Feasibility of C-arm guided closed intramedullary pinning for the stabilization of canine long bone fractures.

Anupreet Kaur,Narinder Singh Saini,Ashwani Kumar,Deepesh Kumar,Jitender Mohindroo

doi:10.14202/vetworld.2015.1410-1415

Anupreet Kaur, Narinder Singh Saini + Show 3 more

Open Access

https://doi.org/10.14202/vetworld.2015.1410-1415

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Abstract

Aim:To evaluate the feasibility of C-arm guided closed intramedullary pinning (simple Steinmann and end threaded) techniques for the stabilization of various canine long bone fractures.Materials and Methods:The present study was conducted on 19 dogs with long bone fractures which were stabilized using simple Steinmann (Group I; n=6) and end threaded (Group II; n=13) pinning under C-arm guidance. Signalment, history of trauma, clinical examination, and hematobiochemical findings were recorded at the time of presentation. Radiography of the affected limb was carried out in two views to determine type and site of the fracture. Treatment of all the fractures was attempted using simple Steinman and end threaded pinning under the C-arm guidance. The success and failure of the closed technique were correlated with age, site, and type of fractures.Results:The mean body weight and age of the dogs were 18.53±2.18 kg and 21.58±5.85 months, respectively. Early presented cases at a mean day of 2.84±0.54 were included. Out of 19 cases, it was possible to place implant successfully in 10 cases (success rate 52.63%) only. The remaining 9 cases had serious intraoperative complications like a misdirection of the pin after engaging the proximal fragment (n=3), missing the proximal fragment completely, and formation of the false tract (n=6). The majority of these complications were associated with younger age and proximal or distal third oblique fractures. High success rate of C-arm guided closed pinning was observed in midshaft fractures (75%) and transverse fractures (77.78%) in dogs of more than 1 year of age (77.78%). Simple Steinmann pinning was better feasible in a closed manner with a high success rate (66.70%) but also had implant related complications. Although, C-arm guided end threaded pinning was less (46.15%) successful, slightly tedious and time-consuming but had better implant stability than that of simple intramedullary pinning.Conclusions:From the present study, it was concluded that C-arm guided closed pinning is recommended in transverse and midshaft fractures of the long bones in dogs older than 1 year of age. Furthermore, there is need to improve traction devices for enhancing the success of C-arm guided intramedullary pinning in dogs.

Highlights

Reduction, retention, and immobilization are the basic principles of fracture management
High success rate of C-arm guided closed pinning was observed in midshaft fractures (75%) and transverse fractures (77.78%) in dogs of more than 1 year of age (77.78%)
From the present study, it was concluded that C-arm guided closed pinning is recommended in transverse and midshaft fractures of the long bones in dogs older than 1 year of age

Summary

Introduction

Retention, and immobilization are the basic principles of fracture management. Reduction of long bone fractures can be achieved by closed and open methods. Reduction by the open method is associated with additional soft tissue trauma, periosteal stripping, and disturbance of hematoma at the site of fracture [1]. Hematoma formation is a necessary stage for the initiation of fracture healing [2] as it contains multilineage mesenchymal progenitor cells and has the inherent osteogenic potential [3,4]. Biological osteogenesis is a recent concept that involves adequate stabilization of fracture without interfering physiological environment at the site of fracture [5]. It can be achieved by using C-arm guided closed intramedullary pinning which is a safe and widely practiced procedure [6].

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