Surgical repair of femoral neck fractures in two dogs and a calf

The surgical techniques employed in the repair of femoral neck fractures in two dogs and a Charolais calf are described. All the fractures were extracapsular; one of the dogs also had a fractured femoral diaphysis. For both dogs, exposure of the femoral neck was made from a dorsal approach after removal of the greater trochanter, while for the calf, a gluteal transection technique was used. All the fractures were successfully fixed using cortical screws, and in the case of the femoral diaphysis, a vitallium plate was used. All the animals were walking with minimal lameness eight weeks after surgery.     

Management of humeral and femoral fractures in dogs and cats with linear- circular hybrid external skeletal fixators

Linear-circular hybrid fixators were used to stabilize humeral and femoral fractures in 21 dogs and five cats. Twenty-two of 24 fractures with sufficient follow-up radiographic evaluation obtained union. Time to radiographic union ranged from 25 to 280 days (mean +/- standard deviation [SD] 110+/-69 days; median 98 days). Eleven animals developed minor and two dogs developed major pin and/or wire tract inflammation. Functional outcome was rated as excellent (n=16), good (n=5), and fair (n=3) at the time of final long-term assessment (range 4.5 to 60.0 months; mean +/- SD 28.4+/-15.4 months; median 28.5 months). Follow-up information was unavailable for two animals. Hybrid fixators were useful constructs for stabilization of humeral and femoral fractures, particularly fractures with short, juxta-articular fracture segments.     

Use of intramedullary fully-threaded pins in the fixation of feline and canine humeral, femoral and tibial fractures

Intramedullary fully-threaded pins were manufactured from an alloy of titanium, aluminium and vanadium in a fully-threaded style. Pins were produced in various diameters, ranging from 4 mm to 11 mm. Pin lengths varied from 5 cm to 22 cm. The proximal end of the pins was designed to fit into a hexagonal screwdriver, while the distal end was slightly tapered to allow for ease of entry into cancellous bone. Treatment using the fully-threaded intra- medullary pin was carried out in a total of 175 fractures of the humerus, femur, and tibia in 95 cats (bilateral femur in 1 case) and 77 dogs (bilateral femur in 2 cases). Radiographic follow-up for the cases was performed at monthly intervals. Non-union developed in one dog with a femoral fracture in which cerclage wire had also been used. Delayed healing and lameness were observed in two other dogs. Healing with excessive callus formation was observed in 16 dogs. However, there were not any problems noted in these dogs in regards to limb usage. Clinical and radiological results obtained for the remaining cases were found to be very good. Normal, complete fracture healing occurred between four to 14 weeks in dogs, and between four to 12 weeks in cats. Pins were removed upon observation of satisfactory functional and radiographic recovery. Pins could not be removed from 26 cats and 21 dogs as the owners had declined pin removal, or because the owners were lost to follow-up.     

Evaluation of surgical repair of humeral condylar fractures using self-compressing orthofix pins in 23 dogs

OBJECTIVE: To report short- and long-term clinical and radiographic outcomes in dogs with humeral condylar fractures repaired using self-compressing Orthofix pins. STUDY DESIGN: Retrospective evaluation with solicited long-term clinical and radiographic evaluations. ANIMALS: Twenty-three dogs with humeral condylar fractures. METHODS: Medical records and radiographs were reviewed. Owners were asked to return dogs for long-term clinical and radiographic evaluation. RESULTS: Dogs were aged 1.5-26 months (mean+/-SD, 5.8+/-5.0 months) with 20 dogs weighing <5 kg (mean, 3.6+/-2.8 kg). Of 21 dogs with immediate post-operative radiographs, 10 had anatomic reduction with the rest having either a step and/or gap at the articular surface. Kirschner wire migration and implant loosening were the most common post-operative complications. All fractures with adequate follow-up radiographic evaluations achieved union. Twelve of 13 dogs returned for long-term evaluation (mean, 19.0+/-18.5 months) were either sound (10 dogs) or had subtle, weight-bearing lameness (2). Fourteen dogs had radiographs >/=75 days after surgery (mean, 18.7+/-18.3 months), 8 dogs (57%) had no radiographic evidence of osteoarthritis (OA; mean OA score, 0.8; median 0), and all dogs had good or excellent limb function. CONCLUSIONS: Self-compressing Orthofix pins are suitable implants for the stabilization of humeral condylar fractures in small breed dogs. Implants were convenient and simple to use and complications were easily resolved. Dogs consistently had good long-term clinical and radiographic outcomes with no or minimal lameness and OA. CLINICAL RELEVANCE: Self-compressing Orthofix pins should be considered for the repair of humeral condylar fractures in small breed dogs.     

