Comparative functional outcome of supracondylar femoral fracture stabilized with cross and end threaded intramedullary pinning in dogs
340 / 175
Keywords:
Dog, Functional outcome, Goniometry, Orthopaedic surgery, Stifle joint stiffness, Supracondylar femur fractureAbstract
The study was conducted on 24 clinical cases of dogs (with 26 fractures) suffering from supracondylar fractures of femur which were stabilized using cancellous negative intramedullary (IM) end-threaded pin with 5 screws (Group I, n=8), cross-pinning (Group II, n=8, 9 fractures) and cancellous negative end threaded IM pin having 10– 18 threads (Group III, n=8, 9 fractures). Data collected included signalment, fracture characteristics (etiology, duration, Salter-Harris classification, pre-operative and post-operative displacement), surgical information (implant size, surgical duration) and outcome assessment (functional outcome and complications). Cross pinning technique used to stabilize supracondylar fracture of femur adversely affects flexion angles of stifle joint leading to joint stiffness compared to either of the end threaded pinning techniques; however, extension angles remain unaffected. Early weight bearing in group II suggested that crossing pinning is a rigid fixation technique compared to either end threaded pinning techniques. Minor implant related complications were recorded in group II (3) followed by group 3 (2) and group 1(1) which were managed successfully. Though fixation of supracondylar fractures using double armed end threaded pin with 5 cancellous negative threads was associated with shorter duration of surgery, and fewer postoperative complications; however, based on formation of minimal and smooth callus and better functional outcome, conventional end threaded pin with 10–18 cancellous negative threads was assessed to be a better fixation technique and was recommended for the repair of supracondylar fractures of femur in dogs.
Downloads
References
Aithal H P and Singh G R. 1998. Evaluation of fixation devices for resistance of bending and rotations in supracondylar femoral fracture fixation in dogs. Indian Journal of Animal Sciences 68: 1121–25.
Aithal H P, Singh G R and Bisht G S. 1999. Fractures in dogs: A survey of 402 cases. Indian Journal of Veterinary Surgery 20(1): 15–21.
Aithal H P, Singh G R, Sharma A K and Amarpal. 1998. Modified technique of single pin fixation and cross intramedullary pin fixation technique for supracondylar femoral fracture in dogs: A comparative study. Indian Journal of Veterinary Surgery 19: 84–89.
Arkader A, Warner Jr W C, Horn B D, Shaw R N and Wells L. 2007. Predicting the outcome of physeal fractures of the distal femur. Journal of Pediatric Orthopaedics 27(6): 703–08. DOI: https://doi.org/10.1097/BPO.0b013e3180dca0e5
Arnockzy S P, Wilson J W and Schwarz P. 1985. Fractures and fracture biology. (Ed.) Slatter D H. Textbook of Small Animal Surgery. Saunders, Philadelphia, pp. 1939–45.
Balagopalan T P, Devanand C B, Rajankutty K, Amma T S, Nayar S R, Varkey C A and George P O. 1995. Fracture in dogs - A review of 208 cases. Indian Journal of Veterinary Surgery 16(1): 41–43.
Benjamin M M. 1985. Outline of Veterinary Clinical Pathology. 3rd edn, pp 60–63 and 71–75. Kalyani Publishers, New Delhi, India.
Berzon J. 1980. The classification and management of epiphyseal plate fractures. Journal of the American Animal Hospital Association 16: 651–58.
Boekhout Ta C L, Kim S E, Cross A R, Evans R and Pozzi A. 2017. Closed reduction and fluoroscopic assisted percutaneous pinning of 42 physeal fractures in 37 dogs and 4 cats. Veterinary Surgery 46(1): 103–10. DOI: https://doi.org/10.1111/vsu.12582
Brand R A. 1979. Fracture Healing. (Eds.) Abright J A and Brand R A. Scientific Basis of Orthopaedics. Appleton Century Crofts, New York.
Brinker W O, Piemattei D L and Flo G L. 1983. Handbook of Small Animal Orthopaedics and Fracture Repair. W B Saunders, Philadelphia, pp 100–05.
Cook J L, Evans R, Conzemius M G, Lascelles B D X, McIlwraith C W, Pozzi A, Clegg P, Innes J, Schulz K, Houlton J, Fortier L, Cross A R, Hayashi K, Kapatkin A, Brown D C and Stewart A. 2010. Proposed definitions and criteria for reporting time frame, outcome, and complications for clinical orthopaedic studies in veterinary medicine. Veterinary Surgery 39(8): 905– 08. DOI: https://doi.org/10.1111/j.1532-950X.2010.00763.x
Cook J L, Tomlinson J L and Reed A L. 1999. Fluoroscopically guided closed reduction and internal fixation of fractures of the lateral portion of the humeral condyle: prospective clinical study of the technique and results in ten dogs. Veterinary Surgery 28(5): 315–21. DOI: https://doi.org/10.1111/j.1532-950X.1999.00315.x
Deyoung D J and Probst C W. 1993. Methods of internal fracture fixation. (Ed.) Slatter D H. Textbook of Small Animal Surgery. 2nd edn, pp. 1610–27. W.B. Saunders Company, Philadelphia. Ferguson J F. 1998. Fracture disease. (Eds) Coughlan A R and Miller A . Manual of Small Animal Fracture Repair and Management. British Small Animal Veterinary Association, Shurdington, pp 305–10.
Harasen G. 2001. Fractures involving the distal extremity of the femur. Part 1 - The immature patient. Canadian Veterinary Journal 42(12): 949–50.
