Fractures occur for a variety of reasons in dogs and cats commonly as a result of trauma or a fall. The patient may have serious concurrent internal or external injuries as a result of the causative trauma, particularly where a motor vehicle is involved. A wide variety of options are available for stabilization of fractures depending on the type and location of the fracture.
Dogs and cats that are diagnosed with fractures may be investigated for internal injuries prior to surgery. This assessment may happen at the regular family veterinary practice, at an emergency clinic or with Veterinary Specialist Services. This may include xrays of the chest and ultrasound of the abdomen, as well as blood tests to assess blood count, protein levels, internal organ function and blood clotting ability. Some animals with fractures need additional surgery or intensive medical treatment for their internal injuries prior to stabilization of fractures. Fractures are typically assessed with xrays, but in some cases a CT scan will be advised to gain more information.
TYPES OF FRACTURE FIXATION
Veterinary Specialist Services has a wide variety of internal fixation devices available. The exact fixation used in each fracture depends on the characteristics of the fracture, the patient age and temperament and surgeon preference. Veterinary Specialist Services has locking and dynamic compression bone plating systems, interlocking nails, circular and linear external skeletal fixation and pin/kirschner wire based fixation options along with casts and splints. In addition, fluoroscopy (low dose intra operative xray) is used in some procedures to confirm accurate fracture alignment and implant placement, or to minimize the extent of surgical dissection needed (minimally invasive fixation).
TIMING OF FRACTURE TREATMENT
Most fractures are best treated as soon as practically possible, providing the patient is well enough to have general anaesthesia for surgery. Dogs and cats are assessed on a case by case basis to determine the treatment plan in some cases this means other internal injuries are treated first, either medically or surgically. Initial patient management may include splinting a broken bone with a bandage or cast to support the area and provide pain relief while the patient is stabilised for surgery.
TYPES OF FRACTURES
Long bone fractures
These are fractures of the long bones of the limbs in the front legs the humerus, and radius and ulna, and in the back legs the femur and the tibia and fibula. These fractures are typically stabilized with bone plates, interlocking nails or external fixation, but occasionally are amenable to splint or cast support.
Fractures of the pelvis typically occur as a result of significant blunt force trauma such as a motor vehicle accident. These patients are more likely to have significant concurrent injuries and need additional surgery or intensive medical support prior to surgery. Pelvic fractures are treated surgically if they affect the ability of the patient to bear weight or move their legs or tail, if the patient has nerve weakness affecting the legs, tail, bladder or anal sphincter or if there are concurrent fractures to other bones in the limbs. Pelvic fractures are typically stabilized with bone plate techniques or screw fixation, and fluoroscopic assistance is frequently used.
Spinal fractures are fractures of the bones of the vertebral column. These cases are complicated as treatment must consider both bone stabilization and nerve or spinal cord injury. Despite the severity of these injuries, most dogs recover if they retain feeling in their legs. Spinal fracture stabilisation is commonly performed with bone plates and screws, or bone screws and bone cement in combination.