Repair of Comminuted Fractures of the Proximal Ulna and Olecranon in Young Horses Using Tension Band Plating

A report of the successful surgical repair of 3 ulnar fractures in young horses is presented and the adaptation of dynamic compression plating to the treatment of these fractures is discussed.     

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.     

Medial Plating for the Repair of Middle and Distal Diaphyseal Fractures of the Humerus in Dogs

Six middle and distal humeral shaft fractures in dogs were repaired by the application of a bone plate along the medial shaft of the humerus. In all animals, clinical and radiographic evidence of normal bone healing was observed. The bone plate and ancillary implants were removed from five dogs by 10 months. In none of the six dogs were any untoward effects of placing the bone plate along the medial shaft of the humerus detected nor were there any difficulties encountered with the medial humeral soft tissues.     

Evaluation of an Interfragmentary Compression System for the Repair of Equine Femoral Capital Physeal Fractures

Femoral neck and proximal epiphyseal lengths were measured in 37 femurs from 19 cadaver foals that were 1 day to 12 months old to determine the applicability of a human interfragmentary compression system to equine femoral capital physeal fractures. Because components of the implant system are available only in fixed sizes, its use was possible in foals older than 5 weeks of age, but not in younger foals. The 135 degree angle plate conformed best to the equine femur. Femoral capital physeal fractures were created surgically and repaired with the implant system in three foals. Fracture stability was evident clinically and radiographically in all three foals until euthanasia at month 3. At necropsy, the treated femurs were 4, 8, and 27 mm shorter than their mates. Epiphyseal viability was verified in all three foals by tetracycline deposition and new appositional bone growth comparable with that in the contralateral control epiphyses. The treated capital physis was open but reduced in thickness in one foal, disorganized in one foal, and closed in one foal. Fixation by compression with the implant system resulted in stability sufficient for fracture healing and maintenance of epiphyseal viability, although it was associated with reduced longitudinal femoral growth.     

Repair of a type IV Monteggia fracture in a foal

A Monteggia fracture is a humero-radial luxation combined with a fracture of the ulna. It is a rare injury, infrequently reported in the horse. This case report describes the surgical repair of such a fracture in a 4-month-old filly.     

Repair of Bovine and Equine Mandibular Fractures

Clinical findings, surgical repair and postsurgical care of a unilateral fracture of the mandible of a bull and of a bilateral mandibular fracture in a horse are described. Compression plating limited the pain suffered by the animals and resulted in a quick return to function of the mandibles.     

Feline Ilial Fractures: A Prospective Study of Dorsal Plating and Comparison with Lateral Plating

Objective— To (1) report a technique for repair of feline ilial fractures using a dorsally applied bone plate and (2) compare outcome with cats treated by a lateral plate.
Study Design— Prospective study.
Animals— Cats (n=10) with iliac fractures.
Methods— Cats with ilial fractures (January 2005–December 2006) were treated by application of a dorsally applied bone plate. Immediate postoperative radiographs were compared with those taken 4–6 weeks later to assess screw loosening, screw purchase, and pelvic canal narrowing. Owners were contacted for medium-term (>3 month) follow-up. Data were compared with a report of outcome after lateral plating (LP) in 21 cats.
Results— Mean (± SD) screw purchase (89 ± 11 mm) was significantly greater ( P <.01) with a dorsal plate compared with a lateral plate (33 ± 8 mm). Significantly more screws ( P <.01) were used with a dorsal plate (median, 7) compared with a lateral plate (median, 6). Significantly less postoperative pelvic canal narrowing developed in the dorsal plating group between postoperative and 4–6-week follow-up radiography compared with the LP group (2% versus 15%, P <.01).
Conclusion— Dorsal plating of feline ilial fractures results in significantly less screw loosening and pelvic canal narrowing at 4–6 weeks after surgery compared with LP.
Clinical Relevance— Dorsal plating of feline iliac fractures may reduce complications associated with pelvic canal narrowing such as constipation and megacolon.     

Application of a Hook Plate for Management of Equine Ulnar Fractures

Closed fractures of the proximal aspect of the ulna were repaired in 10 horses younger than or equal to 6 months of age by application of a hook plate using a tension band principle. Ulnar fractures were classified as type 1A (2 horses), type 1B (4 horses), type 2 (1 horse), type 3 (1 horse), and type 4 (2 horses); all fractures had displacement of a proximal fragment. Complications were implant deformation (4 horses), screw pullout (1 horse), osseous sequestration (1 horse), ulnar fracture through a hole used to apply a tension device (1 horse), and metacarpophalangeal deformity associated with a displaced anconeal fragment (1 horse). Hook deformation was likely associated with failure to insert screws in all of the proximal holes of the plate and also in two horses, possibly with difficult recovery from anesthesia. Seven horses were discharged from the hospital and were being used for athletic activities. Insertion of the hook through the tendon of the triceps muscle and incorporation of the fragment within the hook can be used to effectively reduce and stabilize a fragment that might otherwise not hold screws.     

Ulnar Subluxation Following Repair of a Fractured Radius in a Foal

Compression plating of a transverse mid-diaphyseal radial fracture in a 4-month-old Arabian filly resulted in subluxation of the ulna. Two screws transfixed the radius to the ulna and resulted in synostoses. This was followed by uncoordinated growth of the radius and ulna, and subluxation of the ulna. Progressive remodeling of the ulna subsequently reestablished articular congruity between the humerus and ulna.     

