Pelvic fracture in a dog: signs, diagnosis, treatment. Traumatic dislocation of the femoral head in dogs

A fracture is a complete or partial break in the integrity of a bone. Fractures in dogs can be closed (the integrity of the skin is not broken) and open (the integrity is broken, the bone comes to the surface).

First of all, these are various mechanical effects, that is, bruises, blows, falls on a hard surface, shocks, sharp jerks, gunshot wounds. Less often, the pathological effects on the bone structure of the tissue against the background of diseases: dystrophic, inflammatory, tumor, metabolic disorders, pregnancy become the fault.

Symptoms of fractures in dogs

For a broken limb:

the dog cannot step on the damaged paw and constantly keeps it on weight,
edema begins to form quickly at the fracture site,
the damaged paw is about twice the volume of healthy limbs,
the paw can move freely and unnaturally,
when trying to inspect and touch, the dog experiences pain and whines

When the tail is broken also whines when touched. For rib fractures when injured, the dog whines strongly, behaves restlessly, breathes rapidly and shallowly.

Very serious injuries are fractures of the skull and spine. A skull fracture is accompanied by concussion, bleeding from the mouth and nose, cerebral edema, and hemorrhage. Pelvic fractures are often accompanied by rupture of the bladder, rectum, uterus.

With such injuries, the dog cannot stand up, lies all the time and whines. At the same time, her limbs are paralyzed, involuntary bowel movements and urination with blood, bleeding from the genitals can be observed. It is not uncommon for a dog to experience shock from severe pain. With a fracture of the spine, individual vertebrae are injured, compression or rupture of the spinal cord.

First aid for fractures

If the fracture is open and there is bleeding, it must be stopped. It is necessary to treat the wound, close it with a napkin and apply a bandage. With a closed fracture, the first thing to do is to ensure immobilization, that is, fixation of the injured limb or completely limit the movement of the animal in the position in which it is currently located.

In no case should you try to correct the configuration of the bones. This will only bring the dog terrible torment. An immobilized animal must be urgently delivered to the clinic, since the choice of treatment method will depend on the X-ray of the fracture.

Treatment of fractures in dogs

For closed ordinary cracks and fractures without displacement of the paws, tail and ribs, conservative treatment is used. This is the provision of rest, the imposition of splints or supporting bandages (Robert Jones, Ehmer). Plaster bandages in the treatment of animals are ineffective.

If it is necessary to connect particles or bone fragments with the help of special structures, then surgical intervention is used - osteosynthesis. This operation provides reliable fixation and the bone tissue has the opportunity to fuse favorably. For osteosynthesis, the following are used: the Ilizarov apparatus (for large and medium dogs with complex injuries), the Kirchner apparatus (on the thigh, jaw, pelvic bones and spine), polymer and knitting needles (for the smallest breeds), fixator inside the bone.

As with humans, fractures in dogs and cats are not uncommon. Treatment of fractures in animals is comparable in complexity to that in humans, and is often much more complex and comparable in complexity to pediatric traumatology.

There are a huge number of different types of fractures, and each type requires a different approach.

Types of fractures

A bone fracture can have a very complex name (diagnosis), such as "open comminuted fracture of the right condyle of the femur." This name is associated with a complex classification of fractures.

When broken, parts of the broken bone are called fragments.

If the fragments have not shifted relative to each other after the fracture, then this is a fracture without displacement. If they have shifted in any direction, then this is a fracture with a displacement.

A type of fracture without displacement - crack, microfracture of the bone. With such a fracture, the fragments are not only not displaced, but the fracture itself is not visible on a regular x-ray. Such a fracture is a time bomb, it can grow together, or it can finally break or, in the worst case, become a constant source of inflammation and pain. Computed tomography is required to diagnose these fractures.

If sharp fragments, after displacement, pierced the surrounding muscles and skin and came out, then this open fracture, if the skin is not damaged, then such a fracture closed.

If the fragments broke obliquely, then the fracture oblique, If the fragments broke at an angle of 90 degrees, then straight(the easiest option), if the fragments broke in a spiral, then spiral fracture.

If small fragments are formed during the fracture, then such a fracture is called splintered.

