Gizmo, a 6 year old spayed female Pekingese, presented on November 14, 2010 as an emergency to Hickory Veterinary Hospital after falling out of a parked car. She was not weight bearing on her right front leg and her elbow was painful and unstable on palpation. No wounds were observed. The rest of her physical examination was nonremarkable.
Radiographs of Gizmo's right front leg revealed a comminuted, intercondylar fracture of the humerus. Open surgical repair was necessary for accurate reduction of the fracture. Gizmo was hospitalized overnight on intravenous fluid support and pain medications, her preanesthetic bloodwork revealed no abnormalities, and she was prepared for surgery the following morning.
Gizmo's fracture was reduced and repaired with internal fixation. Two lag screws were placed distally to reduce the medial epicondylar fracture and a lag screw and cerclage wire were placed proximally. Antibiotics and pain medication were continued and Gizmo boarded at the hospital after surgery for confinement and observation. Although clinically doing well and partially weight-bearing, post-operative radiographs taken one week later revealed a loss of fixation around the proximal screw and cerclage wire.
A second surgery was necessary to remove the proximal screw and re-reduce the fracture. A lag screw and two K wires were placed in the proximal fracture and an autologous bone graft was performed to encourage and accelerate new bone growth. A spica splint was used to provide additional external support.
Although Gizmo required extended confinement with the splint in place, she continued to remain bright and comfortable. Serial radiographs taken over the following months revealed progressive callus formation and bridging of the fracture. Currently, Gizmo is weight bearing on her leg and is able to run and play.
Fracture healing is dependant on adequate blood supply and rigid stabilization. Immature animals (less than 6 months of age) possess extensive circulation and can heal at a rapid rate. Metaphyseal and epiphyseal fractures and simple, less traumatic fractures also heal faster because of enhanced vasculature and increased chance of stable fixation. Gizmo's fracture was traumatic, comminuted, and required surgical fixation. These factors compromised her blood supply and were contributing factors to the instability of the initial repair and the extended length of recovery. However, with dedicated care Gizmo achieved a good outcome and return to function.