Section: Diagnosis In-depth
Following a traumatic injury, fractures will be low down on the list of priorities for your dog in comparison to bleeding problems and breathing disorders. Life threatening problems will be evaluated and treated initially.
For this reason, all fractures of the extremities will be noted on a thorough examination but will be addressed once other systems are stable. Fractures associated with the skull and the spine may necessitate careful handling of your pet and modifications of early treatment protocols to offset spinal cord or brain swelling. Once stabilized, tests and treatment may include:
Open wounds with protruding bone fragments will be covered and protected. Antibiotics will be started until the area can receive some form of temporary stabilization.
Careful physical examination will usually allow localization of a suspected fracture due to the pain produced on palpation of the area or the restriction of range of motion in that region of a limb.
The bones of the jaw and skull will be examined to evaluate dental alignment, jaw motion, nasal deviation and the presence of swollen or depressed contours of the skull where fractures may have occurred.
If your dog is recumbent (lying down and unable to get up), a neurological examination will be performed to evaluate the cranial (head) nerves, consciousness and reflexes of the forelimbs and hindlimbs. Any abnormalities may be suggestive of skull or spinal fractures or spinal dislocations.
Radiographs (X-rays) are the mainstay of fracture diagnosis. Before X-rays are taken of the limbs, blood work, chest and/or abdominal radiographs may be more important to ensure that vital systems are in order and to assess your pet's risk for anesthesia, if surgery were necessary.
Chest and abdominal X-rays may provide valuable information with regard to rib fractures, spinal injuries and some upper forelimb and hindlimb fractures that happen to be included on the film.
Only when your dog is stable will views be taken specifically to evaluate the nature of a fracture. This may be done prior to anesthesia or under anesthesia as certain views may be difficult to obtain in a conscious and painful animal.
Based on the type of fracture(s) present your veterinarian will present options for treatment. This may include referral to an orthopedic specialist.
Use of CT scans or MRI is occasionally helpful for the diagnosis of fractures, particularly involving the skull or spine to assess involvement of underlying nervous tissue.
Special radiographic views, such as skyline views or oblique views, can be used to highlight certain fractures and experienced radiographers may be needed to obtain these images.
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