A technique for repair of femoral capital epiphyseal fractures in the dog

A new method for repair of femoral capital epiphyseal fractures in the immature dog is described. The technique employs two small AO/ASIF cortical screws inserted in lag fashion from the articular surface into the femoral neck. The screw heads are countersunk, so as not to project from the articular cartilage of the femoral epiphyseal fragment, While this is an early report it is hoped that it will prompt the use of the technique by others so that its long term assessment may be more rapidly determined than by one clinic working alone.     

The repair of humeral condylar fractures in the dog: a review of seventy-nine cases

The method of fixation of lateral condylar, medial condylar and intercondylar fractures of the humerus in 79 dogs is described. Follow-up examinations were carried out to evaluate the success of fracture repair.     

Use of external skeletal fixators in the repair of femoral fractures in cats

This paper reports the results of fixation of 35 femoral fractures in cats using an external skeletal fixator alone or in combination with supplementary devices. All the fractures healed. The average time to fixator removal was eight weeks and two days. The external skeletal fixator offers a method of repairing many types of femoral fractures in cats allowing sound orthopaedic principles to be maintained and producing a successful outcome.     

Modified intramedullary pin technique for repair of distal femoral physeal fractures in the dog and cat

A modified intramedullary pin technique for surgical repair of distal femoral physeal fractures in dogs and cats provided stability at the fracture site and allowed early range of motion. The fixation and stability of this technique was compared with that achieved with a multiple pin technique. Fixation failure did not occur in 11 animals treated by the modified intramedullary pin technique, whereas there were 2 failures in 13 patients treated by a multiple pin technique.     

Incomplete humeral condylar fractures in the dog

The details of eight dogs (11 elbows) referred to the authors with lameness relating to elbow pain associated with incomplete fracture of the humeral condyle were reviewed. In all cases, a diagnosis was reached by radiographic examination, with the pathognomonic feature being a radiolucent line, in the sagittal plane, through the condyle. Treatment involved placement of a transcondylar bone screw with or without bone tunnels being created parallel to this implant. Six dogs (nine elbows) made a complete recovery without subsequent complications.     

Fixation of humeral intercondylar fractures using a lateral plate in 14 dogs supported by finite element analysis of repair.

Fourteen Spaniels that presented with an intercondylar fracture of the distal humerus were managed using a lateral plate and an additional pin in twelve cases. Fixation of the fracture was achieved using a plate applied laterally which incorporated the transcondylar lag screw in the most distal hole. Of the 14 cases, two had poor results, one of which was a bilateral case, whilst the remaining 12 cases had good or very good results with only occasional stiffness or lameness. Finite element (FE) modelling of a distal humerus was generated, and loading of fracture repairs using a lateral plate and caudal plate was completed in a comparative study to determine which fixation method resisted micro-motion most effectively. Finite element analysis revealed that the lateral plate fixation provided significantly more resistance to micro movement at the fracture site that the caudal plate fixation, with 40% more micro-motion in the latter.     

Surgical repair of femoral fractures in New World camelids: five cases (1996-2003)

Five New World camelids were admitted to the Western College of Veterinary Medicine between 1996 and 2003 for evaluation of femoral fractures. There were three alpacas and two llamas. Four of the animals were female and three were less than 3 months of age. Fracture configurations consisted of distal physeal fractures (three), a comminuted diaphyseal/metaphyseal fracture, and a transverse diaphyseal fracture. Fractures were diagnosed with a combination of physical examination and radiographs in all cases. All five fractures were repaired with internal fixation and three animals were discharged from the hospital with fractures that healed. One cria underwent successful internal fixation but died from pulmonary oedema during recovery from anaesthesia. Postoperative complications were rare and limited to inadequate fracture stability in one alpaca and prolonged recovery to weight bearing in another. One llama with a comminuted metaphyseal fracture, repaired with a 4.5 mm dynamic compression plate, subsequently had catastrophic failure of the bone 17 days after surgery. Overall the clients were pleased with the outcome of discharged animals. Although femoral fractures are considered rare, they pose a unique opportunity for the large animal veterinarian to successfully achieve fracture union with the aid of internal fixation.     

