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Objective: Femoral fractures are often catastrophic in large animals. Radiographic diagnosis is limited by patient size and feasibility, especially in ambulatory settings. Ultrasonography is widely available and may provide an alternative to radiography for definitive diagnosis., Animals: 12 large animals (6 horses, 5 cattle, and 1 elephant)., Procedures: Retrospective analysis of large animal patients diagnosed with femoral fracture by use of femoropelvic ultrasonography (2000 to 2019)., Results: 5 of 12 cases were ≤ 1 year of age. The remaining 7 cases were 2 to 33 years of age (median, 13 years). All patients developed severe acute lameness after falling (n = 4), limb entrapment (2), dystocia (1), vehicular collision (1), ipsilateral full limb casting (1), or unknown events (3). All were non-weight-bearing or lame at the walk, including 2 recumbent cattle. Ten cases showed upper limb swelling that was variable in location, and 3 had nonspecific upper limb crepitus. Ultrasonography revealed evidence of diaphyseal (n = 6), greater trochanteric (2), capital physeal (2), and distal femoral (2) fractures. Fracture movement during limb manipulation or weight shifting was sonographically visualized in 5 animals. Radiography confirmed fractures in 3 of 8 animals: 2 bovines with distal femoral fractures detected on standing projections and 1 capital physeal fracture that required ventrodorsal projections under general anesthesia. All animals were euthanized (11) or slaughtered (1 bovine). Postmortem examination confirmed ultrasonographic findings in 10 of 10 necropsied animals., Clinical Relevance: Femoral fractures were not localized nor confirmed in any case prior to ultrasonography. Study findings supported the use of ultrasonography for rapid patient-side diagnosis, prognostication, and decision-making in suspect cases.

OBJECTIVE To compare stiffness and resistance to cyclic fatigue of two 3.5-mm locking system plate-rod constructs applied to an experimentally created fracture gap in femurs of canine cadavers. SAMPLE 20 femurs from cadavers of 10 mixed-breed adult dogs. PROCEDURES 1 femur from each cadaver was stabilized with a conical coupling plating system-rod construct, and the contralateral femur was stabilized with a locking compression plate (LCP)-rod construct. An intramedullary Steinmann pin was inserted in each femur. A 40-mm gap then was created; the gap was centered beneath the central portion of each plate. Cyclic axial loading with increasing loads was performed. Specimens that did not fail during cyclic loading were subjected to an acute load to failure. RESULTS During cyclic loading, significantly more LCP constructs failed (6/10), compared with the number of conical coupling plating system constructs that failed (1/10). Mode of failure of the constructs included fracture of the medial or caudal aspect of the cortex of the proximal segment with bending of the plate and pin, bending of the plate and pin without fracture, and screw pullout. Mean stiffness, yield load, and load to failure were not significantly different between the 2 methods of stabilization. CONCLUSIONS AND CLINICAL RELEVANCE Both constructs had similar biomechanical properties, but the conical coupling plating system was less likely to fail than was the LCP system when subjected to cyclic loading. These results should be interpreted with caution because testing was limited to a single loading mode.

Objective: To evaluate the postoperative analgesic effects of epidural administration of morphine and neostigmine, either alone or in combination, in dogs., Animals: 30 dogs undergoing orthopedic surgery on a pelvic limb., Procedures: Anesthetic protocols were standardized. At the end of surgery, 10 dogs each received 1 of 3 epidural treatments: morphine (0.1 mg/kg), neostigmine (5 μg/kg), or morphine plus neostigmine (0.1 mg/kg and 5 μg/kg, respectively). Postoperative pain scores and the need for rescue analgesia were evaluated for 24 hours., Results: Pain scores were higher in the neostigmine group, compared with scores for the morphine-neostigmine group, at 2 and 24 hours after surgery and higher in the morphine group than in the morphine-neostigmine group at 2 and 4 hours. During 24 hours, rescue analgesia was provided for 4, 7, and 2 of 10 dogs each in the morphine, neostigmine, and morphine-neostigmine groups, respectively. The number of dogs given rescue analgesia was significantly different among groups at 2, 3, 4, and 6 hours after surgery. Dogs in the morphine and morphine-neostigmine groups had a lower probability of receiving rescue analgesia within 24 hours than did dogs in the neostigmine group., Conclusions and Clinical Relevance: When administered epidurally, morphine alone or in combination with neostigmine provided effective postoperative analgesia in most dogs after orthopedic surgery, whereas neostigmine alone did not. Findings for this study suggested a potential role for neostigmine as an adjuvant for epidural analgesia in dogs undergoing orthopedic surgeries on the pelvic limbs.

