Biomechanical comparison of canine median sternotomy closure using suture tape and orthopedic wire cerclage.

OBJECTIVE: To compare the mechanical properties of suture tape and orthopedic wire cerclage in an ex vivo canine median sternotomy model. STUDY DESIGN: Ex vivo. ANIMALS: Twelve large-breed canine cadaveric sternums. METHODS: Median sternotomies were performed, leaving the manubrium intact. The specimens were randomly assigned to group W (20-gauge stainless steel orthopedic wire cerclage in a figure-of-eight pattern) or group ST (suture tape in a figure-of-eight pattern). Each specimen was laterally distracted until failure using an electrodynamic materials-testing system. RESULTS: No differences were observed for displacement, yield load, maximum load, implant failure between the groups. The orthopedic wire construct was stiffer than the suture tape construct. CONCLUSION: Suture tape was biomechanically similar to orthopedic wire cerclage for sternotomy closure in dogs, although wire constructs were stiffer. CLINICAL SIGNIFICANCE: Suture tape may represent an alternative to cerclage wire for sternotomy closure in dogs. Additional studies evaluating its clinical use are needed.

Evaluation of a 3-D printed drill guide to facilitate fluoroscopic-assisted Kirschner wire placement for minimally invasive iliosacral screw placement in dog cadavers.

OBJECTIVE: To evaluate the ease and accuracy of using a 3-D printed (3-DP) drill guide to insert Kirschner wires through the ilium and into the sacral body in preparation for minimally invasive iliosacral screw placement in dog cadavers. ANIMALS: 10 dog cadavers weighing 20 to 30 kg (mean ± SD, 24.5 ± 5 kg). METHODS: Kirschner wires were placed using a limited approach to the lateral ilium. Fluoroscopy was used in freehand and 3-DP drill guide application groups to facilitate the placement of a 1.0-mm Kirschner wire that was over-drilled using a 2.5-mm cannulated drill bit. Kirschner wires were placed using a 3-DP drill guide on 1 hemipelvis and freehand wire placement was done on the contralateral hemipelvis. Postprocedural CTs were obtained, and 2-D and 3-D analyses were performed. The Student t-test and Wilcoxon rank sum test were used to compare groups. A Pearson correlation coefficient was performed to evaluate the in-group correlation. RESULTS: Likert scores that assessed the ease of the procedure were significantly greater (P = .04) and the incision length was significantly shorter (P = .016) in the 3-DP drill guide group compared with the freehand group. The time of the procedure, the number of attempts to obtain accurate Kirschner wire placement, and fluoroscopy images did not differ (P > .05) between application groups. Drill tracks were primarily confined to the sacral body, with minor projected screw thread cortical breeches occurred in 1 cadaver in the freehand group and 2 cadavers in the 3-DP drill guide group. CLINICAL RELEVANCE: The 3-DP drill guide simplified appropriate iliosacral Kirschner wire placement through a smaller incision compared with freehand drilling and would appear to be an efficient, practical instrument to facilitate accurate fluoroscopic-assisted screw placement when stabilizing sacroiliac luxations in dogs.

Biomechanical evaluation of three fixation methods in a feline transverse patella fracture model.

OBJECTIVES: This study aimed to compare the biomechanical properties of three stabilisation techniques in feline patella transverse fractures and select the strongest method with potentially minimal complications. METHODS: Patella fracture was simulated in 27 feline cadaveric pelvic limbs (mean weight of the cadavers 3.78 kg), and the limbs were randomly grouped to be stabilised with one of the three stabilisation methods. The modified tension band wiring technique with a single Kirschner wire (0.9 mm) and figure-of-eight wiring (20 G) was applied to group 1 (n = 9). Group 2 (n = 9) was stabilised with a combination of circumferential and figure-of-eight wiring techniques with orthopaedic wire (20 G). Group 3 (n = 9) was stabilised with the same technique as group 2, but with #2 FiberWire. The knee joints were positioned and fixed in the neutral standing angle (135°) and tested by applying tensile force. The loads at gap formations of 1, 2 and 3 mm were recorded, and the maximum failure load was measured in each group. RESULTS: In all the loads at displacement (1, 2 and 3 mm), group 3 was significantly stronger than groups 1 and 2, respectively (P <0.017). Group 3 (261.0 ± 52.8 N) showed significantly stronger fixation in the maximum load compared with group 1 (172.9 ± 45.6 N) (P <0.017). No significant difference was observed between groups 1 and 2 (204.9 ± 68.4 N) or between groups 2 and 3. CONCLUSIONS AND RELEVANCE: This study shows that the combination of circumferential and figure-of-eight techniques with FiberWire is more resistant to displacement than metal wire in this ex vivo feline patella fracture model.

