What Is a Fracture Repair?
A fracture is any break in bone or cartilage, either complete or incomplete. With any fracture there is also damage to the surrounding soft tissues.
What Are the Indications For Performing a Fracture Repair?
All fractures should be repaired. To heal, the fracture must be immobilized, which can be accomplished in several ways. Some do well with bandaging, splints or casts, while other fractures require surgical repair.
What Preoperative Examinations or Tests Are Needed?
Preoperative tests depend in part on the age and general health of the pet as well as the cause of the fracture. In young dogs and cats with no other significant injury, minimal tests are needed. Often simple blood tests, such as a packed cell volume or blood count, are done prior to anesthesia. No tests are typically performed if the pet is splinted or casted without anesthesia. In animals with significant trauma, it is common to perform routine blood count, serum biochemical tests, a urinalysis, and possibly a chest X-ray or EKG prior to anesthesia. These recommendations vary on a case-by-case basis, and depend on the overall health of the pet.
What Type of Anesthesia Is Needed For a Fracture Repair?
As in a human patient, surgical repair of a fracture in dogs and cats requires general anesthesia to induce complete unconsciousness and relaxation. In the usual case, the pet receives a pre-anesthetic sedative-analgesic drug to help him relax, a brief intravenous anesthetic to allow placement of a breathing tube in the windpipe, and subsequently inhalation (gas) anesthesia in oxygen during the actual surgery.
How Is the Fracture Repair Done?
The type of fracture, its location, the age of the animal, the presence of other injuries or fractures and the financial means of the owner, are all major considerations in the choice of fracture repair undertaken. For any given fracture there are often many different treatment options. Some types of repair may require special equipment and experience necessitating referral to a board certified surgeon.
For surgical repair of fractures, the animal is anesthetized and placed on a surgical table with the fractured bone exposed. The hair is clipped over the surgery site and the skin is scrubbed with surgical soap to disinfect the area. A sterile drape is placed over the surgical site.
Fractures are repaired externally or internally. External repairs involve the placement of pins through the skin and bone that protrude on both sides of the leg. These pins are then connected with rods. Internal repair can involve the placement of a metal rod through the center of the bone fragments and wires to stabilize the bone. Metal bone screws or plates can also be used to bring the fracture edges together to help immobilize and repair the fracture. The type of fixation used is based on the type and severity of the fracture, location of the fracture and financial concerns.
How Long Does the Fracture Repair Take?
Depending on the severity of the fracture, repair can take 2 to 6 hours, including the needed time for preparation and anesthesia. In severe fractures, the procedure can take longer and may require two surgeons or the skills of a board certified surgeon.
What Are the Risks and Complications of a Fracture Repair Operation?
The overall risk of this surgery is moderate to low. The major risks are those of general anesthesia, bleeding, postoperative infection and fracture repair breakdown. Overall complication rate is moderate to low, but serious complications can result in death or the need for additional surgery.
What Is the Typical Postoperative Aftercare?
Postoperative medication should be given to relieve pain, which can be significant in certain situations. The home care requires reduced activity until the bones are healing. Many pets will be sent home in bandages or splints, which need to be kept clean and dry. The toes should be checked for swelling and the bandage checked for foul odor or slippage. If the incision line is visible, it should be inspected daily for signs of redness, discharge, swelling or pain.
How Long Is the Hospital Stay Following a Fracture Repair?
The typical stay is one or two days but will vary depending on severity of the fracture and any concurrent injuries.