Fractures

Fractured (broken) bones are not an uncommon injury in pets, and the treatment options are quite varied. If you’ve ever broken a leg yourself, or know someone who has, you might be picturing a hospital bed, a plaster cast, or perhaps some crutches. The options for our pets are slightly different!

©Jonathan Dyce

If you notice that your pet is hurt, it can be difficult to know how serious it is. Sprained or twisted limbs can have very similar symptoms to a broken leg. If your pet is hurt, they may be distressed, hide away or even become aggressive when you try to touch them, so it can be tricky to assess exactly what’s happened.

Here are some things to look out for:

• Wounds, swelling and bruising.
• Severe limping, including not putting any weight on the leg, or just touching the toes down briefly as they walk.
• Vocalizing: crying or howling, hissing or growling when anyone approaches.
• Hiding away, not eating or drinking.
• Not wanting to be touched, or reacting in distress or aggression when handled.

If your pet shows any of the above symptoms, or if you are just concerned: contact your veterinarian. Prompt diagnosis and treatment can make a significant difference to how well a fracture can be fixed and healed, so it is best not to delay. While you wait for your appointment, try to keep your pet contained in a small space such as a room or cage and restrict them from walking around as much as possible. Don’t be tempted to apply a splint or bandage. With cats and small dogs be careful when picking them up and keep the affected leg away from your body. Larger dogs may need some help to walk. A rolled up towel can be used to help support bodyweight.

Your veterinarian will initially examine your pet. They will look at the affected leg, and will also give your pet a thorough check to make sure they have no other injuries, wounds or signs of shock or internal bleeding. Once they have examined your pet, they will then discuss the options for diagnosis and possible treatments with you. Often several x-rays will be required to confirm the fracture and see what type of break it is so that the most suitable treatment can be planned. These will be taken under sedation or anesthesia. Your pet may need pain relief and intravenous fluids before or during the x-ray to stabilize them, especially if they are suffering from shock.

All fractures are different: from large open fractures to small hairline cracks. Broken bones are classified as either ‘open’, where there is a wound exposing the bone, or ‘closed’. They are further classified depending on whether there is a single clean fracture line (‘uncomplicated’ or ‘simple’) or multiple pieces of bone (‘complicated’ or ‘comminuted’) and whether several different bones are affected. Displaced fractures are those where the bones have been pushed out of alignment.

All these types of fractures mean there are lots of different ways of fixing them. The aim of treatment is to help your pet’s body heal the fracture, and return them to comfortable movement again. All pets with a broken bone will require pain relief and rest, but the specifics of treatment will depend on the type of fracture, whether there are other illnesses or injuries present, the age and temperament of your pet and any financial considerations.

Here are some of the common methods of treating fractures:

• 1. Simple, closed and stable fractures may not require surgery. Plaster casts are not widely used in veterinary medicine. Lightweight fiberglass casts are more frequently used, however these must not be thought of as an easy option. Care of the cast at home is extremely important as complications can arise. They must be kept clean and dry and checked regularly. Your pet will need strict rest to allow the bone to heal, and regular check-ups with your veterinary team will be essential.

All open fractures will require surgery, as will most bones with more complicated fractures. These are some different types:

• 2. Plating: the bone fragments are held in position by a metal plate that is screwed into the pieces and holds them together.
• 3. Pinning: a strong metal pin is placed down the center of the bone to hold the fractured area together. Usually this is combined with wires or other implants and not used alone.
• 4. External fixator: several short metal pins are inserted through the skin into the fragments of bone, and are connected on the outside of the leg by bars and clamps.
• 5. In very complicated fractures a combination or pins, plates or external fixators may be used.

If the fracture is severe, or if other treatment methods are not suitable, there is another option:

• 6. Amputation: pets often do very well on three limbs and the surgery is quicker than a fracture repair, with a faster recovery.

Your veterinarian will fully discuss all options with you before it is decided which route to go down.

Fractures generally take a minimum of 6 to 8 weeks to heal, however this varies with the age of the animal, the type of fracture and the fixation method used. The first few days your pet may remain at the veterinary surgery for monitoring, pain relief and antibiotics if needed. They will then likely be discharged to convalesce at home. In this time, your pet will need rest, and so you may need to invest in a crate or cage to restrict their movement. Pets can get very frustrated with enforced rest, so things like puzzle feeders and plenty of TLC will help. Gradually they will be allowed to increase their movement and may be allowed out into one room, and then the rest of the house. The veterinarian will need to see your pet regularly throughout their recovery to monitor the progress of healing. X-rays will be needed during the recovery period to assess how well the fracture is healing and also to detect any problems.

Pets have an amazing ability to heal, and with prompt treatment and correct aftercare, many will do fantastically well and return to full athletic ability. If the fracture has affected a joint (elbow/hip etc) then full function may not be regained and arthritis is likely to form. The length and difficulty of recovery usually depends on the severity of the initial fracture and how quickly it was treated.

There are some complications that can occur:

• Infection: this is most common with open fractures, where there can be a dirty and contaminated wound. Any bacteria that get into the fracture site, especially if there are pins or plates placed there, can multiply very quickly and cause infection at the fracture site. This infection can be very difficult to manage, and will hugely slow down the rate of healing so needs to be tackled quickly.
• Implant related complications: implants can become loose, move or cause problems with the fracture. This is uncommon and can usually be corrected with further surgery to adjust the implants, but can cause problems with the healing bone.
• Incorrect/delayed healing: occasionally the bone can heal out of alignment or take longer to heal than is needed.

These complications are uncommon, and most fractures will heal well. However, the best results come with quick intervention, by following veterinary advice on the best method of treatment and by conforming to strict rest protocols while the limb heals. If you are concerned your pet may have broken a limb, seek veterinary advice as soon as you can.