Treatment of a Mandibular Diastemal Fracture Using Locking Compression Plate and Cerclage Wire in a Mare.

This report describes the combination of two surgical fracture repair techniques and the postoperative management of a mandibular diastemal fracture in a two-year-old mare. The mare was referred to a veterinary hospital with a laceration over the body of the right mandible. Radiographic assessment revealed two mesial fracture lines involving the second premolar tooth and a ventrally displaced bone fragment. The mare was treated under general anesthesia and the fracture was corrected using open reduction and plate fixation. A 3.5 mm narrow 15-hole locking compression plate with seven locking screws were used in a bridge form. Cerclage wire was also used to anchor the incisor teeth to the second and third premolar teeth. The cerclage wire and incisor teeth were covered with polymethylmethacrylate to prevent implant failure and avoid injury to the oral mucosa. Implants were removed 55 days after surgery and the mare was discharged from hospital five days later. The mare returned for cerclage wire removal after 90 days and was allowed to resume exercise thereafter. The combination of two surgical techniques, proper implant choice and appropriate postoperative management, including use of pelleted feed, contributed to successful bone healing and return to function.

The effect of grip location on Kirschner wire bend characteristics: An in vitro study.

OBJECTIVE: To determine the effect of Kirschner wire (K-wire) grip location on bend angle, bend radius, and torque when performing a Z-bend technique. STUDY DESIGN: Experimental study. SAMPLE POPULATION: Ten samples at each of five grip locations for each of three K-wire diameters. METHODS: K-wires of three diameters (0.9, 1.1, 1.6 mm) were drilled into PVC pipe, and a Jacob's chuck was used to bend the wires at five periodic grip locations (distance from the bone model). Torque, bend angle, and bend radius were determined for each sample. Outcome variables were statistically analyzed by grip location to determine significant relationships. RESULTS: A grip location of 2.0 cm in the 0.9 mm K-wire group minimized bend angle (mean ± SD: 75.92° ± 0.81) and bend radius (2.89 mm ± 0.08). A grip location of 3.0 cm in the 1.1 mm K-wire group minimized bend angle (72.88° ± 0.98) and bend radius (2.47 mm ± 0.20). A grip location of 3.0 cm minimized bend angle (74.38° ± 1.93) and bend radius (2.71 mm ± 0.27) in the 1.6 mm K-wire group. Torque at these grip locations for the 0.9, 1.1, and 1.6 mm K-wires was 6.50 N-m ± 0.0, 11.00 N-m ± 0.0, and 19.05 N-m ± 0.16, respectively. CONCLUSION: Bend angle and bend radius can be minimized by bending K-wires at specific grip locations, though torque is not minimized at these locations. Clinical significance These findings provide an evidence-based recommendation of where surgeons should grip K-wires when bending them.

Humeral unicondylar fractures in immature dogs treated using a bone screw and Kirschner wire.

BACKGROUND: To investigate the incidence of implant-related complications when humeral unicondylar fractures in immature dogs are stabilised with a transcondylar bone screw and epicondylar Kirschner wire (K-wire)/pin. METHODS: Records of cases treated by the author in this clinic over a 10-year period were screened for those involving humeral condylar fractures. These were then reduced to include those patients who were less than 7 months of age with unicondylar fractures and follow-up radiographs. RESULTS: Thirty fractures in 29 dogs met the inclusion criteria. All of these had been stabilised with a transcondylar bone screw and epicondylar K-wire. Fracture healing was documented in all dogs. Surgical site infection was not recorded. Implant-related major complications were reported in four (13%) dogs and successfully treated by either implant removal or replacement. Short-term outcome was judged as excellent in 23 out of 30 and good in seven out of 30 of these fractures. CONCLUSION: The use of a transcondylar bone screw in combination with an epicondylar K-wire is an appropriate fixation method for humeral unicondylar fractures seen in puppies less than 7 months of age.

