Open reduction and bone plate stabilization, compared with closed reduction and external fixation, for treatment of comminuted tibial fractures: 47 cases (1980–1995) in dogs

Melissa Dudley From the Departments of Veterinary Clinical Medicine (Dudley, Johnson, Smith) and Veterinary Biosciences (Schaeffer), College of Veterinary Medicine, University of Illinois, Urbana, IL 61802, and the Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210 (Olmstead, Abbuehl).

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Ann L. Johnson From the Departments of Veterinary Clinical Medicine (Dudley, Johnson, Smith) and Veterinary Biosciences (Schaeffer), College of Veterinary Medicine, University of Illinois, Urbana, IL 61802, and the Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210 (Olmstead, Abbuehl).

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Marvin Olmstead From the Departments of Veterinary Clinical Medicine (Dudley, Johnson, Smith) and Veterinary Biosciences (Schaeffer), College of Veterinary Medicine, University of Illinois, Urbana, IL 61802, and the Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210 (Olmstead, Abbuehl).

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C. W. Smith From the Departments of Veterinary Clinical Medicine (Dudley, Johnson, Smith) and Veterinary Biosciences (Schaeffer), College of Veterinary Medicine, University of Illinois, Urbana, IL 61802, and the Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210 (Olmstead, Abbuehl).

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David J. Schaeffer From the Departments of Veterinary Clinical Medicine (Dudley, Johnson, Smith) and Veterinary Biosciences (Schaeffer), College of Veterinary Medicine, University of Illinois, Urbana, IL 61802, and the Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210 (Olmstead, Abbuehl).

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Urs Abbuehl From the Departments of Veterinary Clinical Medicine (Dudley, Johnson, Smith) and Veterinary Biosciences (Schaeffer), College of Veterinary Medicine, University of Illinois, Urbana, IL 61802, and the Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210 (Olmstead, Abbuehl).

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Objective

To compare open reduction and bone plate fixation with closed reduction and external skeletal fixation as treatment for severely comminuted fractures of the tibia. Limb alignment, fracture reduction, operating time, hospitalization time, postoperative care, time to unrestricted activity, bone healing, complications, and number of surgical procedures were considered.

Design

Retrospective case series.

Animals

47 dogs with severely comminuted fractures of the tibia treated with open reduction and bone plate application (22 dogs) or closed reduction and external fixation (25 dogs).

Procedure

Medical records of all dogs included in this study were reviewed. Postoperative and follow-up radiographs were evaluated by 2 independent observers.

Results

Differences were not found in hospitalization time, time to unrestricted activity, or time to earliest radiographic evidence of bone healing between dogs with fractures treated with a bone plate and dogs with fractures treated with an external fixator. Fractures treated with an external fixator had more caudal malalignment, and fractures treated with a bone plate had more valgus malalignment. Malalignments were determined not to be related to clinical problems. Dogs with fractures treated with an external fixator had shorter surgery times and more recheck examinations. Dogs with fractures treated with a bone plate had more complications.

Clinical Implications

Open reduction with bone plate fixation and closed reduction with external fixation were both effective for treatment of comminuted tibial fractures. External fixation was associated with shorter surgery time, but dogs required more extensive postoperative care. Bone plate fixation was associated with more complications. (J Am Vet Med Assoc 1997;211:1008–1012)

Objective

To compare open reduction and bone plate fixation with closed reduction and external skeletal fixation as treatment for severely comminuted fractures of the tibia. Limb alignment, fracture reduction, operating time, hospitalization time, postoperative care, time to unrestricted activity, bone healing, complications, and number of surgical procedures were considered.

Design

Retrospective case series.

Animals

47 dogs with severely comminuted fractures of the tibia treated with open reduction and bone plate application (22 dogs) or closed reduction and external fixation (25 dogs).

Procedure

Medical records of all dogs included in this study were reviewed. Postoperative and follow-up radiographs were evaluated by 2 independent observers.

Results

Differences were not found in hospitalization time, time to unrestricted activity, or time to earliest radiographic evidence of bone healing between dogs with fractures treated with a bone plate and dogs with fractures treated with an external fixator. Fractures treated with an external fixator had more caudal malalignment, and fractures treated with a bone plate had more valgus malalignment. Malalignments were determined not to be related to clinical problems. Dogs with fractures treated with an external fixator had shorter surgery times and more recheck examinations. Dogs with fractures treated with a bone plate had more complications.

Clinical Implications

Open reduction with bone plate fixation and closed reduction with external fixation were both effective for treatment of comminuted tibial fractures. External fixation was associated with shorter surgery time, but dogs required more extensive postoperative care. Bone plate fixation was associated with more complications. (J Am Vet Med Assoc 1997;211:1008–1012)

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