Methods for treating bone fractures in animals. Osteosynthesis on the pelvic limb for a fracture of the femur in a dog Fracture of the tibia in a dog
Currently, dwarf and decorative breeds of dogs have become extremely popular: Yorkshire terriers, Biewer Yorkies, Chihuahuas, Spitz dogs, griffons, papillons, etc.
But the small size of dogs sometimes implies quite big problems.
Today I would like to focus on a fairly common problem in these dog breeds – a fracture of the forearm. As a rule, this fracture is traumatic in nature: a jump from a height of 0.5 to 1.0 m (sometimes a lower jump height is sufficient).
And so the dog jumped off the sofa, squealed and began to tuck its front (chest) limb. (photo 1) When walking and running, the animal does not step on the sore paw; when the owner tries to touch the paw, sharp pain occurs.
What the owner needs to remember: you shouldn’t forcefully touch or try to palpate the place that is causing pain, but you shouldn’t turn a blind eye to the problem, hoping that everything will go away on its own. I also do not advise you to rush headlong, whether day or night, to call a doctor at home or go to any veterinary clinic to get an answer to the question: is there a fracture or not. Even if your dog fracture is a problem this is not fatal and does not threaten the life of the animal; you have exactly 1-3 days to find a clinic with X-ray equipment and a specialist in traumatology and orthopedics.
So, you arrived at the clinic, the dog was x-rayed (usually in 2 projections), a traumatologist looked at the pictures and rendered a verdict: a fracture of the forearm, namely the radius and ulna.
Why does such an injury occur, despite the seemingly low load on the paw? For a long time it was believed that a fracture of the radius (namely, it takes on the entire load at the moment of a jump) occurs due to a narrowing of the width of the radius in the distal third according to the principle hourglass. But recent studies have shown that a decrease in bone diameter in a certain place is also characteristic of many large breeds of dogs and, accordingly, this is not the root cause of this pathology. Density studies bone tissue at the site of narrowing, they also did not give clear answers. And the problem lies in the structure of the intramedullary canal of the radius. In dwarf dog breeds, the intramedullary canal in a certain segment of the radius may either narrow to a minimum size or be absent altogether. (photo 2)
Speaking in simple language The radius bone, at the site of narrowing of the intramedullary canal, looks not like a “tube”, but like a “rod”. (photo 3) At the moment of landing after a jump, physics comes into play: the transfer of high specific stress to the site of narrowing of the intramedullary canal is approximately 5 times higher than to the rest of the surface of the radius, as a result of which it fractures.
In most cases, a forearm fracture in dogs occurs with displacement of fragments of the radius and ulna bones relative to each other (photo 4).
For functional stabilization of the fracture and its further consolidation (fusion), it is necessary to take into account 3 forces acting on bone fragments: torsion, flexion, displacement. (photo 5). Neither splints nor plaster can completely eliminate all three loads on the radius, and can even aggravate the situation with the formation of pseudarthrosis, atrophy and bone lysis.
The main method of treating these fractures is stable functional osteosynthesis, i.e. surgery to stabilize the fracture. On at the moment there are two most effective methods surgical stabilization of a forearm fracture in toy dog breeds:
Bilateral single-plane external fixator.
The method originates from human medicine, namely the installation of the Illizarova apparatus. The principle is practically the same - to provide external fixation of the fracture. But because The Illizar apparatus design is quite massive, and we are talking about patients weighing up to 10 kg, then the way to achieve this fixation is slightly different: Kirschner wires are passed through the soft tissue and bone at an angle to each other (at least 2 in each fragment), the fracture is repositioned, the pins are bent from the outside and fixed with bone cement or cold welding. The result is approximately the following design (photo 6) The photo shows the external fixator 30 days after its installation.
This method is very good for stabilizing complex, comminuted fractures.
I give an example of a series of x-ray images of the staged healing of a complex fracture of the forearm: Yorkshire terrier, 6.5 months, complex comminuted fracture of the radius and ulna of the right thoracic limb (RPL).
