary material).¹⁵ Data recorded for each patient included the following: details at the time of presentation, weight, the affected bone, fracture type, concomitant injury, cause of trauma (if known), implant size, and both clinical and radiographic follow-up, including any complications.

Surgical planning was based on radiographs, using two orthogonal views of the affected bone and the healthy contralateral bone. The implant size was selected based on the desired length, fracture configuration and the available space for screw placement. The nail’s diameter was chosen to ensure it filled at least 80% of the medullary cavity at the bone isthmus.

All cats were premedicated with diazepam (Solupan; Dechra) at a dose of 0.5 mg/kg IV and morphine (Lavoisier) at 0.1 mg/kg IV. Anaesthesia was then induced with propofol (PropoFlo 28; Zoetis) to effect, with repeated doses of 1 mg/kg IV. Anaesthesia was maintained with isoflurane and oxygen. Intravenous (IV) crystalloid fluids (lactated Ringer’s; Virbac) were administered at a constant rate of 3 ml/kg/h throughout the surgery. Ampicillin-sulbactam (Unacim; Pfizer) 20 mg/kg IV was administered intraoperatively and repeated every 90 mins throughout the operation.

All nails were placed in a minimally invasive fashion through two small incisions remote from the fracture line.² The surgical approach follows the safe portal recommendations previously described for minimally invasive ILN implantation.^2,16,17 Both the humerus and femur were approached laterally. For the femur, the nail was inserted in a normograde fashion in the intertrochanteric fossa. For the humerus, the nail was inserted craniolaterally, centred on the crest of the greater tubercle.² Finally, the tibia was approached medially and the nail insertion point was located cranially to the insertion of the cranial cruciate ligament.² Two incisions, each approximately 2 cm long, were made proximally and distally. A pointed reamer was used to penetrate the cortex at the nail insertion site. The fracture was roughly reduced using bone reduction forceps, and a flexible olive guide wire was introduced into the medullary cavity.

In most cases, fluoroscopy was used to confirm proper engagement of the olive guide wire within the distal fracture segment. Fluoroscopy was used to double-check and save time; if not available, the guide wire could be palpated percutaneously in case of incorrect positioning. A reamer matching the selected nail diameter was inserted over the guide wire, and the medullary cavity was reamed while maintaining alignment. During reaming, an olive-tipped wire was used to hold the reamer parts together and to minimise the risk of joint penetration. Once the reaming had been completed, the reamer was removed without removing the olive guide wire. At this point, the olive guide wire was replaced with a smooth wire before nail insertion, as the olive’s diameter exceeded that of the nail cannula, which would have prevented wire removal after insertion. To facilitate this step, a portion of sterile infusion tubing was inserted over the guide wire beyond the fracture line. This allows the olive wire to be removed and the smooth guide wire easily inserted without loss of reduction. The tubing is then removed and the nail was subsequently advanced over the guide wire (Figure 1). The targeting frame was assembled to allow for screw placement. To ensure accurate screw placement into the locking hole, the guide wire was inserted into the cannulated nail, with the distance to the pin stop corresponding to the screw position. Proper positioning can also be verified using fluoroscopy (Figure 2). After surgery, radiographs were repeated to assess correct positioning of the nail and screws, alignment and filling of the medullary cavity.

Figure 1

Illustration of the step-by-step process for exchanging guide wires without losing reduction, using an infusion tubing. (a) Insertion of the tubing over the olive guide wire, beyond the fracture line. (b) Removal of the olive guide wire, holding the tubing in position into the medullary cavity. (c) Insertion of the smooth guide wire into the tube. (d) Removal of the tubing

Figure 2

Intraoperative fluoroscopic images, illustrating the various surgical steps. (a) Engagement of the guide wire within the distal fracture segment. (b) Accuracy of the distal reaming (the only purpose of this fluoroscopic picture is to illustrate the reaming; if the olive guide wire had been placed correctly during first step, fluoroscopy was not needed during reaming). (c) Correct positioning of the screws within the nail. These steps can also be confirmed without the use of fluoroscopy

