Surgical Pins and Plates in Dogs

What is a fracture?

A fracture is a broken bone. There are many different types of fractures, named according to the location of the fracture, how complex the injury is, and whether the bone(s) pierce through the skin. If surgery is recommended, various metal surgical implants will be used, such as pins, plates, wires, or screws.

How are fractures treated?

It is now possible to repair most fractures that a dog may receive due to a traumatic incident. The main objectives of fracture repair are to promote rapid healing of the fracture and to get the dog using its leg as quickly as possible. In most cases, this involves re-aligning the broken bone and fixing it in that position with metallic implants.

The most common methods of fixation of fractures include:

• Placing a stainless steel pin in the marrow cavity of the affected bone
• Plating the bone in position with a plate screwed to the outside of the bone
• Placing several short stainless steel pins vertically into the bone fragments, and connecting these pins on the outside of the leg using metal bars and clamps (an external fixator)

The technique used depends on several factors:

• The type of fracture your dog has
• The equipment your veterinarian or surgeon has available
• Other injuries your dog may have suffered to other limbs
• The age of your dog
• The temperament of your dog
• Financial considerations

How are fractures diagnosed?

If your dog has sustained a fracture, it will normally be unable to bear weight or stand on the affected limb. Usually, a fracture is painful. There may be soft tissue swelling in the area of the fracture.

Your veterinarian can detect a fracture by looking for pain and swelling, and by feeling a grinding sensation between the ends of the broken bones. Radiographs (X-rays) will be used to confirm the diagnosis and search for additional injuries.

If there are no additional injuries, your veterinarian will use the radiographs of the fractured limb to determine which fixation method to use. After the fracture is repaired, radiographs will be taken to assess how well the bones have been joined. The radiographs will also document the exact placement of all the pins and/or plates.

What post-operative care does my dog need?

After a fracture has been repaired, your veterinarian will normally hospitalize your dog for a few days to ensure there are no immediate post-operative complications, such as surgical site infections, movement of the surgical implants, or other problems. Immediately after the fracture has been repaired, a soft bandage may be placed on the fractured limb to provide a small degree of additional support and to minimize any swelling of the soft tissues surrounding the fracture. On rare occasions, it may be necessary to put the limb in a rigid cast; however, this is generally avoided.

Antibiotics will often be prescribed to help prevent infection at the fracture site. Pain relief medications will also be used before, during, and after surgical repair of the fracture. When your dog returns home, it is important to watch for signs of pain by observing whether they can settle down, rest, and sleep.

Some dogs will not eat well while hospitalized and can lose weight. Inadequate nutrition can lead to slow fracture healing. To promote optimal healing, your veterinarian will discharge your dog as soon as it is safe to do so.

For the first several days, your dog may need to have strict cage rest. Depending on the actual fracture repair, your veterinarian may recommend confinement in a small area, such as a bedroom, to allow your dog some limited mobility. In general, it is better to let your dog exercise in a small room while closely supervised than to immobilize them in a cage. Physical activity minimizes muscle loss on the fracture limb, reduces the chance of long-term joint immobility, and speeds healing of the fracture. Physical therapy exercises may also be advised.

The length of time your dog will require confinement and activity restriction depends on the following factors:

• The age of your dog: younger dogs heal more quickly than older dogs
• Whether your dog has a pre-existing illness that may delay healing, such as a metabolic disease
• The type of fracture your dog has suffered
• The type of fixation used
• How quickly your dog starts to use its leg effectively after surgery
• The appearance of the fracture on radiographs after some time has elapsed

Once your veterinarian is satisfied that the fracture has healed adequately, they will advise you that exercise restriction is no longer required. Once healing is complete, your veterinarian will decide whether it is necessary to remove some or all of the metal implants used in the fracture repair. Most pins and plates can safely remain in your dog for life, if required.

What is the long-term prognosis for my dog?

Most fractures can be repaired effectively. In many cases, your dog will resume normal activity levels three to four months after repair. However, if the original fracture involved a joint, your dog may develop some lameness, decreased range of motion (ROM), stiffness, or arthritis over time.