Experimental use of polyamide bands in combination with intramedullary pinning for repair of oblique femoral fractures in rabbits

OBJECTIVE: To evaluate the use of polyamide bands, manufactured for securing electrical cables, for repair of oblique femoral fractures in rabbits. STUDY DESIGN: Experimental study. ANIMALS: Twelve nulliparous, 21-25-week-old, California female rabbits. METHODS: Rabbits were divided into 3 groups (n=4) and studied for 14, 28, or 56 days. A Z-shaped mid-diaphyseal femoral osteotomy was repaired with a 2.5 mm intramedullary pin and a polyamide 6.6 cerclage band. Healing was evaluated at intervals by physical examination, limb use, femoral radiographs, and callus histology. RESULTS: Rabbits had early limb use with good wound healing. From the 1st day, movement of the hip and stifle joints was satisfactory. Radiographically, fractures were healed at 28 days. Histologically, there was no foreign body reaction and bone healing was normal. CONCLUSION: Nylon cerclage band application was accomplished easily, maintained reduction, and resulted in good healing and limb use. CLINICAL RELEVANCE: Sterilized nylon bands, manufactured for electrical use, can be used for cerclage in rabbits.     

Y-T humeral fractures with supracondylar comminution in five cats

Five cats with Y-T fractures of the humeral condyle were reviewed. Breeds presented included domestic shorthair (four cats) and Maine Coon (one cat). Age ranged from two to 16 years. All the cats were neutered males. A road traffic accident was suspected in all cases. Four of the fractures were severely comminuted and one fracture had four fragments. The fractures were repaired via combined medial and lateral approaches. Fixation of the epicondylar ridges was performed using buttress plates in four cases and neutralisation plates in one case. The intracondylar fracture was stabilised using a 2.7 mm lag screw in four cases and a 3.5 mm lag screw in the other. A corticocancellous bone graft was applied in two cases. The intracondylar fracture was accurately reduced in all cases. Complete radiographic healing was documented in two cases 6 and 11 weeks following surgery. Failure of the fixation occurred in the most severely comminuted fracture five days postoperatively. Surgical revision was not performed, and the limb was amputated. Three cats were free of lameness and had resumed outdoor activities at follow-up (five to eight months after surgery). Marked lameness due to loss of elbow movement was observed in the other case.     

Pathophysiology of humeral fractures in a sample of dairy heifers

AIMS: To investigate the pathophysiology of humeral fractures in first-lactation dairy heifers in the North Island of New Zealand.

METHODS: Ten 2-year-old dairy heifers with humeral fractures were subject to euthanasia and the fractured and non-fractured contralateral humeri were collected. Humeri were also collected from 10 unaffected 2-year-old dairy heifers sent for slaughter. Humeri from heifers with and without fractures were examined using computed tomography (CT), and four slices of the diaphysis and lower metaphysis (D1–4) were analysed using the Bone J plug-in for Image J. The humeri were sectioned sagittally and 5?mm bone slabs were processed for histopathology.

RESULTS: There were no differences in bone length between the humeri from heifers with or without fractures (p=0.31). Median cortical bone mineral density at D1 was increased in humeri from affected compared with unaffected heifers (810 vs. 783?mg/cm³; p=0.03), cortical area at D1 was reduced (816 vs. 1,037?mm²; p=0.04), the median stress strain index, a calculated theoretical measure of bone strength, at D1 was decreased (7,288 vs. 9,072?mm³; p<0.01), and the median ratio of overall bone volume (BV) to total volume (TV) was decreased (0.32 vs. 0.38; p<0.01). The median periosteal circumference at D1 was also reduced in humeri from affected compared with unaffected heifers (151 vs. 173?mm; p<0.01). Using a binary logistic regression model, BV/TV was the only variable associated with humeral fractures (p=0.03).In nine of 10 fractured humeri the fracture appeared to have started just distal to the head of the humerus and spiralled distally down the diaphysis to end just above the humeral condyles. Histopathological findings included a reduction in the number, and thickness, of trabeculae in the metaphysis; metaphyseal growth arrest lines, and osteoclastic resorption in fractured humeri. Concentrations of copper in serum from four of five animals with fractures were within, and one was below, normal reference ranges, while concentration of copper in the livers of three heifers with fractures were below adequate ranges.

CONCLUSIONS: The CT and histological findings were consistent with a diagnosis of osteoporosis. We propose that humeral fractures in dairy heifers are associated with osteoporosis, possibly as a result of insufficient deposition of bone during growth because of protein-calorie malnutrition. Increased osteoclastic resorption of bone associated with calcium mobilisation for lactation, and periods of copper deficiency may contribute to bone weakening.