Ellie Mae is a sweet 6 month old mixed breed that stopped using her left forelimb after running into a wall at doggie daycare. Her owner took her to her primary veterinarian who, following an exam and x-rays diagnosed her with a fractured left humerus (Figure 1). She was referred to Veterinary Specialty Care that evening for management of her pain and to have the fracture repaired. Once in the emergency room the emergency veterinarian assessed her and her x-rays and agreed with the diagnosis. That night an intravenous catheter was placed and she was kept comfortable with frequent injections of a morphine like medication and a powerful anti-inflammatory. The following morning she was transferred to my care to have the fracture repaired.
Broken bones, or fractures, are a common problem we see at VSC. While the bones of dogs and cats are incredible strong certain traumas can lead to brakes in any part of a dog’s bones, but most commonly happen in the forelimbs, hind limbs and pelvis. Ellie Mae had fractured her humerus, the long bone between her elbow and shoulder. Her fracture was considered ‘simple’ because the bone broke into two pieces only. The two main ways fractures are repaired include bandaging/casts and surgery. Unfortunately Ellie Mae’s fracture required surgery, as the humeral bone cannot be effectively casted. Later that day she was placed under general anesthesia for surgery. Prior to the procedure a local anesthetic was injected around the nerves that supply the forelimb in order to help control her pain after surgery and make her anesthesia safer. At surgery a large stainless steel rod and wires were used to bring the broken ends of the bone back together and hold them in place during the healing period (Figure 2). That evening Ellie recovered in our ICU making sure her pain was well controlled and she had a smooth recovery from the procedure.
In order for broken bones to heal, as a surgeon we have to get the fractured ends perfectly back into their original position and then make sure the repair method will keep them stable for the next 6-8 weeks. This is the average length of time it takes bone healing to be complete. While in Ellie Mae’s case we used a rod and wires to repair the fracture, other implants can include metal plates, screws, pins, external fixators and interlocking nails. Its important that a surgeon be trained and skilled in multiple ways to repair broken bones because once you are in surgery the plan can change if the fracture is different then anticipated.
The most important part about the recovery period is rest at home. While the implants are strong they cannot withstand unlimited force. Prior to surgery and at discharge we discussed with Ellie Mae’s owner the importance of restricting activity during the healing period. The next morning bruised and swollen she was using the leg again and was discharged home to a very happy owner. While not yet healed she’s one her way to making a full recovery.