ISSN 2398-2985      

Limb fracture repair: internal fixation

6guinea pig

Introduction

  • Technique of fracture fixation.
  • Often used in combination with external coaptation as well as external fixation.
  • Principles of fracture fixation follow the same principles as in dogs and cats.

Uses

  • Surgical fixation of fractures most used for long bones.
  • Internal fixation is often used for fractures of the humerus, femur and tibia.
  • Metacarpal and metatarsal fractures are uncommon and are suitable for external coaptation.
  • Different techniques used:
    • Intramedullary pin.
    • Kirschner wire.
    • Bone plate.

Advantages

  • Intramedullary pin:
    • Easy to place.
    • Require basic orthopedic experience.
    • Low cost: hypodermic needles can be adapted as an intramedullary pin for very small patients.
    • Decreased bone exposure.
    • Can be combined with other devices such as cerclage wires.
    • Preferred method of fixation in animals that would not tolerate an external fixator.
    • Early return to function possible.
  • Kirschner wire:
    • Occasionally used on its own for simple fractures, eg olecranon.
    • Do not require removal unless causing lameness.
  • Bone plates:
    • More control over forces acting on the bone.
    • Good fragment apposition.
    • Do not require removal unless causing discomfort.

Disadvantages

  • Intramedullary pin:
    • Do not counteract rotational forces:
      • Only bending forces are neutralized.
      • If placed through the joint, can predispose to arthritis.
    • Need to be removed.
  • Bone plates:
    • Require an experienced surgeon.
    • Longer anesthetic time compared to other methods.
    • More expensive to place.
    • Thin bone cortex of many patients prohibits the use of plates and screws.
    • Possible loss of bone strength post-operatively.

Requirements

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Preparation

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Procedure

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Aftercare

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Outcomes

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Prognosis

  • Good to guarded depending on complexity of procedure.
  • Open fractures carry a guarded prognosis due to possibility of post-operative osteomyelitis.
  • Patients suffering with metabolic bone disease carry a poor prognosis.

Further Reading

Publications

Refereed Papers

  • Recent references from PubMed and VetMedResource.
  • Macedo A S, Minto B W, Goulart M A et al (2015) Tibial osteosynthesis in a guinea pig (Cavia porcellus). Arq Bras Med Vet Zootec 67 (1), 89-93 VetMedResource.
  • Aguiar J, Mogridge G & Hall J (2014) Femoral fracture repair and sciatic and femoral nerve blocks in a guinea pig. J Small Anim Pract 55 (12), 635-639 PubMed.
  • Dunning D (2002) Basic mammalian bone anatomy and healing. Vet Clin North Am Exot Anim Pract 5 (1), 115-128 PubMed.
  • Helmer P J & Lightfoot T L (2002) Small exotic mammal orthopedics. Vet Clin North Am Exot Anim Pract 5 (1), 169-182 PubMed.
  • Pollock C (2002) Postoperative management of the exotic animal patient. Vet Clin North Am Exot Anim Pract  5 (1), 183-212.
  • Williams M S (2002) Orthopedic radiography in exotic animal practice. Vet Clin North Am Exot Anim Pract 5 (1), 1-22.

Other sources of information

  • Zehnder A & Kapatkin A S (2012) Orthopedics in Small Mammals. In: Ferrets, Rabbits and Rodents. 3rd edn. Eds: Quesenberry K & Carpenter J. Saunders, USA. pp 474-476.

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