Regardless of the type, site or cause of the fracture;
for healing to occur the fragments must be in close proximity
and well immobilized. The basic ways to achieve these goals are
surgical fixation or medical management. Medical management can
be further divided into coaptation devices (casting, splinting)
or confinement without a coaptation device.
Surgical fixation using pins, plates and/or wires
is the idealistic means of fracture repair. It provides the most
rigid stabilization and allows for the fastest healing time. Due
to expense, this method of treatment is not always feasible. Therefore,
the staff of All Creatures has prepared this handout in hopes
of providing essential information that will better assist you
in caring for your injured pet.
Coaptation Management:
Casting and splinting is the process of using a material
(fiberglass resin, cotton, plastic, etc.) placed on or around
the limb in order to provide rigid stabilization of the joint
above and below the fracture site (this is called a coaptation
device). The time required for healing of fractures may vary from
6 to 12 weeks depending on the type and location of fracture,
age of animal and the degree of immobilization.
Generally, most bandages, cast or splints require
periodic changing during the healing process. The type of material
will determine the time frame for changing, but every seven to
fourteen days is average. Therefore, anywhere from three to six
bandages, cast or splints should allow sufficient time for healing
to occur.
Regardless if the coaptation device is a bandage,
cast or splint the guidelines of care for the device are the same.
Things you must do as a caretaker:
- Even with a bandage, cast or splint your pet
MUST be kept well confined to prevent further injury to
the affected limb. The bandage, cast or splint is only an aid
to the healing process and is not meant to be used alone. (See
information below about confinement guidelines)
- Check the area above and below the device daily
to ensure:
If any of the above is noticed, call your veterinarian's
office immediately.
- Keep the bandage dry and clean. If the interior
of the device gets wet and is against the skin of your pet, it
may cause a severe infection and even sloughing of the affected
leg.
- Pain relief may be indicated during the early
stages of recovery. Your doctor will recommend the appropriate
dose for your pet.
- For adult or geriatric patients, placing them
on kitten or puppy food may be of great value due to the increased
nutrient requirement. A calcium supplement may also be beneficial in
the healing process.
Confinement Without a Coaptation Device:
This route may be selected due to expense of the
surgery or of the repeated changes of the coaptation device. Since
there is no external or internal device present to hold the bones
in rigid fixation, the animal must be kept virtually immobile
during the healing process. Any unnecessary movements may cause
repeated separation of the healing fragments. This will delay
or may even prevent the healing process. Please remember, that
the time required for healing of fractures may vary from 6 to
12 weeks depending on the type and location of fracture, age of
animal and the degree of immobilization.
Please follow the guidelines given below to ensure
proper care and fracture healing:
- Confinement is best performed with the use of
a hard plastic pet taxi or pet carrier. If you do not already
own one, they may be purchased from Wal-Mart, Sam's, Pet Stores,
etc. The size should be appropriate for the individual animal
being confined. It should allow room for the animals food and
water dishes, litter box for cats and allow some movement for
the animal. There should be space enough to allow your pet a clean, dry, padded
area to rest, AND a spot for an emergency bathroom.
Your pet should remain in the carrier at all times!!!
- The animal should be assisted in going outside
to urinate and/or defecate. Carrying is best, if appropriate (small
dog or cat). If to large an animal, then a towel may be used as
a sling. Place it under the affected area (abdomen or chest) to
support the affected limb(s) during movement.
- The affected limb(s) should be inspected daily
for any signs of excessive swelling of toes, hemorrhage or any
other abnormalities.
- Pain relief may be indicated during the early
stages of recovery. Your doctor will recommend the appropriate
medication for your pet.
- Once s/he starts to use the affected limb,
it should be in the form of on-leash walks only and then progressively
increase the intensity of the exercise over weeks to months.
- For adult or geriatric patients, placing them
on kitten or puppy food may be of great value due to the increased
nutrient makeup. A calcium supplement may also be beneficial in
the healing process.
One must remember that although coaptation devices
and confinement without coaptation devices do work and provide
suitable results for some types of fractures; the fragments were
not perfectly realigned nor stabalized before healing began and thus
healed with some degree of misalignment and movement so the results will
not be as good as with a surgical repair. Because of this, your
pet may experience significant amounts of arthritic changes and
discomfort in the future due to excessive new bone growth, etc.
This can be treated with anti-inflammatory medication (as in people)
to allow for a reasonable quality of life for your pet.
We hope that you will find this information helpful in your quest
for better pet care. If you have any questions or comments, please call your
veterinarian's office, or feel free to
e-mail us.
David E. Hammett, DVM
and the Staff of All Creatures Veterinary Clinic, PC
