Fractures

Fractures are a common injury usually following road traffic incidents and often in order to optimise outcome surgical stabilisation is usually necessary. Fractures of the long-bones usually result in an inability to weight bear, pain, swelling and discomfort. Radiographs are often necessary in to determine the exact location and configuration of the fracture.

Following fracture classification a decision can be made with regards to the most suitable fixation method. The options usually available are broadly classified as either internal fixation or external fixation.

Internal fixation usually involves the use of screws, plates, wires and pins. At The Grove we have available the latest instrumentation and implants for internal fixation developed by the world-renowned manufacturer Synthes and developed by the AO foundation in Switzerland.

We use the latest locking compression plates which provides flexibility when treating fractures internally and has the added advantage that locking screw technology can be utilised to increase stability of our fracture fixations and minimise the risk of implant loosening and implant failure.

Femoral fracture treated with Synthes locking plate and screws

 

Certain fractures including avulsion fractures and fractures in young animals involving growth plates often necessitate internal fixation with pins and wires.

External fixation involves the use of frames and pins which are located on the outside of the limb and are advantageous in highly comminuted fractures, fractures involving the extremities of long bones and also fractures where open wounds are present.

At The Grove we have a variety of external frames ranging from simple linear components with external fixations bars and transfixation pins to more complex circular frames involving tensioned wires, which allow more flexibility in pin placement and fracture fixation. A combination of linear and circular frames can be utilised in what is known as a hybrid fixation. Circular frames also allow the ability to distract (lengthen) bones and also to correct angular limb deformities.

Tibial fracture treated with a hybrid external skeletal fixator

 

Both internal and external skeletal fixations have their advantages and disadvantages. Internal fixation allows an early return to weight bearing function and minimal postoperative management but necessitates an open surgical approach to place the implatns. External frames do not necessarily require an open surgical approach are always removed once the fracture has healed. However they do require slightly more involvement in the postoperative period with monitoring of the external frame, bandage changes and it is not uncommon to see minor complications with the transfixation pins.

Fracture healing is usually monitored by follow up radiographs at specific points postoperatively. Once fracture healing is deemed to be complete then exercise can be increased and animals returned to more normal levels of activity. The time it takes a fracture to heal is influenced by a number of different factors such as age of the animal, individual bone involved and concurrent systemic disease.