Comparison of median sternotomy closure-related complication rates using orthopedic wire or suture in dogs: A multi-institutional observational treatment effect analysis.

OBJECTIVE: To determine and compare median sternotomy (MS) closure-related complication rates using orthopedic wire or suture in dogs. STUDY DESIGN: Multi-institutional, retrospective observational study with treatment effect analysis. ANIMALS: 331 client-owned dogs, of which 68 were excluded. METHODS: Medical records of dogs with MS were examined across nine referral centers (2004-2020). Signalment, weight, clinical presentation, surgical details, complications, and outcomes were recorded. Follow-up was performed using patient records and email/telephone contact. Descriptive statistics, treatment effect analysis and logistic regression were performed. RESULTS: Median sternotomy closure was performed with wire in 115 dogs and suture in 148. Thirty-seven dogs experienced closure-related complications (14.1%), 20 in the wire group and 17 in the suture group. Twenty-three were listed as mild, four as moderate and 10 as severe. Treatment effect analysis showed a mean of 2.3% reduction in closure-related complications associated with using suture versus wire (95% CI: -9.1% to +4.5%). In multivariable logistic regression, the only factor associated with increased risk of closure-related complications was dog size (p = .01). This effect was not modified by the type of closure used (interaction term: OR = 0.99 [95% CI: 0.96/1.01]). CONCLUSION: The incidence of closure-related complication after MS was low compared to previous reports. The likelihood of developing a closure-related complication was equivalent between sutures and wires, independent of dog size, despite a higher proportion of complications seen in larger dogs (≥20 kg). CLINICAL SIGNIFICANCE: Use of either orthopedic wire or suture appear to be an appropriate closure method for sternotomy in dogs of any size.

Double-loop cerclage resists greater loads for more cycles than twist and single-loop cerclage.

OBJECTIVE: To compare the mechanical performance of cerclage secured with twist, single-loop, and double-loop knots subjected to cyclic loading. STUDY DESIGN: In vitro biomechanical study. SAMPLE POPULATION: Twist, single-loop and double-loop cerclage configurations of 1.0 mm wire. METHODS: The peak load resisted by each cerclage type was determined (n = 6). Cerclage were loaded cyclically to 80%, 60%, 40%, or 20% of its peak load (n = 8 per load level). The number of cycles until each cerclage loosened (residual tension <10 N) was recorded. RESULTS: All wires that failed did so by loosening. Twist cerclage cycled to 390 N and 290 N loosened within the first 10 cycles, and, when cycled to 100 N, they loosened by 250 cycles. All twist knots loosened by untwisting. Single-loop cerclage cycled to 320 N loosened within 10 cycles. At 240 N, 5 single-loop cerclage resisted 250 cycles before loosening. At 160 N, 2 of the 8 single-loop cerclage did not loosen by 100 000 cycles. When cycled to 640 N, one of the double-loop cerclage did not loosen following 500 000 cycles. When cycled to 480 N, 3 of the 8 wires did not loosen. CONCLUSION: Double-loop cerclage will be tighter and are better able to resist cycling than twist or single-loop cerclage. CLINICAL SIGNIFICANCE: Use of double-loop cerclage to stabilize bone fragments or prevent fissure propagation can be expected to provide greater resistance to loosening than twist or single-loop cerclage, both initially and with repeated loading.

Traumatic physeal fractures in cats: a review of 36 cases (2010-2020).

