Leczenie braku zrostu septycznych złamań kości przedramienia i kości podudzia u psów przy użyciu okólnego zewnętrznego mocowania szkieletowego – badanie retrospektywne. Cz. II

Treatment of antebrachial and crural septic nonunion fractures in
dogs using circular external skeletal fixation – a retrospective study.
Part II

Results

Patients in the study

Twenty-three of the 27 dogs in which CESF was used to manage septic nonunion antebrachial or crural fractures at our institution met the inclusion criteria. There were 14 males, four intact females and five spayed females with a mean age of 54 months (SD: ± 41 months; range: 7-144 months) and mean body weight of 20 kg (SD: ± 14 kg; range: 3-44 kg).

Twelve antebrachial and 11 crural nonunion fractures were included. Thirteen nonunion fractures were located in the metaphysis, eight in the diaphysis, and two involved the carpal joint. There were nine open fractures, five of which were grade 1 and four of which were grade 2.

Fractures had initially been stabilized with a linear external fixator (n = 11), a bone plate (n = 11), or an intramedullary pin (n = 1). One dog had previously undergone two surgical procedures before referral to our hospital. Draining tracts were present in 17 dogs and loss of carpal extension was noted in nine dogs. Five dogs had a lameness score of IV and 18 dogs had a lameness score of V. The nonunion fractures were classified as atrophic (n = 11), oligotrophic (n = 5), necrotic (n = 3), hypertrophic (n = 2), slightly hypertrophic (n = 1), and dystrophic (n = 1). The time be tween injury and CESF application (mean ± SD) was 76 ± 45 days (range: 15-180 days).

Surgical technique

The Hoffmann Small Bone Fixator system (Small Bone Fixator: Hoffmann S.a.S, Monza, Italy) was used in 15 cases and the Imex Circular External Skeletal Fixation system in eight cases. The CESF frame was preassembled with two doublering blocks in 11 cases and included a single-ring block in 12 cases.

One nonunion fracture was treated in a closed fashion and 22 were treated using an open procedure. Seven of the latter underwent a traditional surgical debridement and 15 u...