Hindlimb & pelvis

Pelvic fractures are commonly referred. Modern locking plating techniques have greatly improved the treatment of many of these injuries.

We get a lot of long bone fractures referred to us here in Burton-Upon-Trent, and this case history of a tibial fracture in a middle-aged greyhound illustrate the sorts of things we need to think about and address when managing these cases.

Here at West Midlands Referrals we see this frequently in cats that have been shunted from behind by cars, often in association with other pelvic injuries.

A much loved 13-year-old cat called Chalk presented to us at West Midlands Referrals after severe trauma, including a fracture/luxation on the right side of the pelvis and multiple fractures affecting the left side of the pelvis.

Poppy, a much loved cat, went missing in the Derby area for weeks over the summer of 2013. It is a mystery how she survived with severely displaced and comminuted (fragmented) fractures of the humerus of her upper right forelimb and the femur of her upper left hind limb. She was, almost incredibly, managing to walk on her two remaining legs.

Pelvic fracture is a common injury in cats after road traffic accidents we see them frequently at West Midlands Referrals. We often use modern locking plates to stabilise these injuries. Nice alignment of the pelvis can usually be achieved by placing this from dorsally (ie from the top). This does mean working the plate under the major nerve to the hind limb, the sciatic nerve.

Fracture through the weaker cartilage growth plate that is situated at the end of the femur (thigh bone) is relatively common in juvenile cats. These can occur following trauma within the house with the high-jinks that young cats get up to, or after accidents outside, such as road traffic accidents etc.

At West Midlands Referrals, we often see tibial (shin) bone fractures in cats, often at the lower end of the tibia.

Pelvic fractures are common injuries after road traffic accidents in dogs and cats; we see them all the time at West Midlands Referrals. The pelvis almost always breaks in at least two places and usually more.

Star, a much loved working dog and also a family pet from a sheep farm in the Welsh valleys, was involved in a road traffic accident on the farm.

This young dog suffered a tricky distal tibial fracture with limited soft bone at the lower end of the tibia (shin bone). It was fixed with a hybrid external fixator using a circular ring.

Ralph, a 5-month-old Yorkie pup, suffered a fracture of the proximal (top) end of his tibia (shin) bone just below his stifle (knee). This fracture involved the growth plate, the cartilage zone from which bone grows and which appears as a black line on X-rays near the ends of the long bones in growing dogs.

This cat had a fracture-luxation between the metatarsal bones and the tarsal bones (bones of the foot and of the ankle respectively).

Interlocking nails are an innovation in fracture fixation that came from WWII. They were a closely guarded military secret because they got injured German pilots back into the air faster than ours!

Pablo, a cat, presented to us at West Midlands Referrals with a tricky femur fracture (thigh bone). The bottom end that forms part of the knee joint was comminuted (multiple fragments).

Dressings/casts/splints often seem like a perfect, economical, minimally invasive and straightforward way to immobilise fractures. Still, some issues relating to casts or splints make them less than ideal: We have delved into the issue surrounding their use at West Midlands Referrals.

A 4-month-old crossbreed presented to us at West Midlands Referrals with an unstable proximal tibial “dome” fracture ten days after the injury. Unfortunately, an initial attempt to stabilise this with a splint dressing had not worked and had in fact caused some dressing sores.

This case is a favourite – a horrendous fracture, a challenging surgery, planning with CT advanced imaging, a lovely cat, patient and committed owners, and a great outcome. What’s not to like.

Nellie, a 5-month-old female Border Collie destined to be a working sheepdog, managed to break the ball of her femur off the rest of the femur. The fracture occurred through the growth plate.

A 2y old, 30kg racing greyhound presented after sustaining an injury on the track. X-rays showed a slab fracture of the right central tarsal bone, and of the medial proximal corner of the 4th tarsal bone (T4) too.