OBJECTIVES: The aim of this study was to describe the demography, aetiology, location and classification of physeal fractures in cats, and to describe their management and outcomes. METHODS: Clinical records and radiographs of cats referred for management of physeal fractures were retrospectively reviewed. Fractures of the proximal femoral physis were excluded. Descriptive statistics were used to describe signalment, cause of injury, presence of concurrent injuries, fracture description, treatment modality, complications, follow-up, physeal closure, implant removal and outcome. RESULTS: Thirty-four cats with 36 fractures were included, of which 17 affected the distal femur, 11 the distal tibia and fibula, five the distal radius and ulna, two the proximal tibia and one the distal humerus. Salter-Harris classification was type I in 14, type II in 16, type III in two and type IV in four fractures. Thirty-four fractures were treated with primary fixation, and the most common method was crossed Kirschner wires (24/34 fractures). Complications were observed in 14 fractures, of which 12 were minor. At radiographic follow-up, physeal closure was reported in 23 fractures, of which 15 were considered premature. Implant removal was performed in three fractures. Outcome was good in 28, fair in four and poor in two fractures. CONCLUSIONS AND RELEVANCE: Fracture of the distal femoral physis was the most common physeal fracture seen. Cats presenting with physeal fractures may be skeletally immature or mature with delayed physeal closure. The rate of physeal closure after fracture repair was relatively high but without apparent impact. The frequency of implant removal was very low, indicating that despite having a physeal fracture repair, most cats did not require a second procedure to remove implants. Overall, internal fixation provided a good outcome in most fractures.

Biomechanical Comparison of Three Stabilization Methods for Tibial Tuberosity Fractures in Dogs: A Cadaveric Study.

OBJECTIVE: The aim of this study was to compare the biomechanical properties of a hybrid external skeletal fixator (HESF) construct to the placement of paired interfragmentary Kirschner wires alone, and pin and tension band wire (PTBW) fixation for the stabilization of simulated tibial tuberosity fractures in dogs. STUDY DESIGN: Tibias were harvested from 12 skeletally mature dog cadavers weighing 20 to 30 kg. An osteotomy was made through the base of the tibial tuberosity, which was subsequently repaired with either paired Kirschner wires, PTBW fixation or a HESF. A tensile load was applied to the tibial tuberosity until failure occurred. Mode of failure was described and biomechanical parameters obtained were compared between fixation groups. RESULTS: The PTBW fixation and HESF construct afforded greater stiffness and load at 3 mm of axial displacement compared with fixation with Kirschner wires alone. There was no significant difference in stiffness and load at 3 mm displacement between PTBW and HESF fixation. Failure occurred by bending and pullout of the Kirschner wires for all fixation groups, preceded by untwisting of the knot in PTBW specimens. CONCLUSION: The HESF may provide a favourable alternative to PTBW fixation for tibial tuberosity avulsion fracture stabilization in dogs with substantial remaining growth potential.

Polyaxial pedicle screw external fixation to stabilize oblique mandibular fractures in three standing, sedated horses.

OBJECTIVE: To report the radiographic, surgical and postoperative features in horses with unstable oblique mandibular fractures secured with polyaxial pedicle screws (PPS) external fixation construct and intraoral wiring. ANIMALS: Three client-owned horses. STUDY DESIGN: Short case series. METHODS: Two horses each had a unilateral fracture, which did not improve after conservative management, and one horse had bilateral fractures. Clinical and radiographic features were documented. Polyaxial pedicle screw external fixators and intraoral tension band wiring were applied in standing horses after combining sedation and regional nerve anesthesia. Intraoral wires were implanted through a lateral buccotomy between teeth (two horses) or burred through exposed crown (one horse) and then secured around the incisors. The PPS were inserted under radiographic guidance to avoid tooth roots. Healing was assessed with radiographic examination. The PPS external fixator rod and intraoral wires were removed first. The mandible was manipulated, and, if it was stable, the PPS were removed. RESULTS: Implants were removed at 6, 8, or 10 weeks after the mandibles were palpably stable. Complications included broken wires in one horse, bone sequestration in one horse, and infection in one horse. Follow-up communication with the owners 12 to 18 months later confirmed complete healing without further complications of the fractured mandibles or teeth. CONCLUSION: Polyaxial pedicle screw external fixation led to fracture healing and a return to function in all three horses. The complications encountered did not preclude a successful outcome. CLINICAL SIGNIFICANCE: Polyaxial pedicle screw external fixation coupled with intraoral wiring provides an alternative to treat unstable equine mandibular fractures without general anesthesia.