All cats were discharged once they were bearing weight on the operated limb and exhibited no signs of abnormal local inflammation (such as excessive swelling, warmth or discharge) or systemic complications (such as fever, anorexia, or lethargy). Meloxicam (Meloxidyl; Ceva) was continued at home (0.05 mg/kg PO q24h for 5 days). Amoxycillin-clavulanic acid (Clavaseptin; Vetoquinol) was continued at home for cats that presented with an open fracture or when the animal presented with trauma-related skin lesions justifying the use of antibiotics. The latter was then prescribed at a dose of 20 mg/kg PO q12h for 5–10 days. Strict rest instructions were given for at least 2 months and follow-up radiographs were recommended at a minimum of 1 and 2 months postoperatively. Radiographic union was considered complete when the bone callus bridged at least three cortices on the two orthogonal views. Clinical union time was determined based on follow-up examinations, the attending veterinarian’s records or questionnaires completed with each owner. Intra- and postoperative complications were recorded for each case. Complications were considered minor or major, depending on the need for revision surgery.

Results

A total of 26 cats met the inclusion criteria. Of the 26 cats, 23 were domestic shorthairs and there was one each of Maine Coon, Burmese and Siamese. Among these cats, 16 were males (12 castrated and four intact) and 10 were females (nine spayed and one intact). The mean age at presentation was 63.3 months (range 10–182) and the mean body weight was 4.3 kg (range 2.2–6). The bone most frequently affected was the femur (n = 16/26), followed by the tibia (n = 6/26) and the humerus (n = 4/26). Fractures were predominantly mid-diaphyseal (n = 13/26) and comminuted (n = 18/26). Of the 26 cats, 20 had a closed fracture, while six had a grade 1 open fracture. The cause of fracture was unknown in 10/26 cats, resulted from a fall from a height for 9/26 cats, was due to a road traffic accident for 6/26 and one was caused by a dog attack. Four cats presented with concomitant injuries. One had a partial rupture of the patellar tendon, which was sutured during the same procedure. Another had superficial skin wounds and pulmonary contusions. A third cat exhibited bilateral sacroiliac luxation, managed conservatively because of financial constraints. The fourth cat suffered from severe bite wounds. A 3.5 mm nail was used in 13 cases, a 4 mm nail in 11 cats and a 5 mm was used for the remaining two cases.

Intraoperative complications occurred in two cases. In one case, the distal screws missed the nail holes but could be correctly replaced intraoperatively. In another case, a significant widening of the fissure line of the proximal fragment occurred, resulting in a loss of anatomical reduction, which required conversion to an open approach and the placement of cerclage wire (Table 1).

