Fracture Repair: Methods, Planning, and Owner Compliance

Objective of Fracture Repair

The primary objective of fracture repair is to provide rigid stability for the bone and facilitate proper bone union. This stability can be achieved through internal or external fixation implants, both of which play a crucial role in ensuring successful bone healing.

Internal Fixation

Internal fixation involves placing a metallic implant beneath the skin to stabilize the bone. Commonly used internal fixation devices include:

• Pins

• Plates

• Screws

A wide variety of implants are available in the market, and the selection depends on factors such as the surgeon's preference and the specific type of fracture. Internal fixation offers rigid support, promoting faster and more effective healing.

External Fixation

External fixation is achieved using a device that penetrates the skin and firmly holds the bone in place. Typically, external fixation involves:

• Pins connected to an external metallic bar

• Circular external fixators

This method allows for stabilization without the need for invasive surgery. However, external fixation requires careful management to prevent infection and ensure proper healing.

Alternative Methods

Fracture healing can also be facilitated using external bandages and splints. While these methods are less invasive, they may necessitate frequent bandage changes and pose risks such as:

• Delayed union or non-union of the bone

• Poor limb immobilization

• Sedation required for bandage changes

  
  

Fracture Planning and Owner Compliance

Effective fracture repair requires careful planning and consideration of various factors to ensure successful healing. Once the patient is stabilized, preoperative data is analyzed and summarized using a fracture assessment score based on three key factors:

1. Mechanical Factors

Mechanical factors determine the strength requirements for the implant based on the type and location of the fracture.

2. Biological Factors

Biological factors assess the bone healing potential, considering the patient's:

• Age

• Overall health condition

• Nutritional status

  
  

3. Clinical Factors

Clinical factors involve owner and patient compliance, including:

• Adherence to post-operative care instructions

• Follow-up visits

• Proper wound management

A low fracture assessment score indicates a higher risk of delayed healing or non-union fractures, which could result in treatment failure.

Enhancing Fracture Healing Success

To mitigate the risks of fracture repair failure, the following measures are recommended:

• Conducting comprehensive preoperative blood tests

• Selecting the most appropriate implant type based on the fracture

• Ensuring strong client compliance with post-operative care at home

At discharge, owners will receive detailed leaflets with step-by-step instructions for post-operative care, helping to ensure a smooth and effective recovery for their pet.

By understanding and following these guidelines, pet owners can play a crucial role in the successful healing of fractures and improve their pet's overall well-being.

Type of Implant

Internal Implants

Most of the time, internal implants remain in place and do not necessitate additional surgery for removal; however, in rare cases, they may cause skin irritation. In such instances, prompt surgery is necessary to remove the implant.

External Implants

External implants are removed after bone healing, typically between 4-8 weeks. Extra care and attention should be taken during the removal process of these implants.

Early Implant Removal and Complications

Early implant removal may be necessary in very young animals, as their bones tend to heal faster than those of adult patients.

Generally, the rate of complications is low. The primary complication is infections, which are treated with antibiotics. However, in some cases, implant removal after bone healing may become necessary.

Another potential complication is the rupture of internal implants, especially in comminuted fractures. Sudden jumps, sprints, or fast movements may result in the bending or rupture of the implant. In such cases, a review surgery may be required. Based on this data, we strongly recommend strict rest until the bone is completely healed.