Can bone marrow aspirate improve mandibular fracture repair in camels (Camelus dromedarius)? A preliminary study.

BACKGROUND: Mandibular fractures are common in camels, leading to considerable economic losses. This study explored methods of improving mandibular fractures repair, adjuvant with interdental wire, or bone plate fixation. Autologous bone marrow (BM) injection enhances osteogenesis and rapid healing. OBJECTIVES: To investigate the effect of autologous BM aspirate as an adjuvant treatment for repairing mandibular fractures in camels with interdental wire, or bone plate fixation. METHODS: Thirty dromedary camels aged 5-8 years and of both sexes were randomly divided into 4 treatment groups: group 1 (n = 10) treated with stainless steel wire fixation and BM injection at the fracture line, group 2 (n = 10) treated with plate fixation and BM injection at the fracture line, group 3 (n = 5) treated with stainless steel bone wire fixation and placebo saline injection at the fracture line, and group 4 (n = 5) treated with plate fixation and placebo injection at the fracture line. The mandibular fractures were followed weekly for 12 weeks postoperatively to assess improvement and healing based on clinical evaluation, radiographic union scale, and bone turnover markers (i.e., bone alkaline phosphatase, osteocalcin, pyridinoline, and deoxypyridinoline). RESULTS: Compared to other groups, elevated bone turnover markers in group 1 were demonstrated (p < 0.05) on the seventh postoperative day. Likewise, compared to other groups, both clinical findings and radiographic union scale significantly improved (p < 0.05) in group 1 on the 56th postoperative day. CONCLUSIONS: BM aspirate has a promising beneficial osteogenic effect on mandibular fracture repair in camels, most notably when combined with interdental wire fixation.

Feline Distal Tibial Physeal Fracture Repair Using a Modified Cross-Pin Technique with Four Pins.

OBJECTIVE: The aim of this article was to report the surgical technique and clinical outcome of a modified cross-pin technique for the treatment of distal tibial physeal fractures in cats without postoperative external coaptation. STUDY DESIGN: This study was a retrospective clinical study. ANIMALS: A total of 9 cats were presented with fracture of the distal tibial physis. MATERIALS AND METHODS: Medical records from July 2014 to September 2018 were reviewed. In all cases, a second medial and a craniolateral Kirschner wires were added to the traditional cross-pin technique. Information reviewed included orthogonal radiographs pre- and post-surgery and at subsequent re-examinations, subjective assessment of lameness and passive range of motion, veterinary clinical assessment and completion of a functional questionnaire (feline musculoskeletal pain index) at the time of writing this report. Eight owners completed the questionnaire. The mean questionnaire follow-up time was 12.7 months. RESULTS: Uncomplicated fracture healing occurred in all patients. Two patients required implant removal due to Kirschner wire migration and protrusion through the skin at 5 and 12 months post-surgery. No other complications were noticed. Eight patients had an excellent outcome, and one patient had a good outcome. CONCLUSION: Distal tibial physeal fractures in cats can be treated successfully with the use of a modified cross-pin technique and without the use of external coaptation. Prognosis should be considered favourable for this type of fracture.

Influence of wire configuration on resistance to fragment distraction of tension bands placed in a greater trochanteric osteotomy model.

OBJECTIVE: To determine the influence of wiring configurations on initial tension and resistance to tensile loads in tension band constructs without the contributions of Kirschner-wire stabilization. STUDY DESIGN: Experimental study. SAMPLE POPULATION: A solid brass femur model manufactured on the basis of computed tomography of a normal right femur of a 30-kg dog modified by transection of the greater trochanter and placement of two pins that did not cross the simulated osteotomy. METHODS: Four tension band configurations were applied to the metal trochanteric osteotomy model: figure-of-eight with one twist (OT), figure-of-eight with two twists (TT), dual interlocking single loop, and double loop (DL). Configurations were tested under both monotonic loading (n = 8 per configuration) and incremental cyclic loading (n = 8 per configuration). Initial tension after tying, residual tension remaining after each cycle, and failure load at 2 mm of displacement (considered equivalent to clinical failure) were compared between configurations. RESULTS: The initial tension and the load to 2 mm of displacement were lower for OT wires compared with TT wires. The DL was the strongest and most stable configuration, generating 2.3 to 3.5 times greater initial tension, maintaining a greater percentage of residual tension under incremental cyclic loads, and resisting 2.0 to 2.4 times greater load before failure at 2 mm. Failure load was highly correlated with initial tension. CONCLUSION: Wire configurations reaching greater initial tension, such as the DL, allowed constructs to resist higher tensile loads. CLINICAL IMPACT: Wire configurations allowing higher initial tension may be warranted when tension bands are expected to sustain high tensile loads.