Objective: To assess the analgesic effects of 2 doses of meloxicam on the degree of postoperative orthopedic pain in pigeons., Animals: 21 domestic pigeons (Columba livia)., Procedures: In each bird, a standardized osteotomy of 1 femur was performed and the fracture was immobilized with an intramedullary pin. Birds were randomly allocated to receive saline (0.9% NaCl) solution (control) or meloxicam (0.5 mg/kg [low dose] or 2.0 mg/kg [high dose]). The first treatment was administered i.m. after surgery was completed. Subsequent treatments were administered p.o. every 12 hours for 9 days. Degree of postoperative pain was assessed for the first 4 days after surgery by use of 3 methods: an electronic perch for assessment of weight-bearing load differential of the pelvic limbs, 4 pain scales, and analysis of video-recorded partial ethograms for bird activity and posture., Results: No significant differences were observed between the control group and the low-dose meloxicam group in any tested variable. The high-dose meloxicam group had a greater degree of weight bearing on the affected limb from the second to the fourth postoperative day as well as lower pain scores for at least the first 2 postoperative days, compared with the other groups. Return to presurgical behavior was achieved faster in pigeons that received high-dose meloxicam than in the other groups. No adverse effects were observed., Conclusions and Clinical Relevance: Administration of meloxicam at 0.5 mg/kg appeared ineffective in minimizing postoperative orthopedic pain in pigeons, but the 2.0 mg/kg dose provided quantifiable analgesia that appeared safe in this species in experimental conditions.

Objective: To validate a model of postfracture pain in perching birds., Animals: 21 adult domestic pigeons (Columba livia)., Procedures: In each bird, a standardized osteotomy of 1 femur was performed and the fracture was immobilized with an intramedullary pin. Degree of postoperative pain was evaluated 6 times/d for 4 days by use of 3 methods: an electronic perch for assessment of weight-bearing load differential of the pelvic limbs, 4 numeric rating pain scales for assessment of pain (all of which involved the observer in the same room as the bird), and analysis of video-recorded (observer absent) partial ethograms for bird activity and posture. Measurements obtained were compared with data collected before the surgery to evaluate the ability of these methods to detect pain., Results: The weight-bearing load differential was a sensitive, specific, reliable, and indirect measure of fracture-associated pain in the model used. Two of 4 tested pain scales (fractured limb position and subjective evaluation of degree of pain) were sensitive and specific for detecting pain and were reliable in a research setting. Interobserver reliability of the 4 pain scales was excellent. Partial ethograms were sensitive for identifying pain-associated behavior in pigeons, particularly during the first 2 days after surgery., Conclusions and Clinical Relevance: The fracture pain model was reliable and reproducible and may be useful for experimental studies involving postsurgical pain in pigeons. Weight-bearing load differential was the most sensitive and specific means of determining degree of pain in pigeons during the first 4 days after hind limb fracture induction.

Objective: To describe the use of a novel intramedullary interlocking nail for femoral fracture repair in newborn calves and outcome associated with this treatment modality., Design: Retrospective case series., Animals: 25 calves., Procedures: Medical records from calves referred for femoral fracture repair between November 2008 and June 2009 were included. Signalment, clinical findings, and results of lameness examination and complete radiographic examination were recorded. Details of surgical technique, orthopedic fixation, associated complications, and outcome were also noted., Results: 25 Charolais calves were included in the study. All fractures were closed and located in the diaphysis; 18 extended to the distal metaphysis, 1 was located proximally, and 6 were midshaft fractures. Fractures were localized to the left femur in 17 calves and to the right femur in 8 calves. An interlocking nail was used as the sole means of internal fixation in 16 calves and was reinforced in 9 calves. Two calves were euthanatized for reasons related to the surgery, and 4 died of unrelated reasons. Long-term prognosis was considered excellent for 15 calves and fair for 4 calves. Age, body weight, overall musculoskeletal strength at initial evaluation, affected limb, configuration and location of the fracture, need for reinforcement of the repair, and quality of the reduction had no significant association with positive outcome of the surgery., Conclusions and Clinical Relevance: The novel intramedullary interlocking nail used in the present study was associated with a good prognosis for surgical repair of femoral fractures in newborn calves regardless of the location of the fracture.

