Retrospective evaluation of perioperative clinical outcomes of diaphyseal femoral fractures repaired with the string-of-pearls locking plate system with adjunctive fixation.

ABSTRACT

OBJECTIVE: To evaluate outcomes and complication rate of utilizing a string-of-pearls (SOP) plate augmented with adjunctive fixation in the repair of canine femur fractures. METHODS: Records of canine patients with mid-diaphyseal femoral fractures repaired with the SOP plate and adjunctive fixation were reviewed. Information retrieved from medical records included signalment, patient weight, fracture configuration, repair technique, healing time, and complications based on perioperative radiographic follow-up to clinical union. Forty client-owned dogs met inclusion criteria for this study. Variables analyzed for association with major complications included body weight, fracture configuration, repair technique, and adjunctive fixation. RESULTS: Major complications requiring surgical revision occurred in 8 of 40 fractures. Five cases experienced intramedullary pin migration and were successfully treated with sedated pin removal. The remaining 3 cases involved implant failure via screw shear breakage and required surgical revision of the fixation to achieve a successful outcome. On the basis of a calculated Bonferroni correction, no statistical significance of the tested variables was found in association with major complications; however, significance was limited due to the low statistical power of this study. CONCLUSIONS: The use of adjunctive fixation with the SOP locking plate system led to radiographic union without complication in most cases, and no instances of plate breakage were reported. However, implant complications secondary to the adjunctive fixation can occur. CLINICAL RELEVANCE Adjunctive fixation used with the SOP plate for repair of canine femur fractures has a high success rate, though pin migration as a complication persists.