VetTips: Fine and Fiddly Fracture Repair

We asked Dr Stanley Kim to give us some useful tips on fracture repair for toy breeds and cats.  This is just a taste of the amazing skills you’ll learn at the Fine and Fiddly Fracture Repair Workshop.

Tip 1: THINK TWICE before recommending external coaptation for antebrachial fractures in toy breed dogs

Distal diaphyseal antebrachial fractures in toy breed dogs are very common, and typically the result of a low impact injury such as a jumping of the couch or falling from a low height. The radius of the toy breed dog is particularly prone to injury because of its unique cross-sectional shape.

It is very tempting to recommend external coaptation for these injuries because they are distal, the animals are small, and the costs are low. While successful healing has certainly been documented with external coaptation, there is a high risk of non-union, malunion, and skin ulceration. The fracture configuration is typically highly unstable, and the small size of the segments translates to a very high strain environment. Furthermore, there is evidence that the vascular pattern of toy breed dogs is poorer than that of larger dogs. Collectively, these factors translate to a high-risk scenario, and salvage of the limb after failed coaptation becomes very challenging.

Tip 2: BEWARE of implant failure with tibial fracture using plates in cats

Pound-for-pound, cats are much stronger than dogs. In certain fractures, cats may therefore stress implants relatively more than dogs. In a recent study, high failure rates were documented following tibial diaphyseal fracture repair using plate-screw fixation. Special consideration of plate and/or rod selection and application should be given to avoid plate bending following tibial fracture repair in cats.

Tip 3: Lacking confidence with sacroiliac repair? Opt to do no harm

Sacroiliac luxation is a common injury. It is also remarkably well tolerated in many animals. Surgery is not always the treatment of choice. Indeed, repair is challenging, especially in small animals. The corridor for safe screw placement is small, and poor positioning can result in catastrophic iatrogenic injury. While the recovery period can be prolonged, conservative management of most sacroiliac luxations typically results in a satisfactory outcome.

To develop your practical skills, join specialist surgeon Dr Stanley Kim in April 2019 for a two-day focus on small fractures and develop your skills to treat your patients better. Register TODAY for the Toy Breeds Workshop. This workshop will be helpful to veterinarians with a foundation in orthopaedics who want to extend their skill set and master techniques with support from Australia’s finest and friendliest surgeons. For more information, check out the brochure.