Objective: To design and manufacture free-form biodegradable polycaprolactone (PCL) bone plates and to compare mechanical properties of femoral constructs with a distal physeal fracture repaired by use of 5 stabilization methods., Sample Population: 40 canine femoral replicas created by use of additive manufacturing and rapid tooling., Procedures: Surgery duration, mediolateral and craniocaudal bending stiffness, and torsional stiffness of femoral physeal fracture repair constructs made by use of 5 stabilization methods were assessed. The implants included 2 Kirschner wires inserted medially and 2 inserted laterally (4KW), a commercial stainless steel plate (CSP), a custom free-form titanium plate (CTP), thin (2-mm-thick) biodegradable PCL plates (TNP) placed medially and laterally, and thick (4-mm-thick) PCL plates (TKP) placed medially and laterally., Results: Surgical placement of 4KW was more rapid than placement of other implants The mean caudal cantilever bending stiffness of CTP and CSP constructs was greater than that for TNP TKP and 4KW constructs, and the mean caudal cantilever bending stiffness of TNP and TKP constructs was greater than that for 4KW constructs. The mean lateral cantilever bending stiffness of TKP constructs was greater than that for 4KW constructs. Differences among construct types were not significant in yield strength, ultimate strength, yield torque, and ultimate torque., Conclusions and Clinical Relevance: The mechanical properties of fracture repair constructs made from free-form PCL biodegradable plates compared favorably with those of constructs made from Kirschner wires. The impact of PCL plates on musculoskeletal soft tissues, bone healing, and bone growth should be evaluated before clinical use.

Objective: To compare an electron beam melting-processed (EBMP) low-modulus titanium alloy mesh stem with a commercial cobalt-chromium (CC) stem in a canine cadaver model., Sample Population: 9 pairs of cadaver femora., Procedures: EBMP stems of 3 sizes were placed in randomly chosen sides of femora (left or right) and CC stems in opposite sides. Stem impaction distances were recorded. Five strain gauges were attached to the femoral surface to record transverse tensile (hoop) strains in the femur during axial loading. Constructs were axially loaded 4 times to 800 N and 4 times to 1,600 N in a materials testing machine. Axial stiffness of constructs and bone surface strains were compared between EBMP and CC constructs., Results: Stems were impacted without creating femoral fissures or fractures. Stem impaction distances were larger for EBMP stems than for CC stems. Mean axial stiffness of EBMP constructs was lower than mean axial stiffness of CC constructs. Subsidence did not differ between groups. Bone strains varied among strain gauge positions and were largest at the distal aspect of the stems. At a load of 1,600 N, bones strains were higher in CC constructs than in EBMP constructs for 2 of 4 medial strain gauges., Conclusions and Clinical Relevance: EBMP stems were successfully impacted and stable and led to a focal decrease in bone strain; this may represent an acceptable option for conventional or custom joint replacement.

Case Description: An adult male American bullfrog (Rana catesbeiana) was evaluated by the North Carolina State University College of Veterinary Medicine's Turtle Rescue Team following vehicular trauma., Clinical Findings: A fracture of the left femur was suspected on examination and palpation of the hind limbs, but no other injuries or abnormalities were detected. While the bullfrog was sedated, whole-body radiographic views were obtained, which revealed a closed midshaft comminuted fracture of the left femur., Treatment and Outcome: The fracture was repaired by use of an internal fixation technique that included Kirschner wires, a positive-profile pin secured along the femur with encircling sutures, and polymethylmethacrylate molded around the entire apparatus. There were no major complications during the postoperative rehabilitation period. One year after surgery, radiography revealed complete fracture healing and the bullfrog was released back into the wild., Clinical Relevance: Presently, there are no widely accepted methods for fracture fixation in amphibians. Factors associated with their aquatic environment and lengthy fracture healing time must be addressed when planning fracture fixation strategies. In the bullfrog of this report, the applied internal fixation method provided effective long-term stabilization of the femur, allowed for normal movement, and enabled the bullfrog to be housed in an aquatic environment immediately after surgery.