Bony fixation with DCP mini plate.
The main difference from the first method is the absence of any external fixators. The fracture is stabilized by placing a compression plate directly on the bone and fixing it with 2 mm cortical screws. The plate itself is made of titanium alloy and despite its tiny dimensions (thickness 1 mm, width 4 mm), it is able to withstand the load of the entire weight of the animal, even at the moment of loading (jumping or running). (photo 7).
Both methods equally well eliminate the 3 forces acting on the fracture, which I wrote about earlier. The main difference is the aesthetic aspect, because... the plate is attached to the bone and hidden under soft tissues animal (skin, muscles, tendons) But this method is not suitable for complex (comminuted) fractures of the forearm bones!
Immediately after installing the plate, the paw looks something like this (photo 8):
And examples of x-rays:
Example 1: Yorkshire Terrier, 3 months
Example 2: Brussels Griffon, 4.5 months
Example 3: Yorkshire Terrier, 4.5 months
Example 4: Papillon, 11 months
I want to emphasize special attention owners about the need to take repeated x-rays at a certain time interval (usually 4-5 weeks after surgery)! Even despite wellness and full weight bearing on your pet’s paw, in some rare cases and if there are indications (age of the animal / proximity of the plate installation to the bone growth zone in puppies), the DCP plates must be removed.
In conclusion, I would like to say that osteosynthesis with a plate or a bilateral single-plane external fixator is a comfortable method of treating a forearm fracture for the animal and its owner, and gives maximum clinical effect if adhered to basic principles osteosynthesis.
References:
1. Yagnikov S.A., Kozhushko P.S., Anatomical and biomechanical prerequisites for the occurrence of forearm bone fractures in dogs of dwarf breeds. Russian veterinary journal. Small pets. No. 3. 2014 p. 23-28.
Surgeon-traumatologist at the Argos Veterinary Center
A fracture is a violation of the integrity of bones. The basis of the treatment of any fracture is the comparison of bone fragments with their fixation. The type of fixation of bone fragments depends on the type of fracture. Fundamentally different:
1. Conservative closed reduction with the application of a fixing bandage in the form of a splint or plaster.
2. Surgical reposition, the essence of which is to connect bone fragments using plates, knitting needles, pins, fixed inside the medullary canal, on the bone or passing through the bone and fixed on the surface of the body (external structures).
For animal owners, the most “familiar” one is the first method, which involves applying a plaster cast. In practice, fixation with external bandages has only one indisputable advantage - low cost. Although this advantage is debatable if, after 3-4 weeks, the damaged bone has to be re-fixed surgically.
Metaphyseal fracture of the femur in a cat. Permanent intraosseous fixation with wires.
Intramedullary osteosynthesis of an oblique comminuted diaphyseal fracture of the femur in a cat.
Dislocation of the femur with rupture of the round ligament. Fixation of the femur
External fixation of intra-articular wrist fracture
Lameness
– the main symptom with which pet owners turn to an orthopedist. Lameness of the hind limbs is more often associated with pathology of the hip (HJ) or knee joints. Let's consider the two most common congenital pathologies of the development of the hip joints: aseptic necrosis of the femoral head and hip dysplasia (HJD).
Legg-Calvé-Perthes disease (aseptic or ischemic necrosis of the femoral head, juvenile osteochondrosis), affects representatives of dwarf dog breeds, develops at a young age of 5-10 months. The trigger point for the development of pathology is a violation of the blood circulation of the bone tissue of the femoral head, which leads to necrosis of the femoral head and its deformation. The development of lameness occurs gradually or suddenly after a jump or fall due to injury to the affected area of the bone.
