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Treatment of fractures of the distal radius and ulna in toy breed dogs with circular external skeletal fixation: a retrospective study
Received:11 June 2010
Accepted:15 March 2010
19 December 2017 (online)
Objective: To evaluate the effectiveness of circular external skeletal fixation (CESF) in treating fractures of the distal radius and ulna in toy breed dogs, and to document the type and frequency of complications associated with this technique.
Methods: The medical records of small breed dogs with fractures of the distal radius and ulna admitted to the University of Turin and to the Clinica Ferretti between 2002 and 2009 were retrospectively reviewed. The criteria for inclusion of cases in the study were: body weight of 5 kg or less, transverse or short oblique fracture of the distal third of the radius and ulna, no previous repair attempts, and treatment with CESF as the sole method of fixation.
Results: Twenty fractures in 16 dogs satisfied the criteria for inclusion into this study. No signs of infection or failure of fixation were detected in any case. Mean frontal plane alignment was 4.7° ± 2.7° and mean sagittal plane alignment was 12.7° ± 7.2°. Postoperative complications occurred in one patient. All fractures achieved union. Mean time until radiographic evidence of a bridging callus and subsequent implant removal was 71 days (range: 30–120).
Conclusions: The results of this study support the use of CESF for treatment of fractures of the distal radius and ulna in toy breed dogs as an alternative to other methods of fracture fixation. However, this technique requires a series of follow-up examinations to evaluate the stability of the apparatus, the soundness of the wires and to determine the appropriate time for implant removal.
- 1 Nunamaker DM. Fractures of the radius and ulna. In Newton CD, Nunamaker DM. editors Textbook of small animal orthopedics. Philadelphia: JB Lippincott; 1985: pg. 373-379.
- 2 Denny HR. Fracture of the radius and ulna. In: A guide to canine orthopaedic surgery. 2nd ed. Boston: Blackwell Scientific Publications; 1985: pg. 179-85.
- 3 Leonard EP. Fracture of the radius and ulna. In: Orthopaedic surgery of the dog and cat. 2nd ed. Philadelphia: WB Saunders; 1971: pg. 163-171.
- 4 Phillips IR. A survey of bone fractures in the dog and cat. J Small Anim Pract 1979; 20: 661-674.
- 5 Lappin MR, Aron DN, Herron HL. Fractures of the radius and ulna in the dog. J Am Anim Hosp Assoc 1983; 19: 643-650.
- 6 Muir P. Distal antebrachial fractures in toy breed dogs. Compend Contin Educ Pract Vet 1997; 19: 137-145.
- 7 Muir P. Distal antebrachial fractures in toy breeds of dogs. Vet Surg 1997; 26: 254-255.
- 8 Larsen LJ, Roush JK, McLaughlin RM. Bone plate fixation of distal radius and ulna fractures in small-and miniature-breed dogs. J Am Anim Hosp 1999; 35: 243-250.
- 9 Hunt JM, Aitken ML, Denny HR. et al. The complications of diaphyseal fractures in dogs: A review of 100 cases. J Small Anim Pract 1980; 21: 103-119.
- 10 Waters DJ, Breur GJ, Toombs JP. Treatment of common forelimb fractures in miniature and toy breed dogs. J Am Anim Hosp Assoc 1993; 29: 442-448.
- 11 Welch JA, Boudrieau RJ, DeJardin LM. et al. The intraosseous blood supply of the canine radius: implications for healing of distal fractures in small dogs. Vet Surg 1997; 26: 57-61.
- 12 Summer-Smith G, Cawley AJ. Non-union of fractures in the dog. J Small Anim Pract 1970; 11: 311-325.
- 13 Sumner-Smith G. A comparative investigation into the healing of fractures in miniature poodles and mongrel dogs. J Small Anim Pract 1974; 15: 323-328.
- 14 Vaughan LC. A clinical study of non-union fractures in the dog. J Small Anim Pract 1964; 5: 173-177.
- 15 Sumner-Smith G. A histological study of fracture nonunion in small dogs. J Small Anim Pract 1974; 15: 571-578.
- 16 Herron MR. Repair of distal radio-ulnar fractures in toy breeds of dogs. Canine Pract 1974; 1: 12-17.
- 17 Atilola MAO, Sumner-Smith G. Nonunion fractures in dogs. J Vet Orthop 1984; 3: 21-24.
- 18 DeAngelis MP. Causes of delayed union and nonunion of fractures. Vet Clin North Am 1975; 2: 251-258.
- 19 DeAngelis MP, Olds RE, Stoll SG. et al. Repair of fractures of the radius and ulna in small dogs. J Am Anim Hosp Assoc 1973; 9: 436-441.
- 20 Maclain DL, Braun SG. Fixation of radius and ulna fractures in the immature dog and cat. A review of popular techniques and a report of 8 cases using plate fixation. Vet Surg 1982; 11: 140-145.
- 21 Haas B, Reichler IM, Montavon PM. Use of the tubular external ?xator in the treatment of distal radial and ulnar fractures in small dogs and cats. Vet Comp Orthop Traumatol 2003; 3: 132-137.
- 22 Laverty PH, Johnson AL, Toombs JP. et al. Simple and multiple fractures of the radius treated with an external ?xator. Vet Comp Orthop Traumatol 2002; 15: 97-103.