The middle of a bone is called the diaphysis, and the end of the bone that meets another bone at a joint is called the epiphysis. If the bone is broken in the middle, then it is a fracture. diaphyseal. If the bone is broken at either end, then such a fracture is called epiphyseal.

Type of epiphyseal fracture articular fracture. With such a fracture, the epiphysis is broken inside the joint, and not only the bone and surrounding muscles are damaged, but also the joint, which significantly worsens the condition of the dog and can result in permanent lameness and arthrosis of the joint.

There are many types of articular fracture.

Detachments. There are separations of muscles from the bone or breaks of pieces of bone to which the muscle is attached.

Condylar fractures in which half of the articular surface (condyle) breaks off.

In complex joints, which are formed by several bones, one bone can break and the other is not damaged. it incomplete fracture.

If there is only one fracture of the bone, then this simple fracture. If there are several fractures of one bone or the fracture is inside the joint, then such a fracture difficult. Difficult because the treatment of such a fracture requires more experience and knowledge of the doctor, and the operation is long in time.

After reading these classifications (which are far from all listed), you might think that anything and anything can break down in an animal in accordance with the classification.

In real life, things are a little different. There are statistics and according to her data, animals break only a few bones in 70% of cases, the remaining 30% are rare.

Most often, cats and dogs break their paws, then the spine, and finally the bones of the skull.

If you take paws, then large bones and major joints break first of all.

If it's front paws, then it's

fractures of the radius and ulna
fractures of the radius and ulna and elbow joint

humerus fractures
fractures of the humerus and shoulder joint

even more rarely fractures in the wrist and metacarpus

If it's the hind legs, then

femur fractures
knee fractures
fractures of the knee and femur
fractures of the knee and tibia
tibial fractures

hip fractures
pelvic fractures
pelvic and hip fractures

even less often fractures in the area of the tarsus and metatarsus

In terms of fractures in the head area, the lower jaw leads.

In fractures of the spine, most often break

first cervical vertebrae
lumbar spine
sacral spine
thoracic spine

By constantly working with the same type of cases, the orthopedic veterinarian studies specific types of fractures in relation to certain bones or joints, studies specific methods for treating such fractures, and has a huge advantage over the general surgeon in the treatment of fractures in animals.

For a veterinary orthopedist, classifications and methods of treatment in relation to a specific joint, and not to a generalized concept of a bone or joint, come to the fore.

Incomplete fracture of a long tubular bone (greenstick)

Treatment of fractures in dogs and cats

The animal is examined by a doctor, if the cat or dog is in a condition that does not threaten their life, a diagnosis of the fracture (X-rays and, in some cases, computed tomography) is performed, and the fracture is treated (osteosynthesis).

Osteosynthesis - (ancient Greek ὀστέον - bone; σύνθεσις - connection) is a surgical operation to connect bone fragments using various fixing structures that ensure stable fixation of fragments in the correct position.

If there is a threat to the life of the patient, then such a patient is first “stabilized”, no matter how much time it takes, and then the diagnosis of fractures and osteosynthesis is carried out.

Anesthesia plays an important role in the treatment of animals with fractures, especially severely injured animals. Without anesthesia, the animal may die from shock or simply suffer from severe pain.

The choice of the osteosynthesis method plays a very important role. The rate of fracture healing and recovery of the animal depends on how correctly the method is chosen.

When choosing a method, the materials used during the operation are also important. For example, a bone can be connected using a plate, but the plates, due to the large surface of contact with the bone, slow down the formation of callus. The imposition of the plate is a factor in slowing down the union. But there are plates made of very strong materials, which are smaller than conventional ones and have limited contact with the bone due to a specially designed rolling profile. Such plates do not affect the healing rate.

When performing osteosynthesis, the main task is to match the fragments as anatomically correctly as possible and fix them in this position 100% immobile. This is the only way to achieve the fastest healing of the fracture.

The second task facing the orthopedic surgeon is to perform the operation quickly and minimally traumatically. The speed is ensured by experience and clear planning of the course of the operation, as well as the chosen method of osteosynthesis.
It is important, during the operation, not to damage the nerves and blood vessels in the surrounding tissues. Their damage can lead to the loss of the paw.

A person is often put in a cast, never an animal. This is an unshakable rule that is constantly violated by general surgeons.

