Kirschner Wire Fixation of Lateral Humeral Condylar Fractures in Small Dogs

Successful treatment of humeral condylar fractures requires accurate reduction and rigid internal fixation. Lag screw fixation is the traditional method of repair for these fractures. An alternative method using Kirschner wire fixation was used to repair humeral condylar fractures in eight small dogs. Long-term follow-up was available for seven dogs: all were reported to have normal limb function.     

Use of an external ring fixator for correction of an acquired angular limb deformity in a donkey

Numerous techniques for surgical correction of angular limb deformities in horses involving an osteotomy of the affected bone and stabilization with an internal fixation device have been described. However, because the osteotomy typically has to be performed at the level of the physis, leaving little bone between the physis and the nearest joint, stabilizing the osteotomy by use of internal fixation devices may be difficult. In horses with severe chronic angular limb deformities, the amount of soft-tissue contracture may make it impossible to correct the deformity during a single procedure without causing stretch injuries to the adjacent tendons and neurovascular structures. Adjustable external ring fixators incorporating hinged rods on 1 side of the limb and an angular motor assembly on the other may be useful for treatment of severe chronic angular limb deformities in younger equids, because they allow for gradual correction of the deformity.     

Principles of conservative fracture management: splints and casts

Splint and cast application is an often overlooked form of fracture management in the current era of internal fixation and external skeletal fixation. External limb splintage is a "tried and true" method; however, there are specific indications for the use of this technique. Splints and casts have a place in our armamentarium of fracture management and when appropriately used under the correct circumstances, fracture healing is expected to be similar to that observed using other means of fracture fixation.     

Femoral Head and Neck Fractures in the Dog and Cat: A Review of 115 Cases

Case histories of 115 dogs and cats with fractures of the femoral head or neck, were reviewed; these animals had been presented to the Ohio State University Veterinary Hospital between 1969 and 1976. Signalment, fracture type by anatomic location, fracture to fixation interval, surgical approaches used, methods of surgical repair, surgical complications, and final results of surgical repair were examined. Avascular necrosis of the femoral head was not a clinically significant problem following internal fixation in this study. Most animals had very good to excellent limb function following fracture repair.     

猫股骨髁粉碎性骨折的手术内固定

为诊断1只高处坠落导致跛行的患猫,采取了临床基本检查、实验室检查及DR影像学检查,确诊为左后肢股骨髁粉碎性骨折。根据检查结果制定手术治疗方案,采用交叉克氏针配合拉力螺钉进行手术内固定。后期回访患猫骨折断端愈合良好,运动功能逐步恢复,表明上述骨折固定方法有效。     

Limb alignment of pes valgus in a giant breed dog by plate-rod fixation.

A 2-year-old, female, neutered Newfoundland presented with pelvic limb lameness due to a distal tibial valgus deformity. A left distal fibula ostectomy and disto-medial tibial cuneiform ostectomy were performed with reduction and stabilisation using plate-rod internal fixation. Following surgical correction of the deformity the dog regained good functional mobility of the limb.     

The Lightcast system of limb immobilisation

Extract

Prior to the use of internal devices for reducing and immobilizing limb fractures, external splints and plaster casts were used. In such circumstances it was necessary to carefully assess the value of the animal and the nature of the problem, before deciding if treatment was warranted. Careful assessment is still important to-day; however, with modem internal fixation equipment, less favourable cases are attempted. In general most failures result from inadequate support during recovery from anaesthesia.     

Treatments for feline long bone fractures.

Orthopedic injuries in cats occur frequently and are amenable to a variety of surgical and nonsurgical treatment options. Complications and delayed healing have been reported and can be attributed to improper fixation. Clinicians have numerous options ranging from external to internal fixation, casting, cage rest, and limb amputation. The goals of reducing patient morbidity and obtaining a return to normal function warrant the selection of an appropriate treatment based on the nature of the lesion, available expertise, and directives of the client.     

Comparison of fixation methods for treatment of long bone fractures in llamas and alpacas

Objective: To determine outcome after repair of long bone fractures in llamas and alpacas. Study Design: Case series. Animals: Llamas (n=11) and alpacas (8). Methods: Medical records (1998–2008) of camelids with long bone fractures were reviewed for history, repair method, and complications. Outcome was also assessed by owner telephone questionnaire. Results: Mean age at repair was 39 months. There were 8 males and 11 females. Fracture distribution was tibia (n=6), metatarsus (5), metacarpus (4), radius and ulna (2), humerus (1), and femur (1), with 13 closed and 6 open fractures. Fracture repair was by internal fixation (n=11), external fixation with a transfixation pin cast (5), external coaptation (2), and cross‐pinning (1). In 1 llama, the limb was amputated to revise a failed external fixation repair. Seventeen animals (89%) were discharged, and 2 were euthanatized. Outcome was available for 13 animals: 9 were used for breeding and 4 as pets. Fewer major complications occurred with internal fixation than with external fixation with a transfixation pin cast (P<.005); however, there were no significant differences in minor complications between groups. Conclusions: Internal fixation with bone plates was associated with fewer major complications than external fixation with a transfixation pin cast.     

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.     

Placement of bone screws in a standing horse for treatment of a fracture of the greater tubercle of the humerus

A mature Thoroughbred gelding that was used as a high level jumper presented for evaluation of a nonweightbearing forelimb lameness following a fall. Radiographs revealed a complete, noncomminuted, minimally displaced sagittal fracture of the greater tubercle. Supporting limb laminitis was a major concern in the short term based on the severe lameness at presentation. Open reduction with internal fixation was chosen over stall rest in an attempt to more rapidly return the weightbearing function to the limb. The procedure was performed standing and 3 bone screws were placed standing in an attempt to avoid implant or catastrophic bone failure that can accompany recovery from general anaesthesia. The day following surgery the lameness was significantly improved as the horse was able to bear some weight on the heel. The gelding was discharged 5 days following surgery and was fully weightbearing at the walk. Six months following surgery the horse was free of lameness and resumed training. This report describes our experience and rationale in placing bone screws in a standing horse for treatment of a greater tubercle fracture.     