Table 1

Summary of fracture characteristics, complications and outcomes for each cat

Case	Age(months)	Signalment	Weight (kg)	Cause	Bone	Fracture configuration	Concurrent injury	Implant size (mm)	Perioperative complication	Postoperative complication	Time to clinical union (weeks)	Time to radiographic union(weeks)
1	87	MC DSH	5.2	RTA	Right tibia	Comminuted distal diaphyseal	None	3.5–110	None	None	4	Unknown
2	13	ME DSH	3.2	Unknown	Left femur	Short oblique proximal diaphyseal	None	4–86	None	None	6	Unknown
3	145	FS DSH	4.6	Unknown	Left humerus	Spiroid, distal diaphyseal	None	3.5–78	None	None	6	Unknown
4	34	MC Maine Coon	4.3	RTA	Right humerus	Comminuted mid-diaphyseal	None	3.5–86	None	None	4	Unknown
5	27	FE DSH	4.1	Unknown	Right humerus	Spiroid, distal diaphyseal	None	3.5–78	None	None	8	Unknown
6	93	ME DSH	4.2	RTA	Right femur	Comminuted mid-diaphyseal open	Partial patellar tendon rupture	4–94	None	None	6	Unknown
7	154	FS DSH	2.2	Unknown	Left femur	Comminuted mid-diaphyseal	None	4–86	None	None	8	10
8	111	MC DSH	4.3	Unknown	Left femur	Comminuted proximal diaphyseal	Superficial wounds, pulmonary contusions	4–94	None	None	6	Unknown
9	20	MC DSH	4.2	RTA	Left femur	Comminuted mid-diaphyseal	None	4–102	None	None	4	Unknown
10	20	MC DSH	4.3	RTA	Right femur	Transverse diaphyseal	None	5–94	None	None	6	Unknown
11	65	FS DSH	4.3	Unknown	Right femur	Comminuted proximal diaphyseal	None	4–86	None	None	6	10.2
12	27	MC DSH	5	RTA	Left femur	Comminuted proximal diaphyseal	Bilateral sacroiliac luxation, ischiatic fracture	4–102	None	None	6	13
13	113	FS DSH	3	Unknown	Left femur	Transverse diaphyseal open	None	3.5–94	None	None	4	13
14	55	MC DSH	4.9	Unknown	Left femur	Comminuted mid-diaphyseal	None	4–102	None	Opening fracture line	6	12
15	62	MC DSH	4.8	Fall	Left tibia	Comminuted mid-diaphyseal open	None	3.5–102	None	None	6	15.2
16	42	FS DSH	6	Fall	Right tibia	Comminuted mid-diaphyseal	None	3.5–110	None	Nail bending	4	17.8
17	81	MC DSH	4.7	Fall	Left tibia	Transverse distal diaphyseal open	None	3.5–110	None	Nail rupture	6	8.5
18	10	M Siamese	5	Fall	Left tibia	Comminuted distal diaphyseal	None	3.5–104	None	None	4	9.3
19	25	MC DSH	5	Fall	Right tibia	Comminuted mid-diaphyseal open	None	3.5–110	None	None	6	14.3
20	12	MC DSH	5.5	Fall	Left femur	Long oblique mid-diaphyseal	None	4–94	None	None	3	Unknown
21	14	FS Birman	4	Fall	Right femur	Transverse distal diaphyseal	None	3.5–86	None	None	8	Unknown
22	167	FS DSH	3.4	Unknown	Right femur	Short oblique proximal diaphyseal	None	5–94	Fracture line opening→ open approach	None	8	8.7
23	182	MC DSH	4.5	Dog attack	Right femur	Comminuted mid-diaphyseal open	Bite wounds	4–104	None	Death and concurrent lesions	–	–
24	34	FS DSH	4	Fall	Left humerus	Comminuted mid-diaphyseal	None	3.5–86	None	None	4	7.5
25	29	M DSH	4.8	Unknown	Left femur	Comminuted mid-diaphyseal	None	4–94 mm	2 misplaced screws; replaced intraoperatively	None	2	Unknown
26	25	FS DSH	4.4	Fall	Right femur	Comminuted mid-diaphyseal	None	3.5–86	None	None	6	9

DSH = domestic shorthair; FE = female entire; FS = female spayed; M = male; ME = male entire; MC = male castrated; RTA = road traffic accident

All patients were able to bear weight on the operated limb, and all cats but one were discharged the day after surgery. One cat (case 23) required an additional 3 days of hospitalisation owing to severe pain caused by multiple bite wounds. This cat died due to concomitant lesions during the short postoperative period.

Of the 25 cats present for follow-up, two suffered from minor postoperative complications. In one cat (case 14), radiographs taken 4 weeks postoperatively showed an open fissure line causing impaction of the proximal segment and anteversion of the femoral neck, without implant rupture or loosening (Figure 3). In the second cat (case 16), the initial radiographs at 4 weeks postoperatively revealed nail flexion leading to a mild valgus deviation (Figure 4). Surgical revision was not performed, as one cat showed continuous improvement in lameness while the other remained asymptomatic, and initial radiographs indicated progressive bone healing.

Figure 3

Caudocranial and mediolateral views of a 4-year-old domestic shorthair cat (case 14) treated for a comminuted femoral fracture with a 4 mm interlocking nail. (a) Immediate postoperative radiographic views. (b) Radiographic views taken at the first follow-up visit 33 days postoperatively. Images show an opening of a proximal fracture line, leading to compaction of the proximal fracture segment and anteversion of the femoral neck

Figure 4

(a) Caudocranial and mediolateral views of a 3.5-year-old domestic shorthair cat (case 16) showing a comminuted mid-diaphyseal fracture of the right tibia. (b) Immediate postoperative radiographic views after placement of a 3.5 mm nail. (c) Orthogonal radiographic views at first follow-up at 35 days postoperatively. These radiographs reveal nail bending associated with valgus deviation of the tibia

A major complication occurred in one cat (case 17), which presented with a nail fracture at the level of the first distal screw 12 days after surgery, despite proper adherence to rest instructions at home. Revision surgery was required in this case. During the revision surgery, a new nail of the same diameter was placed, the most distal orthogonal screws were used and synthetic bone grafting (Bone surgery RTU; TheraVet) was applied at the fracture site. The fibula was also reconstructed with a 1.5 mm locking plate to improve stability (Figure 5).

