Your pet has been admitted to the Bryanston Veterinary Hospital for a fracture. This is a common condition of cats and dogs usually caused by trauma. It can be seen in older dogs secondary to bone cancer but there are usually signs of loss of bone on the x-rays associated with the tumour and the fracture.
There are three main methods of repairing fractures in cats and dogs; these are external co-optation or a bandage, external fixation or internal fixation. All of these methods are acceptable but depend heavily on the age of the dog, the type of fracture and if the skin over the fracture has been damaged.
Bandages can only be used for fractures that are below the elbow or knee. They have limited use to young dogs with fractures that have not displaced or moved apart very much, or when they have not fractured completely. Bandages require intensive care to keep them clean and dry if the get wet or slip they lose their ability to provide support and can lead to damage to the blood supply to the leg. A bandage can be used to support internal fixation in certain cases. It is very important to look after all bandages as if they are not looked after they can cause severe problems.
External fixation provides the most versatile methods of fracture repair that can be adapted to any bone in the body that needs repairing. It entails the placement of pins through a small hole in the skin into the bone. This is done in combination with reduction of the fracture or bringing the bone ends together. These pins are then placed into an external bar which supports the bone and allows it to heal while still bearing weight. The area where the pins go into the skin needs to be cleaned daily for the first 10 days after the surgery. This can be done with betadine or bactroban. It is very important to keep these patients confined to a small room where there is no furniture, security doors that the fixator can get caught on and pull out. This can be very painful and detrimental to healing of the fracture. This type of fixation is very useful in cases where the skin is damaged and the fracture site is exposed, or when there is severe damage to the bone and there are lots of small fragments of bone or in cases of infection at the fracture site. An external fixator can be placed without causing further damage to the blood supply of the bone and helps prevent
infection from establishing itself in open fractures. The uses are endless in the repair of all types of fractures.
The final method is internal fixation and this uses bone plates, screws, pins and wires. Plates and screws are used together most often. These provide excellent rigid support to the animal during healing of the fracture and allow early return to function of the leg. They are placed on the bone by drilling holes in the bone and the securing the plate to the bone with screws. There are 2 main types of plates, a locking plate and a compression plate. A locking plate is the newest and offers the most support and is used in most of the worst fractures. The screws will lock into the plate and not compress the bone. A compression plate is applied in the same manor but has a slightly different shape. It allows 2 bone ends of a simple fracture to be compressed together. Plates are the most expensive method of fixation. They offer the advantage of being under the skin and thus not getting caught on anything. They are usually left in for the entire life span of the dog unless they cause problems. Pins and wires can be used in long oblique fractures that fulfil certain criteria. They are best used in younger animals for these specific fractures and thus are not used as commonly. Wire and pins can be used together with plates and screws in severe fractures.
Regardless of the type of fracture or the fixation used it is essential for the dog to be confined to a small enclosed area for at least the first four weeks post surgery. In older dogs this may be longer, during this time all dogs should be kept separate from other dogs. They can be taken for a walk twice daily as long as they are controlled on a leash at all times. Follow up x-rays are taken 2-4 weeks post surgery, depending once again on the age of the dog and the type of fracture. The patient will gradually use the leg more and more, if however your animal stops using the leg suddenly or seems painful please bring them back strait away for us to look at.
We wish your pet a speedy recovery, please feel free to contact us on 011 706-6023 if you have further questions.
Azithromycin-Containing Regimensfor Treatment of Mycobacterium avium Complex Lung Disease David E. Griffith,1,3 Barbara A. Brown,2 William M. Girard,1 Bryan E. Griffith,2 Leslie A. Couch,1 and Richard J. Wallace, Jr.1,2 Departments of 1Medicine and 2Microbiology and the 3Center for Pulmonary and Infectious Disease Control, the University of Texas HealthCenter, Tyler, Texas Ninety-two patients