Radius and ulna fracture repair with the IMEX miniature circular external skeletal fixation system in 37 small and toy breed dogs: A retrospective study

Comparative microcomputed tomographic structural analysis of the trabecular and cortical bone architecture of radius and ulna in toy dog breeds

Radius and ulna fractures can be detected in dogs with an incidence of 18.0% and occur more frequently in toy breeds with increased complication rates. The reasons for the predisposition and the increased complication rate of antebrachial fractures in toy breeds are not yet fully understood. The aim of this study was to research the associated mechanisms by investigating the trabecular structure parameters (BV/TV (%), Tb.N (mm^-1), Tb.Th (mm), Tb.Sp (mm), Conn. D (mm^-3), DA) and the cortical bone density (Mean Density (mg HA/ccm)) for toy breeds and small dogs of other breeds using microcomputed tomography and to identify the differences between both groups. A total of 70 forearms, originating from toy breeds (n = 36) and small dogs of other breeds (n = 34) were evaluated by microcomputed tomography. The results of this study showed a lower bone volume fraction (BV/TV), more (Tb.N) but thinner trabeculae (Tb.Th) with greater separation (Tb.Sp) and decreased diaphyseal cortical density (Mean Density) in toy breed dogs. This could thus contribute to the increased risk of antebrachial fractures in toy breeds. Within the group of toy breeds inhomogeneous results were observed, whereby the values of the Chihuahuas deviated. This breed had significantly thinner trabeculae (Tb.Th) with a greater trabecular separation (Tb.Sp), lower bone volume fraction (BV/TV) and significantly lower diaphyseal cortical density (Mean Density). These parameters could therefore indicate an increased antebrachial fracture and complication risk, especially in Chihuahuas.

SUCCESSFUL REPAIR OF ANTEBRACHIAL FRACTURES WITH EXTERNAL SKELETAL FIXATION IN THREE MACROPODS

Three captive macropods comprising three different species sustained unilateral antebrachial fractures. All fractures were assumed to be trauma related, although the specific circumstances surrounding each case was unknown. Each fracture was surgically repaired with type Ia (unilateral, monoplanar) external skeletal fixators, which were all removed approximately 3 mo postoperatively. Although each animal experienced at least one complication, all animals showed adequate bridging and remodeling at the fracture sites and had good-to-excellent return to normal function after fixator removal. This case series is the first to describe the successful repair of antebrachial fractures using external skeletal fixation in captive macropods and details some of the complications that can occur with postoperative management of captive animals.

Clinical outcomes of 119 miniature- and toy-breed dogs with 140 distal radial and ulnar fractures repaired with free-form multiplanar type II external skeletal fixation

OBJECTIVE

To report the clinical outcomes of miniature- and toy-breed dogs with primary and previously treated distal radial and ulnar fractures (RUF) treated with a free-form multiplanar type II external skeletal fixation (ESF).

STUDY DESIGN

Retrospective study.

ANIMALS

One hundred nineteen dogs with 140 distal RUF.

METHODS

Medical records (2003-2017) were reviewed for dogs weighing up to 7 kg that had been treated for distal RUF with a free-form multiplanar type II ESF. Data collected included signalment, fracture location and configuration, fracture reduction, intraoperative realignment, time to bone union and implant removal, duration of destabilization and postoperative splint, complications, and outcomes. Follow-up consisted of clinical and radiographic evaluation or telephone interview.

RESULTS

All fractures healed, with a median time of 60 days, and entire ESF was removed, with a median time of 89 days. Major complications occurred in four fractures: premature pin loosening, elbow subluxation, osteomyelitis, and delayed union. Minor complications occurred in 52 fractures (61 events). All dogs had a successful return to normal limb function at final follow-up (median, seven months; range, 2-97).

CONCLUSION

All primary and previously treated distal RUF in miniature- and toy-breed dogs healed and allowed return to normal function after fixation with a free-form multiplanar type II ESF.

CLINICAL SIGNIFICANCE

The free-form multiplanar type II ESF provides an alternative for minimally invasive fixation of distal RUF in miniature- and toy-breed dogs that facilitates fracture reduction, intraoperative realignment, adequate initial fixation stability, destabilization, and implant removal.