Plastering a dog or cat results in:

A. GYPSUM - MOBILITY OF FRAGMENTS - FALSE JOINT - TREATMENT FOR YEARS - RADICAL RECOVERY SURGERY - FREQUENTLY EUTHANASIA

The imposition of plaster on a dog or cat leads to the mobility of the fracture, its long-term non-union and the formation of a false joint. A plaster cast cannot tightly fix the short small and often crooked (unlike human) bones of cats and dogs. Dogs and cats cannot lie down and wait for the fusion, they want to run and loosen the already unreliable plaster cast. The bones at the fracture site are constantly moving and do not allow the formation of callus (fracture union). If the bones are constantly moving at the fracture site, then they “grind” to each other, cartilage is formed at their ends and a false joint occurs. Such a fracture may not grow together for years.

B. GYPSUM - NECROSIS (DEATHING) OF THE PAWS TISSUES - REMOVAL OF THE PAWS - OFTEN EUTANASIUM

Casting a dog or cat results in necrosis (death of the paw) and loss of the paw (removal).
Or to inflammation of the paw, suppuration, long-term treatment and removal of the paw in extreme cases.
People often euthanize animals because they are not ready to take care of a disabled animal.

C. GYPSUM - SEVERE DERMATITIS UNDER GYPSUM - SUPPRESSION - SKIN PLASTY - RADICAL RECOVERY SURGERY - FREQUENTLY LOSS OF PAWS AND EUTHANASIS

Casting is always accompanied by severe dermatitis of the skin under the cast (wool, moisture and dirt cannot simply be preserved under a cast, they destroy the skin and paw under the cast). This is followed by a long recovery of the skin, plastic, antibiotic treatment and a complex reconstructive operation.
People often despair and euthanize animals, because they are not ready to pay for a complex operation to restore a paw, they are not ready to take care of a cripple animal.

THUS, GYPSUM IN 99% OF CASES LEADS TO COMPLICATIONS AND RECOVERY SURGERY WITH A LOWER PROBABILITY OF COMPLETE RECOVERY OF THE PAWS.

60% of the work of orthopedists and plastic surgeons in our clinic is made up of alterations and retreatment after unsuccessful osteosynthesis and plastering at home and in conditions close to those of military field surgery (but these dogs were not on the battlefield), by doctors who do not have experience and knowledge to carry out such operations and do not have the necessary tools and consumables.

Features in the treatment of vertebral fractures

The only difference is time.

The spinal cord and nerves can be destroyed irreversibly and the animal will remain disabled.

Time is not playing into your hands.

If the spine is damaged, there is a possibility of damage to the spinal cord by bone fragments and displaced vertebral bodies. The sooner the load on the spinal cord is removed, the faster the spinal cord will begin to recover and the less chance that irreversible damage to the spinal cord will occur.

Care after surgery

Care for a recovering pet depends on the type of fracture and the type of surgery that has been performed. Although most pets can be allowed to do some exercise almost immediately after surgery, it is important that unrestricted activity such as running or jumping is avoided. Sometimes it is required to keep a pet in a limited area, for example, in a small room. Physiotherapy and hydrotherapy may be recommended as part of a recovery program. In most cases, we re-examine the pet six to eight weeks after surgery. When x-rays show that the fracture has healed, normal activity can be resumed.

Risks and difficulties associated with the treatment of fractures

Even an operation performed flawlessly can carry the risk of certain complications such as infection and difficulty in bone healing. However, if the operation is performed by an experienced specialist, such complications are rare, and most pets recover without complications. Joint fractures can lead to osteoarthritis, which may require long-term follow-up, but most pets do not experience these complications. Before any treatment is started, all aspects of your pet's postoperative care, including the risk of complications, will be detailed during your initial consultation with the orthopedist.

prospects

Most pets gain full use of their limbs and can enjoy a normal life.

Why should you contact us for the treatment of a fracture in your pet?

