Courtesy of Dr. Ronald Green.
Bone fractures are frequently caused by vehicular accidents, firearms, fights, or falls. Fractures can be open or closed and involve single or multiple bones. Characteristics of the fracture—such as simple, comminuted, oblique, transverse, or spiral—are based on disruptive trauma forces (bending, compression, tension, and rotation).
Clinical signs invariably include lameness, pain, and swelling. Radiography is useful in delineating the fracture pattern. Treatments are based on the type of fracture, age and health of the animal, technical expertise of the surgeon, and owner finances.
Young, healthy dogs with incomplete fractures can be treated with external splints or casts. Other injuries are treated with external (fixators) or internal devices, such as bone plates, screws, orthopedic wires, interlocking nails, and pins. Frequently, cancellous bone grafts are used to augment fracture healing in ill or aged patients. Antibiotics are given for open fractures or prolonged repairs. Perioperative analgesics (eg, epidural morphine, narcotic skin patches, systemic narcotics [including constant-rate infusion], oral NSAIDs) are used to alleviate discomfort. Physical therapy or rehabilitation is critical to restore limb function and overall well-being.
Prognosis for recovery is usually good, depending on the nature of the injury and success of repairs; successful wound therapy and monitoring of cardiopulmonary and urologic functions are essential. Followup care includes radiographic and clinical assessments of fracture healing. Internal implants may not need to be removed unless complications such as stress protection, infection, or soft-tissue irritation develop.
