External skeletal fixation in large animals: A review

Abstract

External skeletal fixation (ESF) was first adapted for veterinary medicine in 1934; this fixation method consisted of devices for stabilizing musculoskeletal injuries, such as fractures, dislocations, tendon ruptures, and angular deviation; using transcortical pins or wires connected in sidebars or cast to cover the region of instability. The evolution of orthopedics in veterinary medicine, together with the development of diagnostic imaging and the field of anesthesia, has allowed a substantial increase in success rates in cases of fractures in animals. However, orthopedic cases in large animals, especially, are still challenging due to the unique characteristics of the species, which are associated with bone regeneration and depend on the specific type of lesion and the use of implants that adequately support the stress distribution. External fixation techniques in large animals are plausible strategies for cases of open and/or comminuted fractures of long bones, and the literature shows that these approaches are successful. The objective of this study was to conduct a literature review of the possible configurations of ESF used in large animals and their indications. In addition, we aimed to determine the factors that influence the success rate of these techniques, as well as the advantages and disadvantages, to determine whether the use of ESF in orthopedic patients is a reasonable option for the management of certain diseases.