We have extensive experience in the successful treatment of various fractures;
We are attentive to each patient;
We use modern technologies and methods of treatment;
Our experts regularly take part in veterinary conferences;

About 90% of fractures, including those of the head and neck of the femur, occur in animals between 4-6 months of age. The cause of fractures in most cases is traumatic. Legg-Calve-Perthes disease (aseptic necrosis), which is predisposed mainly to small and dwarf dog breeds, is also a common cause of femoral neck fracture. In dogs with a growing skeleton, the main blood supply to the femoral head comes from the epiphyseal vessels associated with the joint capsule, with a small amount of blood coming from the vessels passing through the round ligament. Only after the closure of the growth zones of the femur at 8-11 months, the femoral head receives additional blood supply from the metaphyseal vessels.

Fractures of the head and neck of the femur in dogs occur within the joint capsule and outside the joint capsule.

If, in the event of a pathology, surgical treatment is not carried out within 2 days and no later than a week, then, given the blood supply, complications may occur in the form of ischemia of the head and neck of the femur and, as a result, destruction, lysis of the bone. Of course, we are talking about fractures that are subject to surgical treatment, i.e. osteosynthesis.

Common clinical signs of femoral head and neck fractures include lameness that does not rest on the diseased limb, pain on palpation of the hip joint area, the occurrence of pathological mobility and pathological sounds during passive movements in the joint, which can be determined by a veterinarian during a clinical examination. To confirm the preliminary diagnosis, a mandatory x-ray examination is performed. In the vast majority of cases, x-rays should be performed under general anesthesia with the animal lying on its back with extended pelvic limbs.

Treatment of hip fracture in dogs is surgical. Treatment depends on the type and location of the fracture. If Legg-Calve-Perthes disease is confirmed, then resection arthroplasty of the hip joint is performed under general anesthesia. As a rule, representatives of dwarf breeds of dogs suffering from this pathology, with a successful operation, despite its trauma, in the overwhelming majority do not experience pain and do not show lameness after undergoing a course of postoperative rehabilitation and fully use the limb. Depending on the fracture in larger breeds and with radiographic confirmation of the absence of aseptic necrosis, osteosynthesis of the fracture is performed. If osteosynthesis is not possible, resection arthroplasty is performed. The terms of postoperative rehabilitation and recovery entirely depend on the nature of the injury, comorbidities, the size of the animal and the willingness of the owners to strictly follow the recommendations of the doctors.

The femur is one of the strongest in the body, so its fracture can occur only with serious injuries or pathologies. Main symptoms: pain, inability to stand on the injured leg. A hip fracture in a dog needs surgical treatment.

The femur is long tubular, the upper end has a spherical head and is involved in the formation of a multiaxial hip joint, reinforced by an intracapsular round ligament.

The lower end of the thigh has two rounded blocks to form the femoral and tibial joints.

The upper end of the thigh, in addition to the head with a hole under it (for attaching the round ligament), has a neck, large and small skewers for attaching the gluteal muscle group. Therefore, in Perthes disease, a fracture of the femoral neck is more often observed, as places with the greatest load. The trochanters are connected by an intertrochanteric ridge, which creates the boundaries of the trochanteric fossa.

The lower end of the femur has two ridges of the same size for the patella, between which there is a groove for it to slide during movement. The lower end ends with two condyles - rounded elevations for attaching the tibia. Between them is the intercondylar fossa.

Causes of hip fracture

According to the etiology, fractures can be divided into two large groups: traumatic and pathological.

The causes of traumatic fractures are varied:

falling from height;
road accident, car collision;
a fight with a larger dog;
a blow from a person;
and others.

Several diseases lead to pathological fractures:

Perthes disease. As a result, a hip fracture is commonly seen in small breeds;
oncology. It is more often registered at old dogs;
alimentary hyperparathyroidism. Can be found in puppies with protein feeding.

Types of hip fractures

In addition to classification for reasons, there is a division according to the type of fracture:

