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“USE OF TYPE I, TYPE II, TIE-IN CONFIGURATIONS AND HYBRID CIRCULAR EXTERNAL SKELETAL FIXATION IN THE REPAIR OF LONG BONE FRACTURES IN DOGS

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Title “USE OF TYPE I, TYPE II, TIE-IN CONFIGURATIONS AND HYBRID CIRCULAR EXTERNAL SKELETAL FIXATION IN THE REPAIR OF LONG BONE FRACTURES IN DOGS
 
Creator Dr. J. RADHAKRISHNA RAO
 
Contributor Dr.V.GIREESH KUMAR
 
Subject biological phenomena, cultivation, hybrids, byproducts, bears, additives, animal husbandry, hides and skins, fruits, meat
 
Description The present study was undertaken in 24 dogs presented with fractures of radius-ulna,
tibia, femur and humerus for treatment at Teaching Veterinary Clinical Complex, Veterinary
Hospital, Bhoiguda, Secunderabad and Department of Veterinary Surgery and Radiology,
College of Veterinary Science, Rajendranagar, Hyderabad, Telangana. All the fractures of
long bones were included in the present study as external skeletal fixation is suitable in
treatment of fractures of these bones. For surgical treatment by External Skeletal Fixation
(ESF), the 24 dogs with fractures of radius-ulna, tibia, femur and humerus were assigned
into four groups of six dogs in each group irrespective of breed, sex and age, based on the
bone involved, type and location of fracture and the surgical procedure adopted for fracture
fixation. The dogs of the Group-I were treated with Type Ia Linear ESF. The dogs of Group-
II were treated with Type IIa Linear ESF. The dogs of group III were treated with Tie-in
configuration and the fractures of long bones in group IV were treated with Hybrid external
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fixator type Ia.
In the present study fractures of radius-ulna were encountered in 13 dogs, tibial
fractures were seen in 3 dogs, bilateral humerus fracture was seen in 1 dog and femoral
fractures were observed in 7 dogs. All the fractures were closed fractures. Pre-operative
radiographs revealed transverse fractures in 12 dogs, short oblique fractures in 2 dogs, long
oblique fractures in 4 dogs, comminuted fractures in 4 dogs, femoral neck fracture in one
pup and supracondylar fracture in one pup.
Limited open approach in 15 dogs, open approach in 7 dogs and closed approach in 2
dogs were adopted. For reduction of fracture fragments, hanging limb technique with the
animal in dorsal recumbency facilitated reduction and alignment of the fracture fragments.
Cerclage wiring and intramedullary pin was used for anatomical reconstruction of fractured
bones wherever necessary.
Clinical evaluation was routinely carried out at periodical intervals for the signs of
swelling, exudation, weight bearing and stability of the fixator in all the dogs.
Medio-lateral and anterio-posterior radiographs of the operated bones were obtained
immediately after surgery and on the th, 30th, th and th post-operative day and
15 45 60
whenever needed on later dates to assess the progress of bone healing. Post-operative
radiographs taken immediately after the surgery revealed good fracture reduction and
immobilization of the fracture fragments in all the dogs of four groups. Postoperative
radiographs showed progressive healing of the fractures.
In group I out of 6 dogs, 5 dogs showed partial weight bearing from 5th postoperative
day. Complete limb usage was noticed from 45th-55th post-operative day. The
mean weight bearing time was 43.66±8.03 day. In group II partial weight bearing was
observed from 3-7th postoperative day. Complete weight bearing was noticed from 32nd day
onwards. The mean time for complete limb usage was 51.08±8.71 day. In group III Partial
weight bearing was noticed from 3rd -5th postoperative day in all the dogs except in one dog
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which had showed only partial weight bearing till the removal of fixator. Complete weight
bearing was seen from 30th day -60th post-operative day with a mean of 41.33±4.33 day. The
dogs in group IV showed partial weight bearing from 3rd – 6th post-operative day in all the
dogs except in two dogs. The complete weight bearing was ranging from 34th -60th postoperative
day. The mean of complete weight bearing was ranging from 42.16 ± 4.54 day.
The fixator was well tolerated by all the dogs of group I and it was stable in all dogs
except in two dogs where in one dog there was caudal angulation of the fracture fragments
of the radius and in other dog there was medial angulation of the radius observed due to the
less rigidity of the fixator. In group II the fixator stability was good in all the dogs. In group
III, Tie-in configuration counteracted torsional forces acting on the fracture fragments and
provided good fixator stability throughout the observation period in almost all the dogs
which suffered femoral and humeral fractures. All the dogs exhibited pain because of the
movement of the IM pin as it was loose and tied to the ESF. In group IV the fixator was
found rigid and stable till the completion of bone healing in all the dogs
Post-operative radiographs revealed that immobilization of fracture fragments was
good in all the cases except in two cases with radius-ulna fractures in group I, one case in
group II, and in one case in group IV. In all the dogs of four groups, the fractures healed
well with proper callus formation. In all the groups, bone healing was seen discernible as
early as 15th day onwards. In all the groups callus formation with adequate radio-density was
noticed on 45th post-operative day. It is vividly delineated that fracture line disappeared and
showing distinct restitution of cortico-medullary continuity by 50th and 60th post-operative
days respectively. Progressive bone healing was observed from post-operative radiographs
in all the groups.
The external skeletal fixators were removed in the six dogs of group I between 52
days to 65 days with mean time of 59.33± 2.41 days. While in the dogs of group II, the
fixator was removed between 37 days to 80 days with mean time of 54.33 ± 6.60 days. In
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group III the tie-in configuration was removed between 30 days to 55 days with mean time
of removal 43.16± 4.46 days. In the present study, the entire tie- in construct was removed in
4 cases without staged disassembly under general anesthesia whereas, staged disassembly
was performed in two cases on 30th and 45th postoperative day, where linear external skeletal
fixator was removed after formation of primary callus and the intramedullary pin was
removed 2 weeks thereafter. In group IV, the HEF Type Ia was removed when sufficient
callus formation was radio graphically visible in all the dogs without any staged
disassembly. The mean time of the fixator removal was 45.33 ± 5.10 days, with a range of
30 days to 60 days.
Complications noticed were slight pin tract discharge, minor pin tract infection,
loosening of proximal most pin, slight osteolysis, serous discharge from the exit site of
intramedullary pin, and wounds due to pressure exerted by fixator, malunion resulting in
synostosis among a few dogs across all the four groups. Slight valgus deformity of radiusulna
was seen in one dog each in Group I, and IV. These findings did not disturb the
stability of the fixator in dogs belonging to all four groups. All the fractures healed well in
all the dogs of four groups.
Results of the present clinical study revealed that the Type Ia ESF and Type IIa ESF,
Tie-In Configurations and Hybrid External Fixators Type Ia can be used with excellent
outcome for treatment of long bone fractures of radius-ulna, tibia, femur and humerus in
dogs. All the ESFs produced remarkable improvement in the normal limb function and
maintained good fixator stability, throughout the observation period in all the dogs of the
four groups. However, the decision whether to use the suitable external skeletal fixation was
made depending up on the long bone involved and type of fracture of the bone.
 
Date 2016-12-31T13:42:03Z
2016-12-31T13:42:03Z
2016-12-31
 
Type Thesis
 
Identifier http://krishikosh.egranth.ac.in/handle/1/93802
 
Relation D;509
 
Format application/pdf
 
Publisher PVNR TVU