Screws, plates and locking plates

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.

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.

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.

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.

Radius and ulna fractures are common in small-breed dogs. These injuries can often affect both forelimbs simultaneously, and these small dogs' fractures have acquired a reputation for being at increased risk of non-union (failure of the bone ends to reunite).  

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.

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 tibia fracture in a growing dog was un-displaced and was fixed in minimally invasive fashion with a locking plate that was slid along the bone between two small wounds.