ISSN 2398-2969      

Limb fracture

Clapis

Introduction

  • Cause: the combination of a light-weight skeleton in the rabbit and underlying osteoporosis of many pet rabbits means that fractures are a common problem. Trauma, improper handling and dropping are the most common causes of limb fractures in pet rabbits.
  • Signs: acute onset lameness following trauma. Skin lesions and wounds associated with open fractures.
  • Diagnosis: physical examination, palpation, radiographic examination.
  • Treatment: conservative, external coaptation, external/internal fixation, limb amputation depending on type and severity of fracture.
  • Prognosis: good if presented early post-trauma.

Print off the Owner factsheets It's an emergency and Health insurance for your rabbit to give to your clients.

Presenting signs

  • Acute onset lameness.
  • Skin lesions and wounds associated with open fractures.
  • Due to the 'preservation reflex' of prey animals, the rabbit may not show visible evidence of pain. However, subtle signs include altered or reduced locomotion, anorexia, or hiding.

Geographic incidence

  • High incidence of fox or dog attacks in rabbits housed outdoors.
  • House rabbits accidentally trodden on by owners when underfoot or dropped during restraint.

Age predisposition

  • One study reported 75% of rabbits with fractures were <2 years old.

Cost

  • Hospitalization of the rabbit.
  • Radiography (pre- and post-surgery and follow up).
  • Orthopedic surgery - all orthopedic procedures in rabbits must have a careful cost analysis discussed with the owner.
  • Case studies report that most limb fractures in rabbits are closed. However, many fractures are both comminuted and contaminated, and need extensive treatment prior to surgery.
  • Surgical repair will necessitate repeated check-up consultations.
  • Cost of implants, splints and dressing changes.
  • Analgesia and antimicrobials.
  • Referral to an orthopedic specialist may be necessary for comminuted distal tibial fractures (this is becoming more of an option now for owners with insured rabbits).
  • After repair, the prognosis for functional recovery is good and most fractures heal without complications, with reports around 86%. Post-surgical complications were reported in 41% of cases in one study. Complications of repair are common, as rabbits are prone to osteomyelitis Osteomyelitis.
  • If cost is a problem, salvage amputation Limb amputation should be discussed as a possible life-sparing option. This is also an option if surgical repair is unsuccessful.

Special risks

  • With comminuted open fractures the risk of osteomyelitis is very high.
  • Lengthy orthopedic procedures also carry an anesthetic risk so expeditious technique is required.
  • The rabbit should be stabilized prior to surgery to reduce the risks related to general anesthesia.

Pathogenesis

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Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Garcia-Pertierra S, Ryan J, Richardson J et al (2020) Presentation, treatment and outcome of long-bone fractures in pet rabbits (Oryctolagus cuniculus). J Small Anim Pract 61 (1), 46-50 PubMed.
  • Sasai H, Fujita D, Seto E et al (2018) Outcome of limb fracture repair in rabbits: 139 cases (2007–2015). JAVMA 252 (4), 457-63 PubMed.
  • Knudsen C S & Langley-Hobbs S J (2010) Spontaneous femoral capital physeal fractures in a Continental giant rabbit. Vet Rec 166 (15), 462-463 PubMed.
  • Carrillo J M, Sopena J J, Rubio M et al (2005) Experimental use of polyamide bands in combination with intramedullary pinning for repair of oblique femoral fractures in rabbits. Vet Surg 34 (4), 387-392 PubMed.
  • Hillyer E V (1994) Pet rabbits. Vet Clin North Am Small Anim Pract 24 (1), 25-65 PubMed.
  • Pead M & Carmichael S (1989) Treatment of a severely comminuted fracture in a rabbit using a Kirshner-Ehmer apparatus. JSAP 30 (10), 579-582 ResearchGate.
  • Terjesen T (1984) Bone healing after metal plate fixation and external fixation of the osteotomized rabbit tibia. Acta Orthop Scand 55 (1), 69-77 PubMed.

Other sources of information

  • Harcourt-Brown F & Chitty J (2013) Manual of Rabbit Surgery, Dentistry and Imaging. BSAVA.
  • Capello V (2006) Small Mammal Orthopedics. In: Proc BSAVA Congress. pp 209-211.
  • Kapatkin A (2004) Soft Tissue Surgery. In: Ferrets, rabbits & Rodents: Clinical Medicine & Surgery.2nd edn. Eds: Quesenberry K E & Carpenter J W. Saunders. pp 221-230.
  • Slatter D (2002) Textbook of Small Animal Surgery. Vol 2. W B Saunders.
  • Hillyer E V & Quesenberry K (1997) Ferrets, Rabbits and Rodents. In: Clinical Medicine and Surgery. W B Saunders.
  • Brinker W O, Piermattei D & Flo G (1990) Handbook of Small Animal Orthopedics and Fracture Treatment. 2nd edn. W B Saunders.

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