Summary
Objectives: To report the application and clinical outcome of the treatment of radial carpal
bone fracture in five dogs using a variably-pitched, headless cannulated compression
screw (Acutrak®).
Methods: Arthroscopy was performed prior to surgical repair in three cases. In two cases,
a fissure within the radial carpal bone was more clearly apparent when oblique indirect
illumination was employed at arthrotomy. Following Acutrak® screw placement via arthrotomy,
external coaptation was applied in all cases for a period of two weeks.
Results: Five dogs were treated, of which four were Boxers, and one was a Labrador Retriever
crossbreed. All dogs were lame prior to treatment. There was no history of trauma,
and all dogs had soft tissue swelling on the dorsal aspect of the radiocarpal joint.
In all cases the fissure or fracture line was oblique in orientation, extending disto-medially
from the midpoint of the radiocarpal joint proximally to the level of the second carpal
bone distally. All fractures treated demonstrated progressive radiographic healing,
and all dogs were free of lameness at six weeks postoperatively, but two of the five
fractures failed to reach complete radiographic union. All dogs remained lameness-free
with mean follow-up of 12.5 months.
Discussion: Acutrak® screws are headless devices which achieve compression, even in small bone
fragments. Threads engage both the near and far fracture segments, leading to increased
screw-bone contact which maximizes pull-out strength and may increase the fatigue
strength of the screw.
Clinical significance: Fixation of two-piece canine radial carpal-bone fractures with the Acutrak® screw
proved a reliable alternative to conventional compression screw fixation, and may
have benefits over alternatives attributable to screw design and application technique.
Keywords
Acutrak - radial carpal bone - scaphoid - compression screw - carpal arthroscopy