Traumatic Bone Injury & Fracture
What is a fracture?Fracture is the term used to describe a broken bone. There are many different types of fractures, named according to the location of the fracture, how complex the injury is, and whether or not the bone(s) pierce through the skin. If surgery is recommended, the use of various metal surgical implants such as pins, plates, wires, or screws will be used.
How are fractures treated?
A better understanding of the theory and practice of fracture repair has resulted in an improved level of care for a pet with a fractured leg.
It is now possible to repair the vast majority of fractures that a pet may receive as the result of a traumatic incident. The main objectives of fracture repair are to promote rapid healing of the fracture and to get the pet using its leg as quickly as possible. In most cases, this involves rebuilding the broken bone and fixing it in that position with metallic implants.
The most common methods of fixation of fractures include:
- placing a stainless steel pin in the marrow cavity of the affected bone,
- plating the bone in position with a plate screwed to the outside of the bone, OR
- using an external fixator, which involves placing several short stainless steel pins vertically into the bone fragments, and connecting these pins on the outside of the leg using metal bars and clamps.
The decision as to which technique is used depends on a number of factors:
- the type of fracture your pet has experienced
- what equipment your veterinarian or surgeon has available
- other injuries your pet may have suffered to other limbs
- the age of your pet
- the temperament of your pet
- financial considerations
How are fractures diagnosed?
If your pet has sustained a fracture, it will normally be unable to bear weight or stand on the affected limb. Usually, a fracture is painful. There may be soft tissue swelling in the region of the fracture.
Your veterinarian will be able to detect if there is a fracture by looking for pain, swelling, and feeling a grinding sensation between the ends of the broken bones. Radiographs will be used to confirm the diagnosis and search for additional injuries.
If there are no additional injuries, your veterinarian will use the radiographs of the fractured limb to determine which method of fixation to use. After the fracture has been repaired, radiographs will be taken to assess how well the pieces of bone have been rejoined. The radiographs will also document the exact placement of all of the pins and/or plates.
What post-operative care does my pet need?
After a fracture has been repaired, your veterinarian will normally hospitalize your pet for a few days to ensure that there are no immediate post-operative complications such as surgical site infections, movement of the surgical implants, or other problems. Immediately after the fracture has been repaired a soft bandage may be placed on the fractured limb to provide a small degree of additional support and to minimize any swelling of the soft tissues surrounding the fracture. On rare occasions, it may be necessary to put the limb in a rigid cast; however, this is generally avoided.
Antibiotics will often be prescribed to help prevent infection in the fracture site. Pain relief medications will also be used before, during, and after surgical repair of the fracture. After your pet returns home, it is important to watch for signs of pain by observing whether they are able to settle down, rest, and sleep.
Some pets will not eat very well while hospitalized and can lose weight. Inadequate nutrition can lead to slow fracture healing. To promote optimal healing, your veterinarian will discharge your pet as soon as it is safe to do so.
For the first several days, your pet may need to have strict cage rest. Depending on the actual fracture repair, your veterinarian may recommend confinement in a small area such as a bedroom to allow your pet some limited mobility. In general, it is more desirable to let your pet exercise in a small room while closely supervised as opposed to strict immobilization in a cage. Physical activity minimizes muscle loss on the fracture limb, reduces the chance of long-term joint immobility, and speeds healing of the fracture.
The length of time your pet will require confinement and activity restriction depends on the following factors:
- the age of your pet: younger pets heal more quickly than older pets
- if your pet has a pre-existing illness that may delay healing, such as a metabolic disease
- the type of fracture your pet has suffered
- the type of fixation used
- how quickly your pet starts to use its leg effectively after surgery
- the appearance of the fracture on radiographs after a period of time has elapsed
Once your veterinarian is satisfied that the fracture has healed adequately, you will be advised that exercise restriction is no longer required. It may be necessary to remove some or all of the metal implants used in the fracture repair once healing is fully complete. Your veterinarian will decide if this is necessary. Most pins and plates can safely remain in your pet for life if the situation requires that they be left in place.