SYMPTOMS AND SIGNS • The animal will not be able to use the leg at all and if able will hold the leg up. Sometimes the foot will be rested on the ground when the animal is standing at rest. • Pain at or near the fracture site and some animals will not allow the limb to be handled at all. • The limb may appear deformed, twisted or shortened. • Swelling around the break. Sometimes it is possible to see bruising if the hair is parted. • A coarse grating may occur if the bone fragments move against the other. However don't actively see this sign. • Shock. This is due to pain and/or blood loss. Severe blood loss can result from femoral or pelvic fractures.
Diagnosis Fractures • Many fractures of the femur can be diagnosed by a veterinarian when he or she is palpating the animals leg, abdomen, or other parts of the body. • X-rays confirm the diagnosis and help diagnose minor cracks in the bone that can’t be palpated. • Blood test and cultures for bacteria are necessary in some animals with fractures in which pieces of bone have penetrated to skin. • Routine x-ray evaluation of suspected fractures should always include both anteroposterior and lateral views. • On a single view, the characteristic displacement, discontinuity in contour, or altered alignment of a fracture may be hidden because of overlap or projection. • Fractures may be missed if the x-ray shows too small an area. A patient complaining of thigh and knee pain, for instance, may actually have a hip fracture causing referred pain; unless x-rays of the entire femur are taken, the fracture may be missed.
Types of fractures • Closed Fractures: Closed fractures are those in which the skin is not broken. The bone is fractured, but the overlying skin is intact. • Greenstick Fractures: Greenstick fractures are small cracks within the bone which leave the bone basically intact, but cracked. In other words, the bone is not completely broken. • Compound Fractures: Compound fractures are breaks in which the broken bone protrudes through the skin, and is exposed to the outside. Compound fractures are risky in that the bones can be contaminated with dirt and debris, resulting in an infection. • Epiphyseal Fractures: Epiphyseal fractures are commonly seen in young, growing dogs. In animals less than one year of age, there are soft areas near the ends of each long bone where growth takes place. These growth plates are more easily fractured because they are the weakest part of the bone. The distal ends of the femur (thigh bone) and humerus (upper front leg) seem to be particularly susceptible to this fracture.
Types of fractures • Transverse fracture line. Drawing represents a reduced transverse fracture. • Oblique fracture line. Drawing represents a reduced oblique fracture. • Spiral fracture line. Drawing represents a reduced spiral fracture.
Types of fractures • Comminuted fracture lines. Drawing represents a reduced comminuted fracture. • Multiple fractures. Drawing represents a reduced femoral neck fracture and a reduced transverse fracture of the distal femoral.
Treatment The fracture must be immobilized to allow it to heal and this can be done in several ways. • A limb can be placed in a splint or cast, which aims to immobilize the joint above and below the fracture. Nowadays, casts tend to be made of fiberglass. This technique is not particularly useful for fractures above the stifle or above the elbow. • External fixation describes the use of pins passed from outside the leg, through the skin and into the bones of the limb, ideally with at least three pins above and below the fracture. These pins can then connect to one another either by bars, or rods or cement or rings. • Internal fixation describes the use of pins and wire, plate and screws, with variations on these themes, such as interlocking nails placed via open reduction of the fracture. Plates and screws can be used for a variety of different fragments, but offer exceptionally stable fixation and in some cases the ability to squeeze or compress the ends of the bone fragments together. Such repairs can ensure an animal can be up and using a fractured limb as soon as possible.
It is not uncommon for a dog or cat to fracture its forearm. The two bones that are usually involved are the radius and ulna. Depending on the severity of the fracture, it is either splinted or surgery is performed to stabilize the bones with plates or pins.
Quiz • What are three symptoms of fractures? • What is the difference between a closed fracture and a compound fracture? • What is internal fixation?