Case: Humeral fracture in a grey hound kicked by a horse
8th June 2013
Nancy, a middle aged grey hound was kicked one weekend by a horse in the London area and suffered a broken humerus. The case was seen promptly at the local Vets Now emergency clinic. The owner rang us as they had been estimated £6000 for specialist fixation of the fracture.
We arranged to see the case the following morning, assuring the owners that our fee would be 25% of that, and ours would include follow up consultations, follow up dressing changes and follow up x-rays. Vets Now were very helpful in sending us full case details and x-rays by email.
Nancy arrived promptly at 8am on the Monday morning, her owner having left early to beat the traffic. Her leg was horribly swollen, the horse’s shoe had lacerated her soft tissues, and the leg was supported in a make-shift sling.
We anaesthetised her and the fracture was straightforwards to fix. The kick had severed the radial nerve, one of the major three nerves to the forelimb, at the level of the fracture site. Fortunately this was a short way below the level at which the critical nerve supply to the triceps muscle had left the nerve bundle. Without the triceps function, her forelimb would be useless.
However the ability to extend the wrist was likely to be lost. We supported the wrist with an external splint support while she convalesced for a couple of weeks. She quickly got back to weight bearing on it. We saw Nancy back for regular post operative checks as she stayed with relatives in Birmingham to convalesce. We had feared that we might have needed to use a padded external wrist support long term, or that we might even have needed to surgically fuse her wrist (see separate article on carpal arthrodesis). But in the weeks following surgery Nancy learned to use the leg as it was, learning to flick her wrist forwards. She only struggled a little at slow speeds when there wasn’t enough momentum to flick the foot forwards, but she copes brilliantly.
Two months on, we removed the pin as there was a little swelling over the top end, as is relatively common with pins. The plate will very likely be left in situ.
So a tank of petrol and a phone call saved the owner at least £4500!!