Top 5 Tips for Navigating Long-Bone Fractures
Sponsored by Arthrex Vet Systems
Fractures of long bones are a common occurrence in companion animal medicine, with femur fractures occurring most frequently.1 These injuries can be complex and require a strategic and thoughtful approach to ensure successful outcomes.
Below are 5 tips to consider when navigating the path from long-bone fracture diagnosis to recovery.
1. Patrol for Pain
In patients with confirmed or suspected long-bone fractures, managing pain should be a top priority. Pain should be controlled and/or sedation should be used when manipulating the patient during orthopedic evaluation and for obtaining diagnostic radiographs.2 Educating pet owners on how to identify pain and the importance of treating pain is critical to patient well-being.
2. Focus on the Diagnosis
In patients presented with broken or suspected broken bones, it is critical to perform a thorough physical examination to assess the patient’s overall status and ensure that the patient is stable, particularly in cases of trauma.
In some cases—especially for radial, ulnar, tibial, and fibular fractures—fractures may be suspected or diagnosed on physical examination; however, radiography is the mainstay for determining fracture type and location. High-quality radiography is important not only for a proper diagnosis but also for creating an appropriate management plan. Radiographs should include at least 2 orthogonal views to evaluate for fracture.3 Oblique and stress radiographs can be obtained if a complex fracture or collateral ligament damage is suspected in metacarpal or metatarsal fractures.4
3. Consult an Expert
Once a fracture has been classified, a treatment plan can be formulated. Although management of some fractures may be done with external coaptation, others may require surgical intervention. When in doubt, an orthopedic specialist should be consulted for guidance on which interventions can offer the best chance for a full patient recovery. Although not all pets will need to see a specialist (or will be able to see a specialist), many surgeons may be willing to offer phone consultations to ensure the best outcomes for patients at their referral partners.
4. Secure the Tools
If surgical intervention is required, it should be ensured that all the necessary equipment is on hand to maximize success. Depending on fracture location and type, fractures can be surgically repaired using bone plate/screws, an external fixator, interlocking nails, intramedullary pins and cerclage, and/or a plate/rod.2
The Arthrex OrthoLine™ fracture management system provides a wide array of state-of-the-art straight, T-style, and anatomic plates in numerous sizes, as well as a large variety of screw options, including partially threaded screws, cannulated lag screws, low-profile screws, QuickFix cannulated screws, and fully threaded, headless, compression screws. Features of the OrthoLine fracture management system include high screw density where needed, anatomic plate designs, strong plates for bridging, low plate contact and low-profile plates, color coding for easier identification, K-wire holes, cortical/locking/variable-angle locking screws, and extensive size ranges to accommodate a variety of patients, from small cats to large dogs.5
5. Formulate a Foolproof Follow-Up Plan
Patients that have undergone both external coaptation and surgical fixation will require routine follow-up. Consideration should be taken to ensure that pet owners have a good understanding of postoperative care and cast/splint care. They should be encouraged to contact the veterinary team at the first signs of concern.
To evaluate for healing, repeat imaging can be performed, keeping in mind that radiographic signs of fracture healing can lag by weeks or months behind actual healing.6 Ultrasonography may be an alternative option to diagnose fracture healing sooner and can be repeated every 2 to 3 weeks in adult patients.6
Conclusion
Navigating long-bone fractures in companion animals can present its share of challenges, from diagnosis through management. However, with the right support, including a variety of surgical tools like those from Arthrex, veterinarians can address a range of fracture types in their patients.