Figure 5

Caudocranial and mediolateral views of a 6-year-old domestic shorthair cat (case 17) initially treated for a transverse fracture of the distal tibial diaphysis with a 3.5 mm interlocking nail. (a) Rupture of the centromedullary nail next to the first distal screw 12 days after initial surgery. (b) Orthogonal radiographic views after revision surgery. (c) Orthogonal radiographic views at 60-day follow-up

Of the 25 cats available for follow-up, radiographic follow-up until complete bone healing was available for 13 of them. The mean time to bone healing in this population was 11.4 weeks (range 7.5–17.8). Regarding functional recovery, 9/25 cats showed no visible lameness at clinical check-up 30 days postoperatively, 12/25 showed no lameness at 6 weeks postoperatively and four patients showed complete disappearance of lameness at 8 weeks postoperatively. Long-term evaluation was conducted through questionnaires collected for each patient at least 12 weeks after surgery (range 12–83). None of the animals exhibited any lasting effects or difficulties in jumping, playing or grooming compared to their condition before the trauma. In addition, none of the patients required painkillers, and there was no need for implant removal.

Discussion

This retrospective study aimed to evaluate the outcomes and complications associated with treatment of long-bone fractures in cats using a CAS-ILN through a minimally invasive approach. The major complication rate in our population was 4%, corresponding to a single case of nail fracture 12 days postoperatively. Nail fracture has been recognised as a major complication across all types of ILNs.^1,14,18 Several factors have been suggested to contribute to this issue, including an insufficient nail diameter, resulting in inadequate filling of the medullary cavity, or the proximity of the fracture line to the screw holes.^2,16,19 In our study, strict adherence to rest guidelines ruled out excessive activity as the cause of failure. The implant’s diameter was appropriate, with a medullary cavity filling of 78%. The only risk factor identified in this case was the presence of a screw hole close to the fracture line, especially in the case of a simple transverse fracture. The proximal end of the nail was reinforced by increasing its diameter to address an area of weakness; however, this adjustment was not applied to the distal end, leading to the formation of a stress riser at that point. Transverse fractures treated with non-angle-stable ILNs have been associated with a higher rate of major complications.¹⁸ This is probably due to the increased mechanical stresses concentrated on a small fracture gap, as well as the ‘slack’ phenomenon, which exacerbates micromotion at the fracture line; this effect is mitigated by the design of angle-stable nails. However, from a biomechanical standpoint, simple transverse fractures are optimally managed with rigid fixation and interfragmentary compression to promote primary bone healing.¹ Although CAS-ILN improves stability compared with non-angle-stable designs, it does not provide compression across the fracture line and may therefore fail to meet the mechanical requirements of this fracture pattern.

Although ILNs have demonstrated biomechanical superiority over plates in gap fracture models, making them particularly well suited for comminuted fractures, evidence regarding their performance in transverse fracture remains limited.^3,5 Consequently, CAS-ILN may not represent the preferred fixation method for simple fracture patterns that are amenable to anatomical reduction and compression plating.

Two cats experienced complications, which were classified as minor since they had no clinical impact. There was no worsening of lameness, the fractures healed completely and the animals remained free of lameness. As a result, revision surgery was not performed, despite the potential for these complications to have led to a debilitating outcome. In our cases, the rate of major complications was lower than that reported in the initial clinical evaluation of this implant (11.5%).¹¹ However, this preliminary study may have been affected by the learning curve across six centres and most complications were linked to technical errors.¹⁴

The cannulated nail design was created to minimise the need for intraoperative fluoroscopy. The screw misplacement rate previously reported with standard nails was approximately 14%.² This rate improved significantly with new-generation nails, dropping to 1.3% for angle-stable designs and down to 0.37% with the cannulated version.^2,14 In our series, the misplacement rate was 0%. Only one animal experienced a distal screw misposition, which was immediately identified and successfully replaced during surgery. This improvement is likely attributable to the implant’s cannulated design.

