Tibiotarsal fracture and neurologic problems of a black-eared kite (Milvus migrans).

A wild-caught black-eared kite (Milvus migrans) was presented with a fracture of the right fibula and tibiotarsus that was repaired using combined crossed pins and a rigid cast technique. The fracture healed well; however, because the bird was not able to regain full use of its legs, radiographs were taken, which revealed a translucent structure involving the vertebral bodies of the notarium-synsacrum area. The condition of the bird deteriorated over the following days, and it was euthanized. Postmortem examination confirmed two bony intumescences involving the last vertebra of the notarium and the synsacrum. The vertebral canal, on a cut surface, was restricted, and the spinal cord was compressed.     

Repair of an Ulnar Fracture With Radial Luxation in a Horse

An ulnar fracture with radial luxation (Monteggia fracture) was repaired in a horse. Reduction of the radial luxation was difficult, requiring 2 incisions, limb traction, neuromuscular blockade, and direct radial manipulation. The ulnar fracture was repaired by use of a dynamic compression plate. Three months postoperatively, the horse was free of any apparent lameness.     

Healing of patellar fractures in two kittens

Two kittens aged between four and five months were presented having sustained patellar fractures. In both cases, healing was subsequently documented radiographically; this has not been reported previously in the literature. One kitten had bilateral patellar fractures - the symptomatic right stifle was treated with a pin and tension-band-wire which later failed, at which point partial patellectomy was performed. The fracture of the left patella was minimally displaced and was treated conservatively. A radiograph of the left patella taken eleven months after initial presentation showed complete healing of the fracture. The second case was treated surgically with a circumferential wire; healing of the fracture was demonstrated radiographically at twelve weeks postoperatively. Radiographic images taken five weeks postoperatively had shown some narrowing of the fracture gap. These two cases demonstrate that bony union of patellar fractures can be documented, given a long enough duration of radiographic follow-up; circumferential wire was an effective treatment in a displaced fracture, and conservative treatment resulted in complete healing of a minimally displaced fracture.     

Lag Screw Fixation of a Patellar Fracture in a Horse

A vertical fracture involving the medial one-third of the patella of a yearling filly was successfully treated by lag screw fixation. Three months postoperatively the fracture was healed and the filly was clinically sound.     

Basic mammalian bone anatomy and healing.

The goal of any method of fracture repair should be the early return to function of the patient with minimum postoperative morbidity. This is accomplished most optimally by having a basic understanding of the biology of bone healing and by being familiar with the musculoskeletal system of the species before attempting fracture repair. Applying the fundamental principles of mammalian bone anatomy and physiology to the bird ensures the best prognosis possible and minimizes postoperative complications in the avian patient.     

Fracture healing after stabilization with intramedullary xenograft cortical bone pins: a study in pigeons

OBJECTIVE: To investigate the effectiveness of intramedullary xenograft cortical bone pins compared with stainless steel Kirschner wire for the repair of a standardized avian humeral fracture. STUDY DESIGN: Prospective randomized study. SAMPLE POPULATION: Thirty mature pigeons (Columba livia). METHODS: Birds were randomly assigned to 3 groups. Transverse mid-diaphyseal humeral fractures were created in 1 humerus in each bird. Fractures were stabilized with intramedullary ostrich or canine xenograft cortical bone pins or Kirschner wire. Radiographic, histological, and biomechanical assessments were used to compare fracture healing 6 weeks after fracture stabilization. The contralateral humerus of each bird was used as a control. RESULTS: All fractures healed regardless of intramedullary pin type. There were no statistically significant biomechanical differences among groups or within groups. Xenograft cortical bone pins induced a mononuclear inflammatory reaction that did not impair bone healing. Bones stabilized with intramedullary cortical bone pins had more periosteal callus and inflammation at the fracture site than bones stabilized with stainless steel Kirschner wires. CONCLUSIONS: Intramedullary xenograft cortical bone pins, derived from mammalian or avian sources, appear to represent an alternative for the repair of avian humeral fractures. CLINICAL RELEVANCE: Intramedullary xenograft cortical bone pins are biodegradable and may reduce the need for additional surgery to remove implants after fracture healing.     