Objective: To determine outcome for dogs and cats with diaphyseal fractures in which a plate-rod construct was used for fracture repair., Design: Retrospective study., Animals: 35 dogs and 12 cats., Procedures: Medical records and radiographs were reviewed to obtain information concerning signalment, fracture severity, construct design, time to radiographic union, complications, and outcome. Clients were contacted by telephone to obtain information on complications, limb usage, and overall satisfaction with the procedure., Results: 31 femoral, 9 humeral, and 7 tibial fractures were assessed. Thirteen fractures consisted of 2 fragments, 22 consisted of 3 to 5 fragments, and 12 consisted of > 5 fragments. Forty-six of 47 (98%) fractures reached union. Mean +/- SD times to radiographic union were 7.5 +/- 2.7 weeks for the dogs and 4.8 +/- 1.3 weeks for the cats. There were 4 short-term, minor complications and 15 long-term complications (2 major and 13 minor). Owners of 21 of 30 dogs (70%) and 9 of 12 cats reported that their animals had normal limb function. Twenty-six of 28 dog owners (93%) and 12 of 12 cat owners indicated that they were satisfied with results of the procedure. As surgery time increased, time to union also increased. Time to union for fractures with > 5 fragments was significantly shorter than time to union for fractures with < or = 5 fragments., Conclusions and Clinical Relevance: Results suggest that plate-rod constructs can successfully be used for repair of diaphyseal fractures of a wide range of severity in dogs and cats.

A 2-year-old sexually intact male Paint horse weighing 427 kg (940 lb) was admitted for examination and treatment of intermittent non-weight-bearing lameness of the right hind limb of 1 week's duration. Radiography revealed a displaced Salter-Harris type-III fracture of the right femoral condyle with the sagittal component of the fracture line located in the intercondylar space and the transverse component exiting on the medial aspect of the femur. The fracture was repaired with a condylar screw plate designed for repair of femoral condylar fractures in humans. The owner reported by telephone 9 months after surgery that the horse was sound. To our knowledge, use of this particular implant system for fixation of a Salter-Harris type-III fracture on the medial side of the femur in a horse has not been described. Results in this horse suggest that this implant can be successfully used for repair of femoral condylar fractures in selected adult horses.

Objective: To determine the outcome of femoral fractures repaired with 4.0- and 4.7-mm interlocking intramedullary nails in cats., Design: Retrospective study., Animals: 12 cats with diaphyseal femoral fractures., Procedure: Records of all cats in which the 4.0- and 4.7-mm interlocking nail system was used for repair of diaphyseal femoral fractures at the Animal Medical Center and Florida Veterinary Specialists between 1996 and 2000 were reviewed. Information included signalment, type of fracture, size of the implant, details of the surgery, intra- and postoperative complications, fracture healing, and clinical outcome., Results: Femoral fractures in 12 cats were repaired. Eleven of the fractures were comminuted, with 2 of these being open. Clinical outcome was excellent in 7 cats, good in 3, and fair in 1. One resulted in a nonunion. Complications included screw breakage (1 cat) and fracture distal to the nail (1). Fracture distal to the nail occurred from a second trauma., Conclusion and Clinical Relevance: Use of the interlocking nail has been limited in cats because of the small diameter of the medullary canal. Use of the 4.0-mm nail will allow for greater application of this implant in small patients. Results of this study indicate that the 4.0- and 4.7-mm interlocking nails can be used to repair simple or comminuted diaphyseal femoral fractures in cats.

