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    daniel felipe gonzalez granados
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    Your options in managing long-bone fractures in dogs and cats

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    6 views9 pages

    Your Options in Managing Long-Bone Fractures in Dogs and Cats

    Uploaded by

    daniel felipe gonzalez granados

    Copyright:

    © All Rights Reserved
    Download as PDF or read online from Scribd
    Flag for inappropriate content
    of 9
    SYMPOSIUM ON FRACTURE MANAGEMENT PEER-REVIEWED Your options in managing long- bone fractures in dogs and cats From casting to surgery, numerous methods are available for stabilizing a fracture. This article discusses current repair techniques and their indications, as well as other factors you should keep in mind when formulating a treatment plan. MARK C. ROCHAT, DVM, MS, Del. ACVS SiBimentcs Acree Frereods na 01S JOHN T. PAYNE, DVM, MS, Dip. AVS, ‘Department ol Veterinary Medicine sr Sugeny (Colage ot Veterinary Meine Univers of Miso (Cou, Missour 65211 (946 VETERINARY MEDIONEIOCTORE 973 FRACTURES of the long bones (the humerus, radius, ulna, femur, tibia, and fibula) are common in compan- ion animals and are usually the re- sult of traumatic events such as ve- hhicular accidents, animal fights, and gunshot wounds. Pathologic frac- tures secondary to neoplasia or metabolie bone disease are less com- mon. This article discusses the deci- sion-making process used to deter- rine the optimal method for manag ing various fractures of the long bones. Diagnosing the fracture The history and physical examination Appropriate fracture manage- ment begins with an accurate his- tory and a thorough physical exami- nation. The information gained pro- vides the clinician with an under- standing of how the fraeture oc- curred and how it relates to the animal as a whole. Managing other injuries or diseases may initially take precedence over fracture re- pair or may alter the options avail- ‘able to the surgeon for repairing the fracture, For example, an animal in shock and with a diaphragmatic her- nia must have those problems con- trolled before its femoral fracture is treated, In such a case, the fracture site is briefly but accurately evalu- ated to determine whether the frac- ture is open or elosed. If open, the site is quickly cleaned, debrided, and bandaged, and the fracture is temporarily stabilized. If radi- ographie evaluation compromises the patient at this time, it should be postponed. Definitive repair can commence once the life-threatening injuries are controlled. "The patient's history should iden- tify pre-existing diseases. Diseases that produce hypoproteinemia, ane- mia, hypoxia, or uremia may delay soft tissue and osseous healing, plac- ing extra demands on the fracture fixation. Hyperadrenocorticism and immunosuppression, regardless of the cause, may delay wound healing and predispose the animal to wound infection. Hyperparathyroidism has been reported to delay bone healing {in people and may influence fracture healing in animals? Radiographic evaluation Radiographs provide information vital to the suecessful management of long-bone fractures. At least two radiographic views at right angles to one another are required; oblique SYMPOSIUM ON FRACTURE MANAGEMENT ‘Managing long-bone fractures (cont) views may be necessary to accu- rately characterize complicated fractures. High-quality radiographs are necessary to identify complicat- ing factors, including fissures, frag- ‘mentation, and changes in bone den- sity. It is much better to identify complicating factors before surgery and plan treatment accordingly than to discover them intraopera- tively and be unprepared. Fracture location and eonfigura- tion ean usually be determined through radiographic examination. ‘The veterinarian should note whether the fracture is trans- verse, short oblique, long oblique (the length of the fracture is more than 1.5 times the diaphyseal di- ameter), spiral, eomminuted, or segmental. The fracture’s eonfigu- ration will influence the plan for surgical stabilization. Other aspects of long-bone frac- tures that should be evaluated radi- graphically inelude the extension of the fracture into adjacent joints, degree of comminution, presence of gas around the fracture site (sug- gestive of an open fracture), degree of muscle swelling and hemorrhage around the fracture, and exact spa- tial configuration of the fracture site To gain a better, three-dimen- sional understanding of the fracture, it is sometimes helpful to examine the radiographs concurrently with a bone of about the same size taken from a cadaver. In addition, it is helpful to compare radiographs of the affected leg with those of the op- posite leg, especially in dogs with abnormal or unusual conformation. ‘Thorough preoperative planning will make surgery more straightfor- ward and will decrease the time needed for surgery. 1948 vey HeDIor

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