Clinical application of intraoperative skeletal traction in the dog

Summary

The purpose of this clinical study was to evaluate the technical feasibility of a method for pre-operative and intra-operative traction for reduction of fractures of the appendicular skeleton. Traction was used in 24 diaphyseal fractures in 21 dogs. For each dog, the data pertaining to signalment, limb circumference, fracture type, interval between fracture and surgery, and the traction modalities were recorded. In patients with a latency between trauma and surgery of less than three days, the duration of traction required to realign the bone segments was shorter than that required for older fractures (P = 0.02). Intraoperative malalignments were corrected by manoeuvres performed with the traction stand. Once realigned, fracture segments were kept stable for prolonged periods, without the need for a surgical assistant. Postoperative radiographs were evaluated for fracture reduction and axial alignment. Postoperative alignment was judged excellent in 21 fractures and good in three fractures. Fractures were stabilized using external skeletal fixation (n=10), plates (n=11) or locked nails (n=3), depending on the fracture type. The use of the technique was straightforward and easily applied in a surgical setting. However, its use requires careful application because of the potential for iatrogenic tissue damage.

Keywords

Dog - diaphyseal fracture - skeletal traction

• References

• 1 Aron DN, Palmer RH, Johnson AL. Biologic strategies and a balanced concept for repair of highly comminuted long bone fractures. Comp Cont Educ Small Anim 1995; 17: 35-49.
• 2 Dueland RT. Open (compound) fractures. In: Brinker WO, Hohn RB, Prieur WD. (eds) Manual of internal fixation in small animals. Springer Verlag; Berlin: 1984: 108.
• 3 Johnson AL. Current concepts in fracture reduction. Vet Comp Orthop Traumatol 2003; 16: 59-66.
• 4 King KF, Rush J. Closed intramedullarynailing of femoral shaft fractures. A review of one hundred and twelve cases treated by the Kuntscher technique. JBone Joint Surg Am 1981; 63: 1319-23.
• 5 Latte Y. Reduction de la fracture. In: Latte Y, Meynard J-A. (eds) Manuel de fixation externe. Editions PMCAC; Paris: 1997: 117-24.
• 6 McCartney WT, Carmichael S. Talar neck fractures in five cats. J Small Anim Pract 2000; 41: 204-6.
• 7 Rovesti GL, Margini A, Cappellari G. et al. Intraoperative skeletal traction in the dog. A cadaveric study. Vet Comp Orthop Traumatol 2006; 1: 9-13.
• 8 Wu CC. An improved surgical technique to treat femoral shaft malunion: revised reamed intrame-dullary nailing technique. Arch Orthop Trauma Surg 2001; 121: 265-70.