Treatment of open, delayed union, and nonunion fractures with external skeletal fixation.

ESF is useful in treatment of open fractures and delayed union and nonunion fractures. The fixation pins can be placed away from the fracture site to avoid disruption of blood supply. The appliance is well tolerated and inexpensive, and many of the parts can be reused. Adjustment of the splint is possible to permit correction of stabilization for optimal results. Gradual reduction of frame rigidity improves the quality of healing by increasing the stress on the bone. As stiffness of the healing fracture increases, return of limb function occurs. Early fixator removal reduces patient morbidity and permits a return to normal activity.     

Scapulohumeral arthrodesis in four Shetland ponies

Four Shetland ponies were presented with severe osteoarthritis of the scapulohumeral joint to the Faculty of Veterinary Medicine of Ghent University over a period of 4 years. Ponies were treated with internal fixation using locking compression plates (LCPs) applied cranially across the scapulohumeral joint. Although two ponies developed mild complications, all ponies were more comfortable in the limb within a few hours following arthrodesis.     

Repair of fracture of the proximal portion of the radius and ulna in a llama

Repair of a comminuted fracture of the proximal portion of the radius and ulna in a 4-month-old llama was achieved by use of internal fixation. An 8-hole narrow dynamic compression plate was applied to the lateral aspect of the radius and a 7-hole narrow dynamic compression plate was applied to the cranial aspect of the radius. One year after surgery, the llama had a normal gait and the cosmetic appearance of the limb was excellent.     

Pathological fracture of the femur secondary to haematogenous osteomyelitis in a weimaraner

A seven-year-old male weimaraner developed an acute-onset non-weightbearing pelvic limb lameness without a history of significant trauma. Radiographs demonstrated an oblique fracture of the femur associated with a lytic bone lesion, while cytology and histopathology of the lesion were consistent with osteomyelitis. A pure growth of Streptococcus intermedius was obtained from culture of affected tissue samples. The fracture healed without complication after rigid internal fixation and antibiotic therapy.     

Use of a Double Hook Plate for Treatment of a Distal Radial Fracture in a Dog

Attempted stabilization of open, distal radius and ulnar fractures in a 3-year-old German shepherd dog using intramedullary pins and a Schroeder-Thomas splint resulted in malalignment of the limb and osteomyelitis. A double hook plate was used to rigidly stabilize the distal radial fracture after anatomical realignment. An autogenous cancellous bone graft was used where a lateral architectural defect remained after reduction. Culture of the fracture site showed Staphylococcus sp., which responded to chloramphenicol therapy. Fracture union and resolution of osteomyelitis occurred by 9 weeks after surgery, and the dog had no lameness and a normal muscle mass 22 weeks after surgery. The double hook plate provided rigid internal fixation of the radial fracture, allowed a rapid return to function during osteosynthesis, and minimal interference of antebrachiocarpal joint function occurred.     

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.     

Internal fracture fixation

Over the past decade, many improvements to small animal internal fracture fixation have been developed, including improved fixation techniques and a more diverse selection of implants. The understanding that appropriate fixation selection is based on a plethora of biologic, mechanical, and clinical factors has also emerged. Classically, the methods of internal fracture fixation have used pins, wires, screws, and plates to rigidly stabilize fractures that have been anatomically reduced with significant disruption to the biologic fracture environment. Newer methods attempt to minimize trauma to the soft tissues surrounding a fracture and promote biologic osteosynthesis using such implants as interlocking nails and plate-rod fixations. This review provides an overview of both the traditional and current principles of small animal internal fracture fixation.     

Canine total knee replacement performed due to osteoarthritis subsequent to distal femur fracture osteosynthesis. Two-year objective outcome

A 27-kg German Shorthaired Pointer was referred for evaluation due to the complaint of left pelvic limb lameness and signs of pain in the left stifle joint. Radiographs revealed signs of a healed supracondylar femoral fracture that had been previously repaired at another hospital with an intramedullary pin and two cross pins. In addition, there were signs of severe osteoarthritis (OA). The OA had been managed medically with administration of carprofen and nutraceuticals for nine months without any improvement. Left total knee replacement (TKR) surgery was performed to alleviate signs of pain. The patient was assessed preoperatively and at six months, one year, and two years after surgery using radiology, force platform analysis of gait, thigh circumference measures, goniometry, and lameness evaluation. Following surgery, the dog resumed normal activity without any signs of pain and a good quality of life at 3.5 months. Force plate analysis found that peak vertical force on the TKR limb was 85.7% of the normal contralateral limb after two years. Total knee replacement was a successful treatment to manage knee OA associated with a healed distal femoral fracture and internal fixation in this dog.     

Repair of an open radial fracture in an adult horse

An open radial fracture in an adult horse (450 kg) was repaired by internal fixation, using two 18-hole 4.5-mm broad dynamic compression plates and 5.5- and 4.5-mm bone screws. The fracture healed completely, but when evaluated 9 months after surgery, the horse was lame on the fractured limb at a trot. Local infiltration of anesthesia along the distal half of the bone plates greatly ameliorated the lameness, suggesting that the plates were irritating the soft tissues and extensor tendons along the cranial and lateral aspects of the antebrachium. Both bone plates were removed simultaneously with no complications, and the horse became sound.