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Radial and Tibial Fracture Repair with External Skeletal Fixation: Effects of Fracture Type, Reduction, and Complications on Healing
Author(s) -
JOHNSON ANN L.,
KNELLER S. K.,
WEIGEL R. M.
Publication year - 1989
Publication title -
veterinary surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.652
H-Index - 79
eISSN - 1532-950X
pISSN - 0161-3499
DOI - 10.1111/j.1532-950x.1989.tb01102.x
Subject(s) - medicine , bone healing , nonunion , surgery , reduction (mathematics) , external fixation , tibia , fixation (population genetics) , malunion , radiography , osteotomy , external fixator , population , geometry , mathematics , environmental health
Twenty‐eight consecutive fractures of the canine radius and tibia were treated with external skeletal fixation as the primary method of stabilization. The time of fixation removal (T 1 ) and the time to unsupported weight‐bearing (T 2 ) were correlated with: (1) bone involved;(2) communication of the fracture with the external environment;(3) severity of the fracture;(4) proximity of the fracture to the nutrient artery;(5) method of reduction;(6) diaphyseal displacement after reduction; and (7) gap between cortical fragments after reduction. The Kruskal‐Wallis one‐way analysis of variance was used to test the correlation with p <.05 set as the criterion for significance. The median T, was 10 weeks and the median T 2 was 11 weeks. None of the variables correlated significantly with either of the healing times; however, there was a strong trend toward longer healing times associated with open fractures and shorter healing times associated with closed reduction. Periosteal and endosteal callus uniting the fragments were observed radiographically in comminuted fractures, with primary bone union observed in six fractures in which anatomic reduction was achieved. Complications observed in the treatment of these fractures included: bone lysis around pins (27 fractures), pin track drainage (27 fractures), pin track hemorrhage (1 fracture), periosteal reaction around pins (27 fractures), radiographic signs consistent with osteomyelitis (12 fractures), degenerative joint disease (2 dogs), and nonunion (1 fracture). Valgus or rotational malalignment resulted in 16 malunions of fractures. One external fixation device was replaced and four loose pins were removed before the fractures healed. One dog was treated with antibiotics during the postoperative period because clinical signs of osteomyelitis appeared. Except for the nonunion, none of the complications appeared to affect the final outcome of fracture healing and return to function adversely.