Surgical Repair Of Fractures
Most fractures require surgery to re-align the broken bone fragments and stabilize them while healing takes place. Dogs and cats that undergo severe trauma are usually not healthy enough for immediate surgery. They can have additional injuries including lung contusions, bleeding in the chest/abdomen, urinary bladder rupture, and/or brain trauma which take precedence. These patients are typically stabilized with intravenous fluids, pain medications, bandaging/splinting, and frequent monitoring in a 24-hour care facility. Most cases are ready for surgery to repair the fracture in 24-48 hours.
While most fractures require surgery to heal, occasionally splinting or casting is sufficient. Splinting/casting is appropriate for simple, non-displaced fractures below the elbow or knee in young dogs. For all other fractures, surgery is necessary for an optimal outcome.
For the majority of fractures, surgery is performed using a metal bone plate and screws. A splint/cast may also be applied for additional support, depending on the nature of the fracture. During and following surgery, a multi-modal approach to pain control is achieved using injectable medications, oral medications, a local nerve block, and topical therapies.
Recovery From Surgery
Most cases are discharged from the hospital 1-2 days following surgery. Animals go home with anti-inflammatories, pain medication, and directions for at-home rest and rehabilitation. Total healing time for most fractures in approximately 8-12 weeks. For complicated fractures, healing can take longer (up to 6 months). Exercise restriction is necessary during the healing process to minimize risk of complications. At 8 weeks post-operatively, x-rays are completed to evaluate healing and determine if the patient’s activity level can be increased.
Prognosis With Surgery
For most cases, the prognosis following surgery is excellent. Cases that can have a more variable prognosis include fractures that involve the joints, pelvis, or vertebral column. Uncommonly, the implants used for fracture repair require removal due to irritation, reaction, or migration.