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Use of a circular external skeletal fixator for stabilization of a comminuted diaphyseal metatarsal fracture in an alpaca

Luis M. Rubio-MartínezVeterinary Teaching Hospital, Ontario Veterinary College, University of Guelph, Guelph, ON N1G 2W1, Canada

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Judith B. KoenigVeterinary Teaching Hospital, Ontario Veterinary College, University of Guelph, Guelph, ON N1G 2W1, Canada

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Krista B. HallingVeterinary Teaching Hospital, Ontario Veterinary College, University of Guelph, Guelph, ON N1G 2W1, Canada

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Katharine WilkinsCampbellford Veterinary Services, 176 Bridge St W Box 908, Campbellford, ON K0L 1LO, Canada

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Kara SchulzVeterinary Teaching Hospital, Ontario Veterinary College, University of Guelph, Guelph, ON N1G 2W1, Canada

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Abstract

Case Description—A 3-year-old male alpaca was evaluated because of non–weight-bearing lameness (grade 5/5) in the left hind limb.

Clinical Findings—Clinical and radiographic examination revealed a closed, comminuted, nonarticular, displaced diaphyseal fracture of the left third and fourth metatarsal bones.

Treatment and Outcome—Initial attempts at treatment via reduction of the fracture under traction and subsequent application of a cast were unsuccessful, and more stable fracture fixation was pursued. The alpaca underwent closed reduction of the fracture, which was stabilized by the application of a 3-ring circular external skeletal fixator (CESF). Improved weight bearing on the affected limb was evident soon after surgery and gradually increased; full weight bearing was evident by the seventh day after discharge from the hospital (day 20 after application of the CESF). Lameness was hardly noticeable during walking at that time. After 3 months, complete fracture healing was evident and the CESF was removed; mild outward rotation of the distal fragment and metatarsophalangeal joint was present. A Robert Jones bandage was applied to the limb, and the alpaca was kept in a stall for another 4 weeks. Eleven months after CESF application, the owners and referring veterinarian reported that the alpaca was healthy, not lame, and serving as a stallion without apparent impediment.

Clinical Relevance—Although mostly restricted to small animals, application of a CESF can be a viable alternative for management of long bone fractures in South American camelids.

Abstract

Case Description—A 3-year-old male alpaca was evaluated because of non–weight-bearing lameness (grade 5/5) in the left hind limb.

Clinical Findings—Clinical and radiographic examination revealed a closed, comminuted, nonarticular, displaced diaphyseal fracture of the left third and fourth metatarsal bones.

Treatment and Outcome—Initial attempts at treatment via reduction of the fracture under traction and subsequent application of a cast were unsuccessful, and more stable fracture fixation was pursued. The alpaca underwent closed reduction of the fracture, which was stabilized by the application of a 3-ring circular external skeletal fixator (CESF). Improved weight bearing on the affected limb was evident soon after surgery and gradually increased; full weight bearing was evident by the seventh day after discharge from the hospital (day 20 after application of the CESF). Lameness was hardly noticeable during walking at that time. After 3 months, complete fracture healing was evident and the CESF was removed; mild outward rotation of the distal fragment and metatarsophalangeal joint was present. A Robert Jones bandage was applied to the limb, and the alpaca was kept in a stall for another 4 weeks. Eleven months after CESF application, the owners and referring veterinarian reported that the alpaca was healthy, not lame, and serving as a stallion without apparent impediment.

Clinical Relevance—Although mostly restricted to small animals, application of a CESF can be a viable alternative for management of long bone fractures in South American camelids.

Contributor Notes

Address correspondence to Dr. Rubio-Martínez.