The pattern of development of Perthes disease corresponds to 5-8 months. age when the animal develops lameness, which gets worse after physical activity. Physically and radiologically, aseptic necrosis of the femoral head should be differentiated from arthritis (typical of older dogs), dislocation of the patella (possible reduction with restoration of limb function, displacement of the patella is clearly visible on the image) and hip dysplasia (typical of large breeds, has certain radiological characteristics). Over time, the dog completely ceases to rely on the affected limb and muscle atrophy develops. With bilateral damage to the joints, the animal exhibits immobility and pain when attempting to forcefully move.
Radiographically, the affected femoral head has an irregular, often almost triangular shape with uneven bone density.
In the early stages of the disease, pain and lameness can be controlled by the use of painkillers and anti-inflammatory drugs, as well as the regular use of chondroprotectors (glucosamine, chondroitin), but this is a short-term and ineffective effect. The most common way to solve the problem is to remove the femoral head, after which the animal’s painful sensations, motor ability is restored, and sometimes lameness disappears.
Sick dogs must be excluded from breeding, since the disease is inherited. At the age of 5-6 months. It is advisable to take X-rays of the hip joint for early detection of pathology.
Dysplasia is a disorder in the formation of an organ or tissue. In dysplastic syndrome in orthopedics, the development of connective tissue is disrupted, which can manifest itself as increased joint mobility combined with connective tissue weakness. Dysplasia of the hip joints in dogs was first described in 1935 by G.B.Schnelh. Since then, it has been proven that the disease is genetic in nature and is characteristic of large and giant breeds.
Clinical signs of dysplastic syndrome appear from 4-10 months. in the form of joint stiffness, lameness, pain and weakness of the muscles of the pelvic limbs. X-ray reveals: dorsal displacement of the central part of the femoral head relative to the acetabulum; expansion of the joint space; flattening of the acetabulum; increase more than 150g. the angle between the neck and the axis of the femur; Bone formations appear secondarily in the acetabulum and on the head of the bone. Based on these changes, five degrees of DTHD are divided into five degrees (an interpretative and prognostic approach to determining the degree of dysplasia in different countries different): A – healthy joint; B – predisposition to dysplasia; C – predysplastic stage; D – initial destructive changes; E – Pronounced destructive changes. In Russia, dogs with degrees D and E are not allowed for breeding.
DTHS should be differentiated from: osteochondrosis, Perthes disease, osteomyelitis, fractures of the growth zone of the femoral head.
The main methods used to treat pathology of the hip joints:
- conservative treatment This is the most common and least effective approach.
- triple pelvic osteotomy – complex surgery to change the geometry of the dog’s pelvis to increase the area of support of the femoral head on the acetabulum.
- changing the neck-diaphyseal angle of the femur - this operation is intended to increase the index of insertion of the head, performed with a low degree of dysplasia and to prevent dislocation hip joint.
- total hip replacement.
- resection arthroplasty of the hip joint, called removal of the femoral head. In fact, this is a complex operation in which not only amputation of the head of the femur is performed, but also plastic surgery of the thigh muscles, as a result of which the function of the limb is completely restored.
Our clinic performs resection arthroplasty of the hip joint.
Fracture of the distal part of the ulna and ulna bones, the most common fractures in our practice are in dogs of dwarf breeds such as Yorkshire Terrier, Toy Terrier, Spitz, etc.
Such fractures occur when animals fall from a height; sometimes an unfortunate landing from a sofa or chair is enough to cause a fracture.
If a fracture occurs, the animal owner must immobilize the limb to prevent injury to the soft tissues from bone fragments.
Most effective way Treatment of such fractures in dogs of dwarf breeds is osteosynthesis using a transosseous external fixator.
Similar fractures in dogs of toy breeds are diagnosed based on clinical signs such as pain, swelling, shortening of the paw, and the dog completely loses use of the limb.
To make a final diagnosis and develop surgical tactics, it is necessary to conduct an X-ray examination.
In most cases, we are faced with a displaced fracture of the distal third of the ulna and radius; often sharp bone fragments perforate the skin.
Review of treatment methods for forearm bone fractures in toy dogs.
