EXTERNAL SKELETAL FIXATION
Fractures of the bones of the body can be repaired using any combination of metal implants of screw, plates, wires and pins placed internally, or wires and frames placed externally. The reason for using these implants is to hold the bones together in a rigid manner so that the bone may regrow and heal following injury and fracture. If there is any movement at the fracture site, then the bone will not be able to heal and become hard and mineralised. Bone healing is generally a race between the progress of bone healing and the implants weakening and failing. Some fractures may be left to heal without any surgery or stabilsation, but the functional outcome of the patient will be the deciding factor as to whether a certain fracture needs to be repaired using metal or left to heal. Fracture stabilisation aims to provide pain relief by immobilising the bone and allowing early return to function and weight bearing.
Fractures of the long bones where there is a high degree of fragmentation which is not able to be reconstructed external frames are used to hold the fragments in position whilst the body regenerates new bone and remodels the injured bone. Once the bone healing and remodelling is complete, generally 8-16 weeks, the external frame will be removed completely under a short general anaesthesia.
Advanced Veterinary Surgery uses a combination of techniques and implants to stabilise fractures on an individual basis at the time of surgery. Modern surgical equipment and a range of surgical kits and implants allow the best decisions to be made for the patient at the time.
Complications rates are low, with the most common complications being infection, usually less than 5% depending on the type of the fracture and other injuries sustained at the time. The infections usually only require antibiotics in addition to the ones dispensed at the time of surgery.
Other complications are related to either the injuries of the trauma themselves of those sustained during manipulation of the bones during surgery and reconstruction. Nerve injuries are often difficult to accurately assess immediately following trauma as there may be a period of time required for trauma related shock and inflammation to resolve, and also the limb function will often be severely affected.
The other most common complication is related to the patient themselves, with over activity and excessive stress placed on the healing bone and implants, with either failure and breakage of the implants or bone the implants are anchored to. Generally gentle lead controlled walks in incrementally increasing lengths are well tolerated in the weeks following fracture repair. However it is the short periods of high risk activity when these avoidable complications occur. Jumping, stairs, slippery floors, any off-lead activity will increase this risk and potentially cause catastrophic failure requiring repeat surgery. As the owner you will be the brains of the recovery and be responsible for enforcing the strict rest and confinement, rehabilitation program, and lead controlled walks, prior to a return to normal activity over a 12-16 week period.