Carolina Veterinary Surgical Service

 

Fracture Management:

A case presentation and discussion of general principles

by

Erik M. Clary, DVM, MS, DACVS

2002 Erik M. Clary.  Unauthorized duplication is a violation of US copyright law.

 

CASE PRESENTATION

DISCUSSION

  

CASE PRESENTATION

 

Signalment: 1-year-old, female-spayed, Domestic Long Hair

History:  Right forelimb trauma (unknown etiology) within 24 hours of presentation

Clinical exam findings: Alert, responsive, Non-weight-bearing on right front limb with moderate brachial swelling; Sensory perception in distal limb is intact.  Physiologic parameters within normal limits.  25ug/kg/h Fentanyl transdermal patch applied to the dorsum of the neck by emergency veterinarian 18 hours prior.

 

 

PRE-OPERATIVE RADIOGRAPHS

 

 

Pre-op CrCd view humeral diaphyseal fracture with medial displacement.  Length preserved on radiograph with proper positioning of humerus parallel to the table

 

Pre-op ML view mid-diaphyseal humeral fracture with cranial angulation and proximal displacement

 

INTRAOPERATIVE FINDINGS

 

Craniolateral approach - note superficial ramus of radial nerve

 

 

Main distal fragment elevated note fissure line on cranial aspect

 

 

Main proximal fragment elevated note long oblique configuation with spiral component; protection of radial nerve with penrose drain

 

Reconstructed humerus note anatomic reduction with interfragmentary compression

 

POST-OPERATIVE RADIOGRAPHS

 

 

Fracture repaired by Dr. Clary, Immediate post-op CrCd view note anatomic fragment alignment and appropriate extra-articular depth of IM pin penetration

 

Post-op ML view showing excellent reduction of fragments and IM pin location just proximal to the level of the humeral epicondyles

 

 

 

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DISCUSSION