Intermedullary osteosynthesis. With this type of treatment, a pin is inserted into the intermedullary canal of the bone. Due to the fact that the diameter of the ulna and radius bones is
Dogs weighing 1.5-2 kg are only 2-3 mm, so the introduction of an intraosseous fixator is extremely difficult, and when introducing fixators, the blood supply to the bone tissue is disrupted, which can subsequently lead to delayed bone healing in dogs or even bone lysis.
Bony osteosynthesis using a plate. This method is the gold standard for treating such fractures in large dogs, but in toy breeds this method is also difficult due to the small diameter of the bone.
Bandages, splints. It is not recommended to use such methods because With these treatment methods, precise reposition (comparison) and immobilization (fixed fixation) of inert fragments is not achieved. Correct fusion usually does not occur.
Extrafocal osteosynthesis with a rod apparatus. This method allows you to reliably fix bone fragments with minimal trauma to the joints and soft tissues; trauma to the bone itself is also minimized, and the functionality of the limb is not impaired.
The surgical operation consists of the following stages:
- Closed or open reposition (comparison) of bone fragments.
- Fixation of fragments with a rod apparatus.
- Suturing soft tissues
In the postoperative period, prophylactic administration of antibiotics and necessary analgesia are necessary.
The device is removed within 30-45 days. The dog begins to use the limb within 4-5 days.
In all cases, treatment was achieved good results treatment.
Complications include early loosening of the needles, breakage of the fixator, repeated fractures or bone fractures at the site of the needle.
The disadvantages of the method are the painstaking nature of the operation, multi-stage treatment and the need for postoperative care of the device.
Extrafocal osteosynthesis with rod devices in the treatment of forearm fractures in miniature dogs is a low-traumatic, reliable method that gives good functional results.
Fractures of the radius occur in all animal species. In cattle they are rarely recorded, in horses they occur in up to 6.7% of the number of fractures of limb bones and are mainly of operational origin. In cattle they account for about 15% of all fractures occurring in them.
Etiology. Fractures of the radius occur due to various mechanical injuries. In horses and cattle, this can occur when a limb is pinched in floor cracks or other places and is forcibly released. They are also observed when struck by a hoof, a collision while riding, stumbling and a sudden fall on hard ground. A fracture of the radius in dogs occurs when hit by a vehicle, falling into a steep ravine, bites, blows, etc. Predisposing factors are pathological processes in the bone (vitaminosis, rickets, osteoporosis, osteomalacia, osteomyelitis, mycosis and malignant tumors).
Clinical signs manifest themselves differently depending on the severity of the fracture. Closed incomplete fractures are characterized by moderate lameness of the supporting limb (sometimes highest degree). There is painful swelling in the fracture area. When standing calmly, the limb is half-bent, the animal rests only on the toe.
Complete fractures are accompanied by lameness of the supporting limb of the highest degree. The animal does not rely on the injured limb. The damaged area is very swollen and painful. When palpating the fracture zone, crepitus is heard. If the fragments are displaced, then the area of the radius is deformed.
Intra-articular fractures are accompanied by impaired joint mobility and hemarthrosis. In dogs, in this case, the signs are clearly expressed. With a complete fracture, a pendulum-like movement of the affected limb is observed. Traumatic and inflammatory swelling develops in the fracture zone, painful on palpation. Crepitation of bone fragments can be clearly heard. The animal does not rely on the injured limb.
Diagnosis. A radius fracture is determined based on anamnestic data and clinical signs. IN necessary cases it is clarified by radiography.
Forecast. Intra-articular fractures cannot be treated. Animals are culled. In small animals with closed fractures, the prognosis is favorable.
Treatment. Osteosynthesis of the radius is performed in small animals. An immobilizing bandage is used, followed by the use of physiotherapy methods. Animals are provided with rest, adequate feeding, and the conditions for keeping and caring for them are improved. Special treatment methods are outlined in the appropriate section (see Methods for treating fractures).
