Fracture Repair Starting at $2000
When a bone breaks, one of the first things that needs to happen is for the bone fragments to be immobilized so they cannot move. A fracture that is immobilized will hurt a lot less and the sharp ends of the bone fragments will not cause further damage to the muscles, nerves and blood vessels surrounding the bone.
At home, before you can get to a veterinary clinic or hospital, you can confine your pet to a very small space. Ideally your pet is lying down in a box, crate or kennel; movement is limited to only that necessary to go to the bathroom or maintain cleanliness. Seek veterinary care as soon as possible – at least call to receive instruction; a bone fracture is very painful and other dangerous medical conditions may have been created at the same time as the fracture. Do not give any medications or apply any therapy unless you receive clear guidance from your veterinarian.
Closed fractures are ideally treated within 2–4 days; open fractures are best treated with an initial surgery to clean the wound and bone within 8 hours of the injury (a final surgery for open fractures can be delayed for 24–48 hours.)
Usually, the best way to temporarily immobilize a fracture prior to final treatment is to place the leg in a splint. To properly immobilize a bone, the joints above and below the affected bone must be prevented from moving. It is fairly easy to temporarily immobilize bones below the elbow and below the knee; the upper arm and the thigh are more challenging to manage because the shoulder and hip are difficult to splint. Often it is best to put the limb in a sling or simply confine your pet to a small space while plans for definitive treatment are made. Splints and bandages, as well as confinement, are best managed at a veterinary facility.
When a bone is broken, it is unable to resist the normal physical forces that act on bones when a pet walks on a leg. Some of these normal forces are:
- bending (like the force used to break a pencil in half)
- torsion (a twisting force around the bone)
- compression (the force that gravity puts on us when we bear weight on our legs)
- traction (the pulling force applied to a small portion of bone by a muscle at its attachment on the bone)
External coaptation: a splint or cast; applied to the outside of the limb; good at resisting bending forces and fair at resisting torsion and compression forces.
External fixation: a surgically applied device that is attached to the bone with pins that thread into the bone, but come out through the skin. These pins are connected to a rigid bar with clamps to “splint” the bone on the outside. This method is very good at resisting bending, compression and torsion forces (Figure 4).
Internal fixation: surgically applied devices implanted inside the bone or on the surface of the bone. Various devices are available and offer different results against the various forces such as plates, screws, nails, pins, wires (Figures 5 and 6).
Several factors go into making up a final treatment plan for a fracture. Each factor has characteristics that support easy/rapid fracture healing and characteristics that result in slow/complicated fracture healing. We use this scale of information to come up with the best repair options for an individual pet. Your veterinarian may refer you to an ACVS board-certified veterinary surgeon for your pet’s fracture repair because of the experience and training involved in successful fracture fixation.