Figure 41: A midshaft tibial fracture that was treated with a full K/E fixator and additional proximal pins. The full transfixation pins are fully threaded, improving their holding power by preventing slipping.

Figure 42: A tibial fracture treated with a full K/E fixator, using pins with central threading (centerface pins). The radiopaque threadsfrom a sterile sponge are visible

Figure 43: (A) Short oblique midshaft tibial fracture. (B) After treatment with a neutralization plate. Note the excellent reduction. The plate extends properly beyond the distal hairline crack. (C) Completely healed fracture. The fusion of the fibula to the tibia is not unusual and is of no consequence.

Figure 44: (A) Comminuted short oblique tibial fracture. (B) Above treated with a neutralization plate. Note excellent use of interfragmentary screws and cerclage wires. (C) After plate removal, healing is complete with minimal callus. The bed in the bone where the plates was seated is visible on this radiograph.

Figure 45: (A) A midshaft transverse fracture that was treated with an IM pin. The pin broke at the threaded portion, a common occurrence. (B) The pin fragments was removed and the fracture was plated. Healing has begun. (C) The fracture healed with a lateral tilt to the distal fragment.

Figure 46: (A) Long oblique midshaft tibial fracture. (B) Treatment with a bone plate.

Figure 47: (A) Radiograph of a severely comminuted tibial fracture. (B) Same injury treated with a reconstruction plate. Interfragmentary screw, and cerclage wires. (C) After healing

Fractures of the metacarpus and metatarsus

Surgical procedures for the metacarpals and metatarsals are essentially the same. Fractures of the metacarpals are relatively common in dog and cat. They may involve one or all four of the bones and vary in severity from green-stick to severely comminuted with contamination or infection. The second and fifth metacarpals (medial and lateral) are more commonly affected, Greenstick fractures and those involving medial and lateral bones with minor displacement are treated with a cast. Midshaft fractures especially those that involve most or all of the bones, do best with IMF or small plates. Nonunions and malunions are treated with small plates.

Figure 48: All four metacarpals are fractured.

Figure 49: These fractured metacarpals have been treated with bone plates and a lag screw.

Fractures of the phalanges

Fracture of the shaft of the phalanx are usually treated by placing the foot in a cast. In very large valuable animals, an external small plate is used.

Figure 50: Fractured metacarpals treated with small bone plates. This phalangeal fracture was treated with a threaded IM pin.

Figure 51: Fractured sesamoids. The second and seventh sesamoids, seen in this radiograph, are most commonly injured.

Luxation of the hip

Uncomplicated luxation refers to the condition caused by trauma whereby the femoral head is forced from the acetabulum usually craniodorsally with minimal damage to the surrounding structures. Rarely the femoral head is located caudoventrally. Replacement should be done as soon as possible, since spasm, scar tissue filling the acetabulum, adhesion of the ligament of the femoral head, erosion of the femoral head and false joint formation are expected complications.

Figure 52: An acute luxation of the hip.

Hip Dysplasia

Figure 53: Bilateral coxofemoral subluxation and subchondral scelerosis of the cranial acetabular margin. Notice the symmetry of the abturator foramina.

Small Animals Fracture Repair

The Extrimities

Hip dysplasia

Figure 54: Bilateral coxofemoral subluxation and subchondral sclerosis of the cranial acetabular margin. Notice the symmetry of the obturator foramina.

Figure 55: Bilateral dislocation of both hip joints due to hip dysplasia. Both acetabula are shown and show marginal lipping. This patient was a three-year-old female German shephered.

Figure 56: Hip dysplasia in a four-year-old male dog. Just the left hip joint is involved (arrow) Only the head of the femur shows some malformation.

Figures 57, 58, 59: A, Pathologic fracture due to osteoperosis. B, Greenstick fracture. The lateral cortex adjacent to the transverse fracture of the radius is intact indicating the greenstick type fracture. The same is true of the ulna. The ends of the bones are in complete opposition. C, Simple transverse fracture. This fracture is complete with separation of the proximal distal fragments and overriding.

Figure 60: A, fracture of the acromion process. There is no displacement of the fragment. B, "T" fracture of the distal end of the humerus.