An 11-month-old sexually intact male red kangaroo (Macropus rufus) was examined because of bilateral radial and ulnar fractures.
Radiography of the forelimbs revealed bilateral, short oblique fractures in the proximal to mid diaphyses of the radii and ulnae. Fractures were overriding and moderately displaced. Wider than expected gaps were evident in the humeroulnar and humeroradial joints bilaterally. Although several physes remained open, no proximal radial physis was radiographically evident.
TREATMENT AND OUTCOME
Dual bone fixation was performed bilaterally, and dynamic luxation of the left radial head was identified and stabilized intraoperatively. Although satisfactory function of both forelimbs was evident at 8 weeks and 26 months after surgery, a persistent gait abnormality affecting the right forelimb was noted. Twenty-six months after surgery, radiography revealed bilateral proximal radial physes and resolution of the abnormally wide gaps in the humeroradial and humeroulnar joints. Despite dual bone fixation, synostoses formed bilaterally and may have contributed to the persistent lameness in the kangaroo's right forelimb.
Veterinarians treating kangaroos should be aware of difficulties in determining skeletal maturity and planning fracture stabilization because of potential differences in skeletal growth and fracture healing, compared with other species. We described critical issues observed in the treatment and outcome of the kangaroo of the present report and provided lessons learned as well as potential explanations of these issues to facilitate future treatment of kangaroos with forelimb fractures.
Case Description—A 4-year-old sexually intact male Labrador Retriever-Poodle mix was admitted to the hospital for treatment of a wound in the left thoracic region. The wound had been debrided and primary closure had been performed by the referring veterinarian 4 days previously.
Clinical Findings—The dog had a 20-cm-long wound covered by a large flap of skin that extended caudally from the scapula over the left side of the thorax. A 3-cm defect was evident at the cranioventral aspect of the wound, from which purulent material was being discharged. The skin flap was necrotic, and the skin surrounding the flap was bruised. Signs of pain were elicited when the wound and surrounding region were palpated. Other findings, including those of thoracic radiography, were unremarkable.
Treatment and Outcome—The wound was debrided, and vacuum-assisted closure (VAC) was initiated for 3 days until a healthy bed of granulation tissue developed. A reconstructive procedure was performed with a rotation flap 3 days after VAC dressing removal. The VAC process was reinitiated 2 days following reconstruction because of an apparent failing of the skin flap viability. After 5 days of VAC, the flap had markedly improved in color and consistency and VAC was discontinued. Successful healing of the flap occurred without the need for debridement or additional intervention.
Clinical Relevance—Use of VAC led to a good overall outcome for the dog, with complete healing achieved. Additional evaluation of this technique for salvaging failing skin flaps is warranted in dogs, particularly considering that no reliable method for flap salvage in veterinary species has been reported to date. (J Am Vet Med Assoc 2013;243:863–868)