Prevention is aimed at eliminating any kind of mechanical damage. Predisposing factors associated with pathological processes in the bone should also be taken into account and promptly eliminated.
For the treatment of fractures, the use of an immobilizing bandage (plaster) has traditionally been used; this method of treatment has a number of disadvantages - the development of atrophy of the muscles of the limb, frequent improper fusion of bones, the formation of bedsores under the bandage, and impaired blood supply to bones and soft tissues. All these complications forced me to abandon wide application plaster to treat fractures, so this treatment method is now only used to treat cracks. More modern method treatment of fractures is osteosynthesis- an operation for surgical comparison of bone fragments using fixing metal structures.
Types of osteosynthesis:
1. Intramedullary osteosynthesis - used to treat fractures of long tubular bones. With this method, a special pin or wire is installed inside the bone. But there are also limitations to this method - for example, it is not suitable for the treatment of fractures of the pelvis, skull, spine, jaw, or for the treatment of comminuted fractures.
Ferret hip fracture
Application of intramedullary osteosynthesis for hip fracture
2. Bone osteosynthesis - with this method, a metal plate is attached to the bones using special bolts. As a result, good stabilization of bone fragments is achieved. This method can treat not only fractures of tubular bones, but also injuries to the pelvis, skull, spine, scapula, etc. The negative side of this method is the fairly high cost of the operation associated with the use of expensive materials (plates, bolts and special tools).
Forearm fracture in a dog
Bony osteosynthesis
Gunshot wound to the lower jaw with fracture of both branches of the lower jaw
View after osteosynthesis
3. Extrafocal osteosynthesis - used to treat not only fractures, but also dislocations, and consists of passing wires through the bone above and below the fracture site with their subsequent fixation from the outside with a special polymer. The advantages of this method are its relative cheapness consumables, speed of operation, reliability of fixation of debris. The disadvantage of this method is the impossibility of applying an external fixation device in large and giant breeds of dogs.
X-ray image after extrafocal osteosynthesis
4. Combined osteosynthesis - consists of using several of the above methods and is used mainly for complex comminuted fractures.
Cat with a complex comminuted hip fracture
Cat after combined osteosynthesis
Intercondylar fracture of the humerus in a dog
After osteosynthesis
Separately, it is worth considering pelvic fractures. As a rule, dogs receive such injuries as a result of car injuries, and cats receive such injuries as a result of falling from a great height. When the pelvic bones are damaged, there are usually multiple fractures, which makes them the most difficult in the practice of a traumatologist.
Multiple pelvic fractures in a dog. On the right - a fracture of the pubic and ischial bones, on the left - a fracture of the acetabulum.
The same dog after osteosynthesis
The use of a compression plate for a complex fracture of the acetabulum
In our veterinary clinic extensive experience has been accumulated in the use of all types of osteosynthesis in animals of all sizes, which allows us to approach the treatment of each case individually and recommend the most optimal method reconstructive surgery.
Prices, rub.
The price does not include consumables and additional work
Question and answerIs it possible to fix an old fracture (radius bone of the dog's front right leg)? If yes, what is this operation called? A week later we made an appointment for an examination and an x-ray of the old fracture, we are waiting to see what they say. But I would also like to get an answer to the question above... The fracture healed crookedly, a dog from the street. Julia
Question: Is it possible to fix an old fracture in a dog?
Hello! Maybe. This is metal osteosynthesis. But you can tell more accurately only from the picture.
Hello. Tell me the approximate amount general expenses, including additional ones, for prosthetic paws for a cat. Amputated as a result of falling into a trap, up to the wrist area.
Question: can you tell me the approximate amount for a prosthetic paw for a cat?
Hello! Regarding prosthetics, write to us by email [email protected] with a note to Sergei Sergeevich Gorshkov. An examination and analysis of the case is necessary. No one can tell you the approximate cost right off the bat.
