Management of fracture of extremities of long bones in dogs

Abstract

The feasibility of various management techniques for fracture of extremity of long bones was evaluated in fourteen clinical cases of dogs with fifteen fractures, presented to Surgery units of Veterinary Hospitals, Mannuthy and Kokkalai, College of Veterinary and Animal sciences, Mannuthy during the period from January 2007 to April 2008. All the animals were subjected to detailed clinical, radiological, haematological and serum biochemical evaluation preoperatively and postoperatively at two weeks interval up to sixth week. The fractures included in study were capital physeal, basicapital, subtrochanteric, supracondylar and distal Salter Harris II fractures of femur; avulsion of tibial tuberosity with separation of epiphysis and proximal metaphyseal fracture of tibia ; supracondylar fracture of humerus and distal metaphyseal fractures of radius and ulna. Reduction was achieved by open and closed approach and fixation was done using intra medullary pins acting as intra medullary pins, cross pins or as transfixation pins of external fixator. Femoral head and neck fracture was fixed by K wire inserted normograde from fovea capitis or from subtrochanteric area. Subtrochanteric fracture of femur, distal femoral fractures and distal humeral fractures were repaired by intramedullary pinning done normograde or retrograde, either alone (in stable fractures) or with auxillary fixations like cross pins. Avulsion of tibial tuberosity was repaired by tension band wiring and proximal metaphyseal tibial fracture was repaired by a derotational K wire inserted in closed method. Distal metaphyseal fracture of radius and ulna was immobilized with type IA external fixator after closed reduction. Fracture reduction was satisfactory in 93 per cent of cases. All animals except two dogs with multiple fracture of femur, showed full weight bearing on the limb in two weeks. Long term functional outcome was excellent in 78 per cent dogs. Development of pseudoarthrosis was observed in three dogs with femoral head/neck fracture and resulted in change in gait in two cases. All fractures in young dogs healed in six weeks and among others, those without fixation failure showed appropriate progression towards healing. Avascular necrosis of femoral head with femoral head/ neck fracture and premature closure of physis were the biological complications noticed. Premature closure of physis caused deformity only in one case. An increase in level of alkaline phosphatase and a decrease in serum calcium level were observed in earlier phases of fracture healing. Intramedullary pin and cross pin in distal femoral and humeral fractures, tension band wiring in avulsion of tibial tuberosity, and type IA external fixator in distal radius and ulna fracture were found excellent. Success of using pins in proximal femoral fractures in large dogs need further study.