Minimally invasive percutaneous medial plate rod osteosynthesis for treatment of bicondylar humeral fractures in dogs: Surgical technique and case report.

OBJECTIVE: To describe a minimally invasive surgical technique for the treatment of comminuted humeral bicondylar (also known as T-Y) fractures in dogs and report outcome in 3 cases. STUDY DESIGN: Surgical technique description and case report. ANIMALS: Three consecutive dogs with traumatic comminuted humeral T-Y fractures. METHODS: Dogs that presented with a traumatic humeral T-Y fracture were prospectively included. The condylar component of the fractures was reduced first by using a combination of percutaneous forceps and K-wires. A transcondylar screw was applied, and epicondylar pins were preplaced medially and laterally. The metaphyseal component of the fracture was then reduced and stabilized with the pins. Finally, a bone plate was applied percutaneously along the medial humeral surface. Intraoperative fluoroscopy was used throughout surgery in all cases. Postoperative alignment in the frontal and sagittal planes was compared to the contralateral limbs. Time to clinical union, clinical outcome, and complications were recorded. RESULTS: Three dogs were included. Body weight ranged from 5.9 to 40 kg. Incomplete ossification of the humeral condyle was identified as the primary pathology leading to the fracture in 2 cases. All cases experienced uncomplicated healing with good to excellent functional recovery. CONCLUSION: The reported technique was associated with good outcomes without complications in 3 cases. CLINICAL SIGNIFICANCE: This study provides evidence that minimally invasive plate osteosynthesis represents an alternative to open reduction and internal fixation in the treatment of comminuted humeral T-Y fractures.

Epoxy-Pin External Skeletal Fixation for Management of Open Bone Fractures in Calves and Foals: A Review of 32 Cases.

OBJECTIVE: The aim of this study was to evaluate epoxy-pin external skeletal fixation technique for the treatment of open fractures in calves and foals. STUDY DESIGN: Twenty-eight calves and four foals (weighing 45-105 kg) with fractures distal to the stifle or elbow made the subject for the retrospective study. The pins (2.0-3.0-mm Kirschner wires, crossed at 60-90°) were fixed at least at two locations in both proximal and distal bone fragments as per the case situation. The pins in the same plane were bent (∼2 cm from the skin) towards the fracture site or joint and were joined using an adhesive tape (additional pins used when required) to make a temporary scaffold of connecting bars or rings. Thoroughly mixed epoxy putty was applied along the pin scaffold (the epoxy columns were 20-25 mm diameter) and allowed to set for 45 to 60 minutes. All animals were evaluated based on various clinical and radiographic observations made at regular intervals. RESULTS: The epoxy-pin fixation was easy to apply and provided stable fixation of bone as indicated by early weight bearing, and fracture healing within 45 to 60 days (17/32 cases). The functional recovery was good to very good in 14 animals and satisfactory in nine cases by 12 months after removal of the fixator. CONCLUSIONS: The multiplanar epoxy-pin external skeletal fixation provides stable fixation of unstable open fractures distal to the stifle or elbow joint; hence, it can be used to treat a variety of fractures in calves and foals weighing up to approximately 100 kg, especially open infected fractures of lower limb, which are difficult to treat by conventional techniques.

Complications Following Surgical Correction of Medial Patellar Luxation in Small-to-Medium-Size Dogs.