Objective: To determine clinical and radiographic findings, treatment, and outcome for llamas with long-bone fractures., Design: Retrospective study., Animals: 6 llamas., Procedure: Medical records of llamas admitted between 1993 and 1998 because of long-bone fractures were reviewed. Data collected included age, sex, type of fracture, method of fracture repair, and postoperative complications. The Fisher exact test was used to compare age and sex of the llamas with long-bone fractures with those of the hospital population of llamas. All owners were contacted by telephone to determine perceived postoperative problems and whether the llamas were able to perform as expected., Results: Mean age was 160.8 days (range, 23 to 365 days). There was 1 male and 5 females. Fractures were more likely to occur in young llamas (< or = 1 year old) than in adults. Five of the fractures were attributed to traumatic episodes. Long bones affected included the tibia (n = 2), radius (2), femur (1), and humerus (1). Internal fixation with lag screws, plating, or both was performed on fractures of all llamas except 1; that llama was treated by use of confinement to a stall. None of the llamas had intraoperative complications, but postoperative complications were reported in 2 llamas. All fractures healed eventually, and clients were pleased with outcomes., Conclusions and Clinical Relevance: Long-bone fractures in llamas are uncommon. Several types of long bone fractures can be successfully repaired by use of internal fixation, resulting in few complications and minimal convalescent time.

Objective: To determine results of using interlocking nails (IN) for fixation of diaphyseal long bone fractures in dogs., Design: Multi-center prospective clinical trial., Animals: 134 dogs with diaphyseal fractures of the femur (n = 92), tibia (23), or humerus (19); 11 had previous unsuccessful treatments, and 103 had comminuted fractures of which 70 were classified as unstable., Procedure: All fractures were stabilized with 6- or 8-mm-diameter IN with 3.5- or 4.5-mm screws, respectively. Cerclage wires and an autogenous bone graft were used at the surgeon's discretion. Participating surgeons provided information on age, sex, weight, and breed of the dog, details of the surgery, details of any intra- or postoperative complications, fracture healing time, and limb function., Results: Eight dogs were lost to follow-up evaluation. In 105 of the remaining 126 dogs (83%), fractures healed without complications. For these 105 dogs, limb function was excellent (n = 90), good (12), fair (2), and poor (1). Complications developed for 21 dogs (17%); limb function after additional treatment was excellent (n = 10), good (2), fair (5), poor (1), or unreported (3). Interlocking nails broke in 9 dogs; breakage was attributed to fatigue failure because of use of too small an IN or because of insertion of the IN so that a screw hole was positioned at the fracture site., Clinical Implications: The high success rate and low complication rate suggest that IN can be used to stabilize diaphyseal fractures in dogs. Good technique is necessary for optimal results.

Objective: To compare fragment reconstruction and bone plate fixation versus bridging plate fixation for treating highly comminuted (> 4 fragments) femoral fractures in dogs., Design: Retrospective study., Animals: 35 dogs with highly comminuted fractures of the femur., Procedure: Medical records of all dogs included in this study were reviewed. Dogs had been treated with fragment reconstruction and bone plate application (n = 20) or major fragment alignment and bridging plate fixation (15). Postoperative and follow-up radiographs were evaluated. Operating and hospitalization times, bone alignment, bone healing, and complications were considered., Results: There were no differences in hospitalization times, limb alignment, and complications between dogs with fractures treated with fragment reconstruction and dogs with fractures treated with bridging plate fixation. Dogs with fractures treated with bridging plate fixation had shorter operative times and faster times to radiographic evidence of bone healing., Clinical Implications: Bridging plate fixation is quicker to perform and results in faster healing than fragment reconstruction and bone plate fixation when used to treat comminuted femoral fractures.

Aseptic loosening of the femoral implant (ALFI) was diagnosed in 10 dogs that had undergone cemented total hip arthroplasty (THA). One dog had bilateral ALFI. Loosening developed at the stem-cement interface a mean of 30 months after THA. The most common clinical sign was intermittent subtle or non-weight-bearing lameness. On radiographs obtained after THA, the distal stem tip was in contact with the cortical endosteum in all dogs. Radiographic changes at the time of diagnosis of ALFI included asymmetric periosteal reaction along the femoral diaphysis (n = 11), radiolucent zone at the stem-cement interface (6), altered implant position (4), and femur fracture (1). Surgical revision resulted in a good or excellent outcome in 9 dogs. In 1 dog, the implant became infected. In another, aseptic loosening recurred. Aseptic loosening of the femoral implant was significantly more common when initial positioning of the implant resulted in contact between the distal tip of the implant and cortical endosteum than when there was no contact.

