A broken bone is known as a fracture while a dislocated joint is known as a luxation. Fracture management/repair in dogs aims to restore normal anatomy and function following injury to bone. Fractures can occur due to trauma, accidents, or even underlying medical conditions. The approach to fracture repair depends on factors such as the type of fracture, location, severity, age of the patient and the overall health of the dog. If your dog has sustained a fracture or your vet has recommended evaluation for this problem, we can help guide you to the best option for your pet.
Patient Assessment
A thorough examination of a patient with a suspected fracture is critical. If a fracture is identified, it can mean other problems, sometimes life-threatening, may coexist with the fracture, especially if the history involves blunt force trauma. Additionally, some fractures are difficult to diagnose and so patient evaluation is a critical step in proper management of these problems.
Diagnosis
Most fractures can be confirmed through radiographs (X-rays), but sometimes CT scans are performed to identify or further assess the type and extent of the fracture. Both diagnostics help in planning the most appropriate course of action.
Treatment Options
Surgery is not always needed to achieve proper healing, but often it improves the overall prognosis. Certain fractures, such as fractures that do not involve both cortices of bone (incomplete fracture) may be best managed solely through external coaptation, such as splints or casts that are used to immobilize and support the fractured limb as it heals. This is often a temporary solution until more definitive treatment can be performed. In other cases, a fracture may be manually realigned, called closed reduction. This involves manipulating the broken bones back into their proper alignment without surgical intervention and is followed with application of external coaptation. Your surgeon will advise you if this is a good option based on known outcomes of patients receiving this intervention.
When Surgery is Indicated
Most often surgery will result in an improved outcome over non-surgical management. Your surgeon may discuss a variety of options. These could include open reduction and internal fixation. This involves exposure of the fracture site, realigning the broken bones, and stabilizing the bones using various internal fixation devices. In some cases, a surgeon may use an “open but do not touch” approach. In yet other cases, an incision may not be made at all and a fracture may be stabilized with a device that exists on the outside of the limb with pins or wires that stabilize the bone above and below the fracture site. This is known as an external fixator. Each of these options has advantages and disadvantages. Your surgeon will guide you through which options may be better than others.
Implants utilized in fracture repair
Surgical intervention is frequently required for many fractures. Surgeons commonly utilize implants to help stabilize fractures. These devices include:
- Bone plates
- Bone screws
- Intramedullary (IM) pins
- Interlocking nails
- External fixators
The surgeons at Spry Companions manage complex fractures, chronic fractures, patients with bacterial infection, malunion fracture (healed with abnormal alignment) and delayed union fractures.
Minimally Invasive Fracture/luxation Repair
When possible, the surgeons like to employ minimally invasive techniques to aid in repair. These approaches utilize smaller incisions, specialized instruments, and imaging guidance to reduce trauma, postoperative pain, and recovery time. Minimally invasive fracture repair might involve percutaneous implant placement under imaging guidance. Here, implants are placed under the skin using fluoroscopy (moving, real-time x-rays) guidance to position the implant into the proper position. There are a number of advantages to this approach. These include reduced tissue trauma resulting from smaller incisions, reduced postoperative pain, and a faster recovery. Many fractures will heal more efficiently due to reduced disruption of blood supply. Smaller incisions may also lower the risk of infection compared to traditional open technique. Minimally invasive techniques can also result in less scarring and a more cosmetically appealing appearance.