Clinical evaluation of the CRIF 4.5/5.5 system for long-bone fracture repair in cattle

OBJECTIVE: To report clinical evaluation of the clamp rod internal fixator 4.5/5.5 (CRIF 4.5/5.5) in bovine long-bone fracture repair. STUDY DESIGN: Retrospective study. ANIMALS: Cattle (n=22) with long-bone fractures. METHODS: Records for cattle with long-bone fractures repaired between 1999 and 2004 with CRIF 4.5/5.5 were reviewed. Quality of fracture repair, fracture healing, and clinical outcome were investigated by means of clinical examination, medical records, radiographs, and telephone questionnaire. RESULTS: Successful long-term outcome was achieved in 18 cattle (82%); 4 were euthanatized 2-14 days postoperatively because of fracture breakdowns. Two cattle had movement of clamps on the rod. Moderate to severe callus formation was evident in 11 cattle 6 months postoperatively. CONCLUSIONS: Movement of clamps on the rod was recognized as implant failure unique to the CRIF. This occurred in cattle with poor fracture stability because of an extensive cortical defect. The CRIF system may not be ideal to treat metacarpal/metatarsal fractures because its voluminous size makes skin closure difficult, thereby increasing the risk of postoperative infections. CLINICAL RELEVANCE: CRIF cannot be recommended for repair of complicated long-bone fractures in cattle.     

Femoral fracture repair and sciatic and femoral nerve blocks in a guinea pig

A four‐month‐old, entire male guinea pig was presented for surgical repair of a closed oblique femoral fracture. Analgesia was provided with 30 µg/kg buprenorphine intramuscularly (im) four times a day and 0 · 3 mg/kg meloxicam subcutaneously once a day. The following day, anaesthesia was induced and maintained with 100 µg/kg medetomidine im, 20 mg/kg ketamine im, 30 µg/kg buprenorphine im and isoflurane in oxygen. Femoral and sciatic nerve blocks were performed with bupivacaine. The fracture was reduced and aligned using an intramedullary 1 · 4 mm K‐wire and a 3 metric polydioxanone cerclage. Three weeks postoperatively remodelling and callus formation was documented, with no evidence of complications. Complete union was present 14 weeks postoperatively.     

Anesthetic management of ostriches.

We evaluated and characterized several anesthetic induction protocols used to facilitate intubation and anesthetic maintenance with isoflurane in 7 adult ostriches and 1 juvenile ostrich. Induction protocols included IV administration of zolazepam/tiletamine, IV administration of diazepam/ketamine with and without xylazine, IV administration of xylazine/ketamine, IM administration of carfentanil or xylazine/carfentanil, and mask induction with isoflurane. General anesthesia was maintained with isoflurane in 100% oxygen for various procedures, including proventriculotomy (6 birds), tibial (1 bird) or mandibular (1 bird) fracture repair, and drainage of an iatrogenic hematoma (1 bird). Heart rate and respiratory rate varied greatly among birds. The arterial blood pressure values recorded from 6 of the birds during maintenance of general anesthesia were higher than values recorded for most mammalian species, but were comparable to values reported for awake chickens and turkeys.     

Salter-Harris type III fractures of the distal humerus in two dogs

Salter-Harris type III fractures of the distal humerus in a four-month-old male Labrador Retriever and a male crossbreed dog (estimated to be 3.5-months-old) are reported. Both fractures were treated with open reduction and interfragmentary compression by lag screw fixation. Both fractures healed and full limb use was regained at four weeks postoperatively. The occurrence of this unusual fracture type may be related to the physeal closure pattern of the distal humeral physis, and a different mechanism of injury compared to the more common Salter-Harris type IV fracture seen in this region.     

FRACTURED SCLERAL OSSICLES IN A RED TAIL HAWK

Following head trauma, the left globe of a Red Tail Hawk showed demonstrable indentation on palpation. Recurrent anterior chamber collapse and reformation dependent on head position was the most significant clinical finding. A fracture of the scleral ossicles in the caudal portion of the scleral ring was identified in the rostrocaudal radiograph of the skull. Conservative management of the fracture resulted in phthisis bulbi. Fractured scleral ossicles have been shown radiographically in the enucleated globe but have not been previously demonstrated in the eye of the living bird.     

