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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
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CASE
PRESENTATION |
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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.
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PRE-OPERATIVE RADIOGRAPHS |
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Pre-op
CrCd view – humeral diaphyseal fracture with medial displacement.
Length preserved on radiograph with proper positioning of humerus
parallel to the table
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Pre-op ML
view – mid-diaphyseal humeral fracture with cranial angulation and
proximal displacement
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INTRAOPERATIVE FINDINGS |
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Craniolateral
approach - note superficial ramus of radial nerve
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Main distal fragment elevated –
note fissure line on cranial aspect |
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Main
proximal fragment elevated – note long oblique configuation with
spiral component; protection of radial nerve with penrose drain
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Reconstructed
humerus – note anatomic reduction with interfragmentary compression
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POST-OPERATIVE RADIOGRAPHS |
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Fracture
repaired by Dr. Clary, Immediate post-op CrCd view – note anatomic
fragment alignment and appropriate extra-articular depth of IM pin
penetration
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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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Click Below to View Discussion
DISCUSSION
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