Distal Humeral Salter Harris (Type II) Fracture Repair by an Ulnar Osteotomy Approach in a Horse

Objectives: To report repair of a comminuted distal humeral type II Salter–Harris fracture using an ulnar osteotomy approach and locking compression plates (LCP). Study Design: Case report. Animal: A 3‐month‐old Standardbred filly with a type II Salter–Harris fracture of the distal humerus. Methods: Radiographic and computed tomography examinations were performed to assist surgical planning. The distal humeral fracture was approached by an ulnar osteotomy and repaired using a 7‐hole broad LCP and screws inserted in lag fashion. The osteotomy was subsequently repaired using a 7‐hole narrow LCP. Results: The distal humeral fracture was successfully approached and stabilized by an ulnar osteotomy approach. At 6‐month follow‐up, the filly was ambulating comfortably with a normal cosmetic appearance. Conclusions: An ulnar osteotomy approach was readily performed and allowed for repair of a type II Salter–Harris fracture of the distal humerus. Clinical Relevance: The equine distal humerus can be accessed readily using an ulnar osteotomy approach. LCPs allow for repair of complicated fractures that have previously been associated with a grave prognosis.     

A New Technique for Repair of Comminuted Diaphyseal Fractures

The broad lengthening plate (BLP) was used to repair eleven comminuted diaphyseal fractures. It offers the advantage of increased implant strength over the area of comminution where bending forces are greatest. The BLP also provides an additional screw hole on each end of the implant as compared to a conventional plate of similar size. Application of the BLP in the proposed fashion improves operating efficiency by reducing operating time and tissue handling which minimizes complications to bone healing.     

The Closed Reduction and Repair of Radio-Ulna Fractures in the Dog

Abstract— The method of treating clinical cases of radio-ulna fractures and the results obtained are described.
Résumé— L'auteur décrit le procédé employé pour trailer les fractures radio-cubitales, ainsi que les résultats obtenus.
Zusammenfassung— Die Methode zur Behandlung klinischer Fa!Ie von Frakturen an Elle und Speiche und die dabei gewonnenen Ergebnisse werden beschrieben.     

Medial Epicondyle Osteotomy as an Approach to Repair of Medial Femoral Condyle Fractures in the Dog

Fracture of the medial femoral condyle in three dogs is described. This injury resulted in lateral (varus) instability, which was difficult to differentiate from a lateral collateral ligament tear. Radiographs and surgical exploration were necessary to differentiate the two conditions. A medial femoral epicondyle osteotomy was used in two cases to expose the fracture. This exposure technique is advantageous because it allows early return to functional use of the injured limb by eliminating postoperative splintage.     

Nonsurgical Management of Ulnar Fractures in the Horse: A Retrospective Study of 43 Cases

Forty-three cases of nonsurgically managed ulnar fractures in the horse were reviewed. Twenty-three per cent of the horses were euthanized, 44% survived but were unsound, and 33% of the horses were sound when surveyed 6 months to 11 years following fracture. Best results were obtained when treating distal semilunar notch fractures (70% sound). Prognosis was poorest for horses with fractures of the olecranon affecting the semilunar notch (0% sound).     

Delayed Repair of an Extensive Lip Laceration in a Colt Using an Estlander Flap

A vascularized full-thickness Estlander flap was used to repair a defect involving approximately 40% of the left lower lip of a colt. Postoperative problems were (1) providing nutritional support, (2) minimizing movement at the surgical site, and (3) partial wound dehiscence resulting in a salivary fistula. The surgical site healed well and the colt was left with a fully functional and cosmetic lower lip.     

Early Experience With the Use of an Interlocking Nail for the Repair of Canine Femoral Shaft Fractures

Static locked nailing was used to repair fractures of the femoral diaphysis in 15 dogs. The implant consists of a 5, 6, or 7 mm diameter stainless steel rod made up of two parts: the body of the nail, in which there are 13 threaded holes, and a piece without holes that contains a slot for anchoring the jig. Good limb function was obtained after less than 3 weeks in 12 dogs and these dogs remained sound throughout the study. Radiographic examination revealed fracture healing in 11 of the dogs, between 8 and 16 weeks after surgery. One dog was not returned for follow-up evaluation until 22 weeks after surgery; complete healing was apparent from radiographic examination. The remaining three dogs had to have additional operations, one because of lameness caused by excessive length of the distal screws, one because of a nonunion, and the third because of a sequestrum. Fracture healing in these dogs was observed at 18, 21, and 24 weeks respectively. Loosening of one screw and angulation of the bone occurred in one dog. These complications had no adverse effects on clinical outcome.     

Surgical Repair of Tibial Tuberosity Avulsion Fractures in Four Horses

Four horses, 2 to 17 years old, were treated for unilateral avulsion fractures of the tibial tuberosity. Two horses were treated successfully with tension band wiring or plating in combination with lag screw fixation. One horse was euthanatized because of implant failure during recovery and one was euthanatized on day 11 because a longitudinal fracture of the tibial tuberosity occurred through the plane of the screws used for stabilization.     

Cranial Approach to the Humerus for Repair of Fractures in Horses and Cattle

A cranial approach to the humerus was developed for application of a compression plate for repair of comminuted humeral fractures in a weanling foal, a calf, a heifer, and a mature cow. An incision was made from the cranial portion of the greater tubercle of the humerus to the radius. The cranial aspect of the humerus was exposed by retraction of the brachiocephalicus muscle and blunt dissection between the biceps brachii and brachialis muscles. A second plate was applied laterally in the heifer and cow by retraction of the brachialis muscle and elevation of the extensor carpi radialis muscle. Successful fracture reduction, alignment, and stabilization were achieved in all four animals.