Incomplete fracture - a crack in the bone. In this case, the bone still remains a single whole, the crack affects only part of its surface. This is the mildest form of hip injury, but quite dangerous, as it can develop into a real fracture at any time.
Impacted fracture. It happens when the load is directed not across the bone, but along. For example, when an animal jumps from too high a height. In this case, one fragment enters another. A fairly complex type of fracture, since it requires the extraction of one end of the bone from the other, but it rarely occurs in the femur. Despite the self-fixation of the bone, the dog is not able to lean on the injured limb.
Fracture without bone displacement. Despite the injury, the fragments do not move relative to each other, so the surrounding tissues are not damaged.
Closed fracture with displacement. The most common type of fracture. Fragments of bones damage the surrounding tissues, resulting in a hematoma or edema. This type of injury is dangerous with internal hemorrhage, especially if large vessels of the thigh are damaged.
Open fracture. In this case, a piece of bone breaks through the muscles, skin and comes out. In this case, the injury is often complicated by an infection that penetrates through the resulting wound, so the fracture requires urgent surgery.
Multiple fracture (with splinters). The most complex type, requiring a long and difficult operation, during which the bone is collected piece by piece. Often, along with such a fracture, other damage to internal systems (vessels, nerves) or open wounds are also observed. This type of injury often has severe consequences for the dog.

Symptoms and first aid

The most common symptom is severe pain. She does not allow the dog to lean on the limb. When trying to feel the injured leg, the dog behaves aggressively, it may even bite the owner. When examining a limb, one can see edema, hematoma, and in severe cases, a wound, sometimes with a bone fragment in it. Often, the asymmetry of the hind limb is immediately visible, but sometimes such symptoms are not detected.

Since the dog can behave aggressively, you should immediately put a muzzle on it so that it does not bite the owner or the doctor. The first aid is to fix the limb. To do this, you need to take a long, strong and not flexible stick and tie it to the dog. On the one hand - to the knee, on the other - to the pelvis in the region of the hip joint.

You can not try to set the bone yourself, it will cause an incredibly strong pain reaction.

In addition, you can damage blood vessels and nerves with fragments of bones. The bone should be set by a specialist and only after an X-ray. X-ray is done in two perpendicular planes.

After fixing the limb, you need to deliver the dog to the veterinarian as soon as possible. Large pets are carried on a piece of plywood, a stretched blanket, and other makeshift stretchers. It is not recommended to do anesthesia, as this can lead to incompatibility of the drugs that the doctor will use.

Hip fracture treatment

Treatment at home is impossible, since the condition with fractures is too dangerous. First of all, anesthesia and general anesthesia are carried out, so that the dog allows itself to be examined calmly. Next, an x-ray is taken to determine the position of the bone fragments. Often, in case of fractures, surgery is done immediately.

In case of incomplete fractures (cracks) or closed fractures without displacement of the bones, plaster is applied or a splint is created. However, this method is not always effective, because the dog may try to remove the cast, thereby injuring his limb again. In this regard, veterinarians prefer to perform operations.

The operation is done under general anesthesia, all methods of fixation can be divided into two large groups.

Intraosseous osteosynthesis with a pin

The first incision is made at the site of the fracture. Through it, small fragments of bones, blood clots are removed, with an open fracture, they are treated with antibiotics. Next, the upper and lower bone fragments are removed into the wound so that it is convenient to manipulate them.

Then, using a stylet and a drill, a hole is made through the bone fragment near the upper head of the femur. It is made from the inside, through the medullary canal, through the first incision, this is necessary to introduce a conductor - a metal wire that will set the direction of the pin.

The conductor is pushed into the bone through the fracture site to the very top, so that it comes out from the upper end of the bone in the area of the vertical cavity (between the head of the bone and the greater and lesser trochanters). When the conductor rests against the skin of the buttock, a second incision is made in this place.

A pin is inserted through the second incision, with the help of a guide it is given a direction. If necessary, help the pin with a hammer to enter the bone. It is pushed until it comes out of the upper fragment by half a centimeter. After that, the ends of the bones are connected and the pin is fully inserted.

Bone osteosynthesis with rings

If in the first case the pin is inserted into the bone, then according to this method, the fixator is attached from above to the bone. This method is preferred for small breeds, as their bones are thin and do not allow the use intraosseous method. The latch itself can be in the form of a plate, beam or rings.

An incision is made at the fracture site, then the injured area is cleaned of small bone fragments, crushed tissues, blood clots. The latch is attached using screws, rings, knitting needles and other devices. It all depends on the type of fixing device.

Further rehabilitation

Further care includes rest, restriction of movement for the first week. The dog itself will determine the time when you can lean on the paw. On the third day, a callus is formed between the fragments of bones, consisting of cartilage tissue, which begins to ossify after 8-10 days. Complete fusion of the bone occurs in 25-45 days.