In Veterinary Practice, we often find that certain conditions present in runs. Some weeks we see lots of cats with runny noses and then the next week it might be itchy dogs.
Last week was the week of the broken leg.
Many Veterinary Practices refer their Orthopaedic surgery to specialist centres. At Donaldson’s, we have the facilities and expertise to repair most fractures at the surgery. We feel that this offers a number of advantages including speed of attention, avoiding lengthy transportation and improved value for money.
During last week, we had at least one fracture repair every day and employed a variety of surgical techniques to repair the affected limbs.
Three of the fractures required “internal fixation”. This is, as the name suggests, when metalwork is applied to the fractured bone and the metalwork is below the skin. We see an enormous variety of sizes of animal and so we have several sets of plating and screwing kit. The 2mm kit is our smallest kit and can be used on rabbits, small cats and miniature dogs. The 2.7 mm kit can be used on cats and small dogs. The 3.5mm kit is used on most medium sized dogs and the largest 4.5mm kit is used on giant breed dogs. All of the sizes of kit work in the same way in that they are composed of surgical grade stainless steel. The holes in the plates are machined to be elliptical which allows the screw to be applied in a manner which compresses the two sides of the fracture as this encourages the fracture to heal more quickly.
One of the fractures was repaired using “external fixation”. With this technique, the fracture is stabilised using pins which are drilled into the bone through little holes which are made in the skin. These pins are connected, using specially designed clamps, to a bar which runs parallel to the limb. This technique has several advantages to plates and screws in that there is less metalwork at the fracture site and less surgical trauma to disturb the blood flow to the fracture site however it does not allow the compression of the bone fragments that can be achieved with a plate.
The final fracture repair of the week was repaired using a cast for external support. Casts can be difficult to manage in dogs. The skin is often thin and it can be difficult to apply a cast which is tight enough to stabilise the fracture but not so tight that it causes skin sores. Casts often seem inexpensive to begin with but can end up being more expensive than a surgical repair in the long run.
Veterinary Practice is always varied so after last week being “broken leg week”, we will need to see what this week entails.