Analysis of the treatment of comminuted fractures of tubular bones of the extremities in cats and dogs

Abstract

Surgical resolution of comminuted fractures of tubular bones is an urgent issue for practicing veterinarians. Comminuted fractures account for 52%, transverse fractures for 8.7%, oblique fractures for 26.1%, and compression fractures for 13.0% of total canine fractures. Thus, comminuted fractures of the tubular bones of the extremities are the most frequent. There are several types of bone fixation in comminuted fractures. Many authors do not recommend using of intramedullary osteosynthesis in the treatment of this type of fracture since it is not possible to connect all bone fractures. The aim of this study was to compare the methods of surgical treatment of comminuted fractures in dogs and cats admitted to the clinics and to choose the most optimal ways of treatment. In total, 4,396 cats and dogs were admitted to the clinic, excluding those admitted for vaccination. The surgical department received 35% of the total number of animals. Patients with bone and joint pathology accounted for 19% of all surgical causes and to 7% of all animals admitted to the clinic. In the group of 9 cats and 9 dogs three main types of fracture were diagnosed: transverse fracture in 6 animals (4 dogs and 2 cats), oblique fracture in 4 animals (3 dogs and 1 cat) and comminuted fracture in 8 animals (2 dogs and 6 cats). The article is illustrated with X-rays images of the clinical cases presented. In order to perform osteosynthesis using a single-plane bilateral external fixator, the authors injected 2-3 Kirchner spokes each into the proximal and distal bone fragments by drilling through the bone while perforating soft tissue on both sides. The ends of the spokes on both sides were bent towards the opposite fragment, parallel to the bone axis, at a distance of 1.0 to 3.0 cm from the skin surface. The ends of the spokes form the rods of a bilateral single-plane fixator. The rod-forming spokes are tightened with wire serrations on 3-4 levels and additionally fixed with fast hardening plastic (turbocast) or bone cement (Palacos, GMW, Osteobond) while controlling the fracture reposition. Combination with wire serclages, sutures, compression screw or intramedullary Kirschner wire osteosynthesis is possible.