OBJECTIVE: The main aim of this study was to describe complications in dogs weighing < 20 kg treated for medial patellar luxation and to determine risk factors associated with these complications. MATERIALS AND METHODS: Medical records were reviewed and cases were grouped based on four techniques of stabilization for the tibial tuberosity transposition (TTT). Variables including animal signalment, clinical presentation, TTT technique, other concurrent surgical techniques and associated complications were investigated. Multiple logistic regression was used to determine the association of the same variables with specific complications such as tibial tuberosity fractures or avulsions, patellar reluxation and implant-related complications. RESULTS: Of the 100 procedures performed, 37 suffered a complication. There were no significant differences in the overall complication rate between TTT stabilization techniques. Preservation of the tibial tuberosity distal cortical attachment was associated with a reduced risk of implant-related complications, whereas adding a medial release to the surgical techniques was associated with an increased risk of medial patellar reluxation. The type of trochleoplasty performed did not affect the complication rate. CONCLUSIONS: In the current study, a high rate of complications was found in dogs < 20 kg undergoing medial patellar luxation surgery. Performing a medial release and preserving the distal cortical attachment of the tibial tuberosity were the only variables associated respectively with an increase and a reduction in the risk of postsurgical complications.

Rostral mandibular fracture repair in a pet bearded dragon (Pogona vitticeps).

CASE DESCRIPTION A 2-year-old male bearded dragon (Pogona vitticeps) was evaluated because of a traumatic mandibular fracture. CLINICAL FINDINGS An open comminuted fracture of the rostral aspect of the right mandible was evident, with a fragment of bone exposed and dorsally displaced. Whole-body radiography revealed no evidence of additional injury. Other findings were unremarkable, except for moderate anemia (PCV, 19%). TREATMENT AND OUTCOME The fracture fragments were stabilized with 2 crossed 36-gauge interfragmentary wire loops. An external fixator device was fashioned from four 25-gauge needles inserted at alternating angles through the fracture fragments; plastic IV fluid line tubing filled with dental acrylic was used as a connecting bar. One day after surgery, the lizard had regained its typical activity level and appetite. Body weight was measured and the external fixator was inspected 1 week after surgery and monthly thereafter. Three months after initial injury, the fracture was stable, radiography revealed bony callus formation at the fracture site, and the external fixator was removed. Recheck radiography performed 5.5 months after initial injury revealed complete osseous union of the fracture fragments, and the interfragmentary wires were removed. CLINICAL RELEVANCE Surgical management of the traumatic comminuted mandibular fracture in this bearded dragon by means of a combination of internal and external fixation resulted in complete healing of the mandible and restoration of function. Management of this complicated fracture was achieved with the aid of readily available and inexpensive supplies in a clinical setting, which may be useful to other clinicians in the management of similar cases.

Stabilization of Olecranon Fractures by Tension Band Wiring or Plate Osteosynthesis: A Retrospective Study of 41 Cases.

OBJECTIVES: This article aimed to describe olecranon fracture in dogs and cats and their stabilization with tension band wiring or plate osteosynthesis, and to evaluate complications associated with each technique. METHODS: Medical records of cats and dogs that had been surgically treated for olecranon fractures with either tension band wiring or plate osteosynthesis were retrospectively reviewed. The surgical technique, complications and long-term outcomes were assessed. RESULTS: Forty-one olecranon fractures were included. Fractures were articular, comminuted and open in 90, 31 and 27% of cases, respectively. Tension band wiring and plate osteosynthesis were performed in 22 and 19 fractures, respectively. Complications occurred more commonly after tension band wiring (74%) compared with plate osteosynthesis (27%) (p = 0.002) and these were probably related to it being used in comminuted fractures (p = 0.01) or to errors in technique. Minor complications included Kirschner wires migration (n = 5), pain (n = 3), osteomyelitis (n = 3), skin breakdown (n = 3) and seroma (n = 1). Implant failure requiring further fixation (n = 4) was observed only in the tension band wiring group. Other major complications included skin wound debridement and closure (n = 1) and chronic lameness requiring implant removal (n = 7). Long-term functional outcomes were excellent regardless of the technique used. CLINICAL SIGNIFICANCE: Plate osteosynthesis should be performed for olecranon fracture repair if technically feasible.