Jani S M Y, Kushwaha R B, Gupta A K, Malik K and Soodan J S. 2014. Occurrence of fractures in dogs: A retrospective study of five years. Indian Journal of Veterinary Surgery 35(1): 73– 74.
Johnson K A. 2014. Piermattei’s Atlas of Surgical Approaches to the Bones and Joints of the dog and cat. 5th edn, pp. 388–90. Elseiver, Missouri. DOI: https://doi.org/10.1016/B978-1-4377-1634-4.00012-5
Kaur A, Kumar A, Kumar D, Mohindroo J and Saini N S. 2015. Feasibility of C-arm guided closed intramedullary pinning for the stabilization of canine long bone fractures. Veterinary World 8(12): 1410–15. DOI: https://doi.org/10.14202/vetworld.2015.1410-1415
Kaur A, Kumar A, Sangwan V, Anand A and Mahajan S K. 2016. Evaluation of end threaded intramedullary pinning for the stabilization of distal diaphyseal and supracondylar fractures in dogs. Indian Journal of Veterinary Surgery 37(2): 105–08.
Kushwaha R B, Gupta A K, Bhadwal M S, Kumar S and Tripathi A K. 2011. Incidence of fractures and their management in animals: a clinical study of 77 cases. Indian Journal of Veterinary Surgery 32(1): 54–56.
Lewis D D, Van Ee R T, Oakes M G and Elkins A D. 1993. Use of reconstruction plates for stabilization of fractures and osteotomies involving the supracondylar region of the femur. Journal of the American Animal Hospital Association 29: 171–78.
Lidbetter D A and Glyde M R. 2000. Supracondylar femoral fractures in adult animals. Compendium on Continuing Education for the Practicing Veterinarian 22(11): 1041–53.
Macias C and McKee M. 2003. Articular and periarticular fractures in the dog and cat. In Practice 25(8): 446–65. DOI: https://doi.org/10.1136/inpract.25.8.446
Mahajan S K, Singh S S, Bains S S and Sandhu H S. 2010. Distribution of supracondylar fractures of femur in dogs: a report of 47 cases. Indian Journal of Veterinary Surgery 31(2): 137–38.
Mahajan S K, Singh S S, Bains S S, Sandhu H S and Singh N. 2007. Clinical studies on the management of supracondylar fractures of femur in dogs. Indian Journal of Veterinary Surgery 28: 120–22.
Marretta S M and Schrader S C. 1983. Physeal injuries in the dog: a review of 135 cases. Journal of the American Veterinary Medical Association 182(7): 708–10.
McKibbin B. 1978. The biology of fracture healing in long bones. Journal of Bone and Joint Surgery 60–B: 150–62. DOI: https://doi.org/10.1302/0301-620X.60B2.350882
Newton C D. 1985. Fractures of the femur. Textbook of Small Animal Orthopaedics. pp. 428–30. (Eds.) Newton C D and Nunamaker D M. Lippincott, Philadelphia.
Ogurtan Z. 2006. ‘Comparative holding strength between partially threaded tipped and non-threaded tipped pins for fracture fixation in canine femur: Biomechanical results’. Ph.D. Thesis, University of Selcuk, Turkey.
Palmer R H, Aron D N and Purinton P T. 1988. Relationship of femoral intramedullary pins to the sciatic nerve and gluteal muscles after retrograde and normograde insertion. Veterinary Surgery 17(2): 65–70. DOI: https://doi.org/10.1111/j.1532-950X.1988.tb00279.x
Salter R B and Harris W R. 1963. Injuries involving the epiphyseal plate. Journal of Bone and Joint Surgery 45: 587–622. DOI: https://doi.org/10.2106/00004623-196345030-00019
Sandhu H S. 2000. ‘Studies on the management of supracondylar fracture of femur in dogs’. M.V.Sc. Thesis, Punjab Agricultural University, Ludhiana, India.
Simpson D J and Lewis D D. 2003. Fractures of the femur. Textbook of Small Animal Surgery. pp. 2078–80. (Ed.) Slatter D H. W.B. Saunders, Philadelphia.
Singh R, Chandrapuria V P, Shahi A, Bhargava M K, Swamy M and Shukla P C. 2015. Fracture occurrence pattern in animals. Journal of Animal Research 5(3): 611–16. DOI: https://doi.org/10.5958/2277-940X.2015.00103.5
Singh S. 2000. ‘Comparative evaluation of cross-pinning, intramedullary cross-pinning and intramedullary retrograde pinning for management of supracondylar fractures of femur in dogs’. M.V.Sc. Thesis, Punjab Agricultural University, Ludhiana, India.
Stigen O. 1999. Supracondylar femoral fractures in 159 dogs and cats treated using a normograde intramedullary pinning technique. Journal of Small Animal Practice 40: 519–23. DOI: https://doi.org/10.1111/j.1748-5827.1999.tb03011.x
Whitney W O and Schrader S C. 1987. Dynamic intramedullary cross pinning technique for repair of distal femoral fractures in dogs & cats: 71 cases (1981–85). Journal of the American Veterinary Medical Association 191(B): 1133–38.
Downloads
Submitted
Published
Issue
Section
License
The copyright of the articles published in The Indian Journal of Animal Sciences is vested with the Indian Council of Agricultural Research, which reserves the right to enter into any agreement with any organization in India or abroad, for reprography, photocopying, storage and dissemination of information. The Council has no objection to using the material, provided the information is not being utilized for commercial purposes and wherever the information is being used, proper credit is given to ICAR.