Use of Bone Plate for Treatment of an Open Third Metacarpal Fracture in a Foal

A 7-month-old, 180-kg, female foal was presented with open diaphyseal fracture of the left third metacarpal bone. The fractured limb was stabilized preoperatively with external coaptation. Open reduction and internal fixation were done using 4.5-mm broad dynamic compression plate, which was applied in a neutralization manner. Postoperatively, external support with padded bandage reinforced with gutter splint made of fiber glass was provided. The incisional infection and the contaminated wound on medial aspect of the metacarpal were managed with regular dressing. Complete radiographic union and functional recovery were noticed by 4 months postoperatively. Open diaphyseal fractures can be managed by proper preoperative fracture stabilization, wound management, and fixation methods using bone plate and external coaptation.     

Type IV Monteggia fracture in a cat

A one-year-old neutered male cat was referred for a grade IIIA open radius and ulna fracture. The mid-diaphyseal radial and ulnar fractures were associated with lateral radio-humeral and radio-ulnar dislocations. From these abnormalities, a diagnosis of type IV Monteggia fracture was made. The annular ligament was found to be intact on examination and the radial head was correctly positioned and stable after fracture reduction and plate fixation. Eighteen months postoperatively, the cat did not exhibit any signs of lameness or any signs of pain on palpation and mobilisation. Signs of mild osteoarthritis were present on radiographs. Type IV Monteggia fractures are very rare in animals. The combination of a radial head dislocation with an intact annular ligament is uncommon. This pattern allowed a single reconstruction with two plates without a radio-ulnar screw.     

Multiple rib fracture in a neonatal foal using a nylon strand suture repair technique

OBJECTIVES: To report rib fracture repair using the Securos Cranial Cruciate Ligament Repair System (SCCLRS; Securos Veterinary Orthopedics, Charlton, MA) in a neonatal foal. STUDY DESIGN: Case report. ANIMALS: A 1-day-old Standardbred foal with fracture of left ribs 2-9. METHODS: Four days after admission the foal was anesthetized and rib fractures were repaired using open reduction and the SCCLRS. RESULTS: Rib fractures were successfully stabilized and the foal was discharged 7 days postoperatively without further complications. CONCLUSIONS: The SCCLRS provided a straightforward, effective method of rib fracture repair in neonatal foals. CLINICAL RELEVANCE: Effective rib fracture repair in neonatal foals can be achieved with the SCCLRS.     

Triple pelvic osteotomy for the treatment of pelvic canal stenosis in a cat

A mature female domestic shorthaired cat with obstipation as a result of pelvic canal narrowing due to a pelvic fracture malunion was treated by triple pelvic osteotomy to widen the canal. The right hemipelvis was moved laterally and a modified bone plate was applied to the right ilium. A mild lick dermatitis occurred over the dorsum of the hind paw seven days postoperatively but resolved without treatment. The cat made an uneventful recovery without recurrence of the obstipation.     

Management of a femoral fracture complicated by clostridial myositis

A clinlcal case of clostrldlai myosltls secondary to a comrnlnuted femoral fracture Is descrlbed. This case is unusual because, despite the severe degree of obvlous muscle necrosls and gas productlon, the dog had mlnlmal slgns of systemic toxiclty. Unlon of the fracture was achleved but six months postoperatively muscular contracture had resulted In permanent stlfle extension.     

Postoperative analgesic efficacy of meloxicam compared to tolfenamic acid in cats undergoing orthopaedic surgery

Objectives : To investigate the efficacy of meloxicam or tolfenamic acid administered preoperatively and postoperatively (five days in total) to cats undergoing surgical fracture repair. Methods : Eighty-eight otherwise healthy cats were matched according to fracture site and then randomly allocated to one of two groups, receiving 0·2 mg/kg meloxicam by subcutaneous injection (group M) or 1·5 to 3 mg/kg tolfenamic acid orally (group T) before anaesthesia. Analgesia was continued with 0.05 mg/kg oral meloxicam once daily or 1·5 to 3 mg/kg oral tolfenamic acid twice daily for four days postoperatively. Pain was assessed by a blinded observer using visual analogue scales and a functional limb score. The drug administrator assessed feed intake and palatability of the treatment. Results : Data from 66 cats were analysed. Visual analogue scale pain scores and functional limb scores decreased over time in both groups but were not significantly different between treatments. Feed intake was similar in both groups. Meloxicam was significantly more palatable than tolfenamic acid on all treatment days. Clinical Significance : Meloxicam and tolfenamic acid demonstrated comparable analgesia, without clinically observable side effects. Meloxicam may be associated with superior compliance in clinical practice due to the higher palatability and once daily treatment resulting in better ease of administration.     