This article specifically addresses the implementation via MINO of a pre-contoured angle-stable ILN and its associated outcomes. During the study period, 30 cats were treated with this ILN. Four were excluded from this study as they necessitated the application of a cerclage wire owing to a fissure line and, as such, cannot be classified as minimally invasive. In this population, one case required conversion to an open approach because of a fissure line opening during nail placement. This cat, who weighed just 3.4 kg, was implanted with a 5 mm nail, with the nail occupying more than 80% of the medullary cavity. The presence of fissure lines extending proximally and distally does not automatically justify choosing an open approach; however, in this case, a smaller nail might have been a better option. In addition, at the 2-month postoperative checkup, bone healing in this cat was still in its early stages. A 5 mm nail was used, secured with three proximal and two distal screws, along with three cerclage wires. The delayed healing could likely be due to the extensive, traumatic approach and excessive rigidity of the fixation, considering the cat’s weight and calm, geriatric nature.

Although the implant is designed and marketed by the manufacturer as suitable for minimally invasive placement without the need for intraoperative fluoroscopy, clinical evidence remains limited. To date, no clinical study has specifically demonstrated the feasibility and safety of implanting this device using a minimally invasive technique without fluoroscopic guidance. Only one clinical study has reported this approach in approximately one-third of cases, but the authors did not specify whether fluoroscopy was used.¹⁴ In our experience, fluoroscopy remains a helpful tool, especially to confirm guide wire positioning in the distal fragment before nail insertion. Although fluoroscopy is not mandatory, its use enhances confidence and precision during key steps of the procedure.

As mentioned earlier, one of the challenges of minimally invasive implantation is the correct engagement of the guide wire within the distal segment. This step must be performed twice: first with the olive guide wire and then with the smooth guide wire. To simplify this step, we use a perfusion tubing or a section of large-diameter urinary catheter. In our opinion, this technique is quick and straightforward, making this step easier during MINO and reduces the number of fluoroscopic images required. Perhaps thanks to the use of fluoroscopy, none of the animals required surgical revision based on postoperative radiographs. This is notable considering that the study encompasses all cases performed since the acquisition of the materials, including our learning curve period.

Pre-contoured ILNs provide clear advantages by more accurately matching the bone’s natural curvature, enabling more distal insertion without causing over-reduction, especially in the distal femur. When a straight nail is used in the tibia, there is a risk of altering the tibial plateau slope or damaging the cranial cruciate ligament insertion.^14,20 Only one study directly compares the biomechanical properties of a straight and pre-contoured angle-stable ILN on a tibial fracture gap model.²⁰ This study shows the mechanical superiority of the pre-contoured nail, with lower compliance and greater resistance to eccentric compression loads. Clinically, no differences in terms of implant failure or major complications have been demonstrated yet between angle-stable ILNs and pre-contoured nails.¹⁴

This study has several limitations, first because of its retrospective design. In addition, many animals did not return for follow-up radiographs until complete bone healing. For each animal, long-term functional outcomes were recorded, showing excellent clinical progress. This made it challenging for owners to see the need for follow-up, given the apparent recovery. Functional recovery was also assessed subjectively, relying on observations from owners and the attending veterinarian, as not all animals returned for follow-up evaluations.

Conclusions

Treatment of long-bone fractures with an ILN (Surg’X) is associated with a very good postoperative clinical outcome, a low perioperative and postoperative complication rate. Minimally invasive implantation is feasible in most cases, with no impact on the risk of complications. Our experience indicates that fluoroscopy is helpful during MINO procedures; however, further clinical studies are warranted to evaluate the safety and outcomes of this nail using a minimally invasive approach without fluoroscopic assistance.

Supplemental Material

Owner-specific questionnaire.

Footnotes

Accepted: 8 April 2026

Supplementary material

The following file is available as supplementary material:

Owner-specific questionnaire.

Conflict of interest

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The authors received no financial support for the research, authorship, and/or publication of this article.

Ethical approval

The work described in this manuscript involved the use of non-experimental (owned or unowned) animals. Established internationally recognised high standards (‘best practice’) of veterinary clinical care for the individual patient were always followed and/or this work involved the use of cadavers. Ethical approval from a committee was therefore not specifically required for publication in JFMS. Although not required, where ethical approval was still obtained, it is stated in the manuscript.

Informed consent

Informed consent (verbal or written) was obtained from the owner or legal custodian of all animal(s) described in this work (experimental or non-experimental animals, including cadavers, tissues and samples) for all procedure(s) undertaken (prospective or retrospective studies). No animals or people are identifiable within this publication, and therefore additional informed consent for publication was not required.

ORCID iD

Esther Deglume

Thibaud Mokrani

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Supplementary Material

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