- 23 Egger CE. A technique for the management of radial and ulnar fractures in miniature dogs using transfixation pins. J Small Anim Pract 1990; 31: 377-387.
- 24 Johnson AL, Kneller SK, Weigel RM. Radial and tibial fracture repair with external skeletal fixation: effects of fracture type, reduction and complications on healing. Vet Surg 1989; 18: 367-372.
- 25 Hamilton MH, Langley Hobbes SJ. Use of the AO veterinary mini ‘T’- plate for stabilisation of distal radius and ulna fractures in toy breed dogs. Vet Comp Orthop Traumatol 2005; 18: 18-25.
- 26 Voss K, Kull MA, Haessig M. et al. Repair of long-bone fractures in cats and small dogs with the Uni-lock mandible locking plate system. Vet Comp Orthop Traumatol 2009; 5: 398-405.
- 27 Lesser AS. Cancellous bone grafting at plate removal to counteract stress protection. J Am Vet Med Assoc 1986; 189: 696-699.
- 28 Saikku-Backstrom A, Raiha JE, Valimaa T. et al. Repair of radial fractures in toy breed dogs with self-reinforced biodegradable bone plates, metal screws, and light-weight external coaptation. Vet Surg 2005; 34: 11-17.
- 29 Tommasini Degna M, Ehrhart N, Ferretti A. et al. Bone transport osteogenesis for limb salvage following resection of primary bone tumors: experience with six cases (1991–1996). Vet Comp Orthop Traumatol 2000; 13: 18-22.
- 30 Rovesti GL, Bascucci M, Schmidt K. et al. Limb sparing using a double bone-transport technique for treatment of a distal tibial osteosarcoma in a dog. Vet Surg 2002; 31: 70-77.
- 31 Marcellin-Little DJ, Ferretti A, Roe SC. et al. Hinged Ilizarov external fixation for correction of antebrachial deformities. Vet Surg 1998; 27: 231-245.
- 32 Trostel CT, Radash RM. Tarsocrural arthrodesis: a clinical report using a circular external fixator. Vet Comp Orthop Traumatol 1998; 11: 193-196.
- 33 Ferretti A. The application of the Ilizarov technique to veterinary medicine. In Maiocchi AB, Aronson J. editors Operative principles of Ilizarov. Baltimore, MD: Williams & Wilkins; 1991: pg. 551-570.
- 34 Lewis DD, Radasch RM, Beale BS. et al. Initial clinical experience with the IMEXTM Circular External Skeletal Fixation System – Part I: use in fractures and arthrodeses. Vet Comp Orthop Traumatol 1999; 12: 108-118.
- 35 Latte Y. A specific vet Ilizarov apparatus for the treatment of fractures, delayed union and nonunion and mal union. Proceedings of the 18th Annual Meeting of the Veterinary Orthopedic Society. 1991. February 3–March 7 Snowmass; Colorado, USA: Pg. 51.
- 36 Marcellin-Little DJ. Fracture treatment with circular external fixation. Vet Clin North Am Small Anim Pract 1999; 29: 1153-1170.
- 37 Anderson GM, Lewis DD Radasch. et al. Circular external skeletal fixation stabilization of antebrachial and crural fractures in 25 dogs. J Am Anim Hosp Assoc 2003; 39: 479-498.
- 38 Rovesti GL, Bosio A, Marcellin-Little DJ. Management of 49 antebrachial and crural fractures in dogs using circular external fixators. J Small Anim Pract 2007; 48: 194-200.
- 39 Farese JP, Lewis DD, Cross AR. et al. Use of IMEX SK-circular external fixator hybrid constructs for fracture stabilization in dogs and cats. J Am Anim Hosp Assoc 2002; 38: 279-289.
- 40 Wolf JW, White AA, Punjabi MM. et al. Comparison of cyclic loading versus constant compression in the treatment of long bone fractures in rabbits. J Bone Joint Surg Am 1981; 63: 805-810.
- 41 Goodship AE, Kenwright J. The influence of induced micromovement upon the healing of experimental tibia fractures. J Bone Joint Surg Br 1985; 67: 650-655.
- 42 Orbay GL, Frankel VH, Kummer FJ. The effect of wire configuration on the stiffness of the Ilizarov external fixator. Clin Orthop 1992; 279: 299-302.
- 43 Paley D. Biomechanics of the Ilizarov external fixator. In Maiocchi AB, Aronson J. editors Operative Principles of Ilizarov. Baltimore, MD: Williams and Wilkins; 1991: pg. 33-44.
- 44 Ilizarov GA. The apparatus: Components and bio-mechanical principles of application. In Ilizarov GA. Transosseous Osteosynthesis. Theoretical and Clinical Aspects of the Regeneration and Growth of Tissue. Berlin: Springer-Verlag; 1992: pg. 63-136.
- 45 Marti JM, Miller A. Delimitation of safe corridors for the insertion of external fixator pins in the dog. J Small Anim Pract 1986; 35: 16-23 1994
- 46 Fox DB, Tomlinson JL, Cook JL. et al. Principles of uniapical and biapical radial deformity correction using dome osteotomies and the center of rotation of angulation methodology in dogs. Vet Surg 2006; 35: 67-77.
- 47 Whelan DB, Bhandari M, McKee MD. et al. Interob-server and intraobserver variation in the assessment of the healing of tibial fractures after intramedullary fixation. J Bone Joint Surg 2001; 84 B 15-18.