POWER DOPPLER ASSESSMENT OF THE NEOVASCULARIZATION DURING UNCOMPLICATED FRACTURE HEALING OF LONG BONES IN DOGS AND CATS

The aims of this prospective study were to test the feasibility of assessing neovascularization with power Doppler ultrasonography and to investigate its usefulness to follow fracture healing of long bones in dogs and cats. A total of 51 patients (44 dogs and seven cats) were followed. Fracture types differed from simple to comminuted. Therapy ranged from external coaptation to plate osteosynthesis. Patients were followed with radiography, B-mode real time and power Doppler ultrasonography every 2-4 weeks until the fracture was healed. All fractures healed uneventfully. A semi-quantitative numerical score based on signal intensity, vessel area, and number of Doppler signals was assigned and the mean value was used to compare patients and examinations. Time postoperatively was divided into periods of 10 days. No Doppler signal was present during the first 10 days. The mean of the scores was highest between 11 and 20 days postoperatively and the median of the scores peaked between 21 and 30 days. A gradual decrease was seen thereafter. The mean of the scores was zero at 71-80 days and the median at 51-0 days postoperatively for the grouped results. In all positive power Doppler examinations, signals were present in and close to the callus. In seven patients (five dogs and two cats) signals were also present in the peripheral soft tissues in one of the follow up examinations. The normal healing process of fractured bones can be visualized using power Doppler ultrasonography and follows a distinctive time-dependent pattern.     

Traumatic craniolateral shoulder luxation and fracture of the lesser tubercle of the humerus in a dog

A five-year old, spayed female, Bearded Collie was presented with a 24-hour history of non-weight-bearing lameness of the right thoracic limb after sustaining vehicular trauma. Radiographs revealed a craniolateral scapulohumeral luxation and a distally and medially displaced fracture of the lesser tubercle of the humerus. Open reduction and internal fixation of the fracture was achieved with lag screw fixation and an anti-rotational Kirschner wire. Surgical repair resulted in compression across the fracture line, anatomic reduction of the articular surface, and a stable scapulohumeral joint following reduction of the humeral head in the glenoid. Six weeks postoperatively, the patient exhibited no evidence of pain or lameness on the right thoracic limb and radiographs revealed complete healing of the fracture and normal articulation of the scapulohumeral joint. This is the first report of a lesser tubercle fracture associated with a craniolateral shoulder luxation. Surgical intervention resulted in the return of full shoulder joint function in this dog.     

Locking compression plate osteosynthesis of sacral fractures in three heifers

Objective: To describe a technique used for reduction and internal fixation of sacral fractures in cattle. Study Design: Case series. Animals: Three heifers aged 19–32 months with deformation of the tail head and tail paralysis attributable to a closed fracture of S5 or S4 and S5. Methods: Fractures were reduced and repaired under general anesthesia. A narrow, 6–10‐hole, locking compression plate (LCP) was placed on the spinous processes of S5 and the first coccygeal (Co1) using 5.0 mm locking head screws. Follow‐up inquiries were made by telephone (3/3), and cows were examined clinically and radiographically 2 (1 cow) to 9 (1cow) months postoperatively. Results: No complications were encountered. The range of movement of the tail improved so that soiling of the tail during defecation was no longer a problem. In all heifers, the normal top line was restored and there was no narrowing of the pelvic canal. Unassisted calving occurred in all heifers, and follow‐up radiographs for 2 cows showed complete fracture healing. Conclusion: LCP‐osteosynthesis of the spinous processes provided sufficient stability for internal fixation of sacral fractures. Marked improvement in tail function occurred postoperatively without decompression by laminectomy.