Fractures of the bones of the body can be repaired using any combination of metal implants or screw plates, wires and pins placed internally, or pins and frames placed externally. The reason for using these implants is to hold the bones together in a rigid manner so that the bone may heal and regrow following injury and fracture. If there is an excessive movement at the fracture site, then the bone will not be able to heal and become hard and mineralised. Bone healing is generally a race between the progress of bone healing and the implants weakening and failing. Some fractures may be left to heal without any surgery or stabilisation, but the functional outcome of the patient will be the deciding factor as to whether a certain fracture needs to be repaired or not. Fracture stabilisation aims to provide pain relief by immobilising the bone and allowing early return to function and weight bearing.
London Veterinary Services uses a combination of techniques and implants to stabilise fractures on an individual basis at the time of surgery. Modern surgical equipment and a range of surgical kits and implants allow the best decisions to be made for the patient at the time.
Complication rates are low, with the most common complications being infection, usually less than 5% depending on the type of fracture and other injuries sustained at the time. Treatment usually only requires antibiotics in addition to the ones dispensed at the time of surgery, or in a much smaller number of cases where the implants are infected, removal of the implant via a short simple procedure. Generally, the implants never need to be removed and cause no problems, however a very small number may develop an infection years following the surgery, which will present as a painful limb, limping or discharging wound near the previous surgical site. Additionally, the implants can cause irritation to the soft tissues causing discomfort and lameness, and may benefit from being removed, although approximately 95% of implants remain in position for life. Should the implants cause discomfort removal is usually an easy procedure requiring a short general anaesthesia.
Other complications are related to either the injuries of the trauma themselves, or those sustained during manipulation of the bones during surgery and reconstruction. Nerve injuries are often difficult to accurately assess immediately following trauma as there may be a period of time required for trauma related shock and inflammation to resolve, and also the limb function will often be severely affected.
The other most common complication is related t o the patient themselves, with over activity and excessive stress placed on the healing bone and implants, with either failure and breakage of the implants or bone the implants are anchored to. Generally, gentle lead controlled walks in incrementally increasing lengths are well tolerated in the weeks following fracture repair, however it is the short periods of high risk activity when these avoidable complications occur. Jumping, stairs, slippery floors, any off-lead activity will increase this risk and potentially cause catastrophic failure requiring repeat surgery. As the owner you will be the brains of the recovery and be responsible for enforcing the strict rest and confinement, rehabilitation program, and lead controlled walks, prior to a return to normal activity over a 12-week period.
Tibia Fracture Repair Discharge Form (PDF)