A 3.3-year-old 125-kg castrated male llama was evaluated because of acute non-weight-bearing lameness on the left hind limb. Physical examination revealed crepitus in the midportion of the femur. On radiographs, a comminuted middiaphyseal fracture was seen. There was also a region of bone lysis with cortical thinning and expansion in the distal metaphysis and epiphysis of the left femur. Multiple small circular lesions were observed in the proximal metaphysis of the left femur, and the proximal portion of the left tibia appeared irregular. The owner elected to pursue treatment, and the fracture was repaired with 2 compression plates. Multiple bone biopsy specimens were obtained and submitted for bacterial culture and histologic examination. Cultures yielded neither bacteria nor fungi. Histologic examination revealed fibrous connective tissue, normal appearing cortical bone, and an absence of medullary structures. The llama was maintained in a hind-limb sling for 14 days after surgery, at which time follow-up radiography revealed a comminuted fracture of the proximal portion of the femur. The llama was euthanatized, and multifocal polyostotic aneurysmal bone cysts were found in the proximal and distal metaphyses of the left femur and tibia. Cysts were lined by fibroblasts or endothelial-like cells.

A simple, oblique fracture of the middle portion of the diaphysis of the right femur was successfully repaired in a 10-month-old 150-kg Berkshire boar, using a 4.5-mm 9-hole broad dynamic compression plate applied to the lateral surface of the bone. A lateral surgical approach provided excellent access to the fragment ends. Intravenous administration of atracurium besylate facilitated traction along the long axis of the bone and fracture reduction. The plate was luted with 5% gentamicin sulfate-impregnated polymethyl methacrylate. Lack of a third trochanter in the porcine species facilitated retraction of the superficial gluteal muscle and provided a smooth plating surface. Full breeding activity by the boar resumed 190 days after surgery without complications. Massive soft tissue in the area over the femur, extensive production of callus, and cautious behavior by the boar contributed to successful fracture repair, indicating that domestic swine may be good surgical candidates for femoral fracture repair.

Complications developed in a dog that underwent intramedullary pin and cerclage wire fixation of a comminuted femoral fracture. The fracture was unstable, the intramedullary pin protruded through the skin over the hip, and Staphylococcus sp was isolated from the fracture site. The loose pin was removed, and the fracture was restabilized with a 6.0-mm interlocking intramedullary nail and 3 interlocking screws. Cephalexin was given orally for 6 weeks. Eight weeks after the second surgery, the fracture was healed radiographically. Seventeen months later, the dog had a persistent mild lameness that was associated with low-grade osteomyelitis. The lameness resolved after the implants were removed, and antibiotics were administered. In human beings, interlocking intramedullary nail stabilization is an accepted treatment for open and contaminated fractures. Chronic infection of bone may be attributable to bacteria in biofilm surrounding implants, necessitating implant removal for resolution.

Open reduction and internal fixation was attempted in a 16-month-old cow with a fracture of the femur and a 10-month-old heifer with a fracture of the humerus. In both animals, manual reduction of the fracture was unsuccessful, but following application of a fracture distractor, reduction was easily accomplished.

Results of total hip arthroplasty in 84 dogs (96 hips) were evaluated. Eight (9.5%) of the 84 dogs developed 1 or more complications after total hip arthroplasty. Complications resolved or were corrected in 4 of the dogs; all 4 ultimately achieved good or excellent hip function. Complications necessitated removal of the prosthesis in the other 4 dogs; 3 ultimately achieved fair hip function and 1 had only poor hip function. Therefore, after resolution of complications, 96% of the hips had good or excellent function. Force plate analysis was performed on 6 dogs with excellent hip function; peak vertical force for the limb that had been operated on was greater than or equal to peak vertical force for the contralateral limb. Radiographically, a radiolucent zone was visible around the acetabular component in 89% of the hips and around the femoral component in 26%. The radiolucent zone around the acetabular and femoral components widened in 14% (6 of 43) and 27% (3 of 11), respectively, of the hips with adequate radiographic follow-up. Aseptic loosening of the acetabular component developed in 3 (3%) of 96 hips; one was successfully revised. Aseptic loosening of the femoral component was not apparent in any of the dogs in this study. Other complications included femoral fracture (n = 3), neurapraxia (3), luxation (1), and unexplained lameness that required implant removal (1). None of the dogs had evidence of wound infection.

The effect of 5 fracture fixation methods on bone mineral density (BMD) measurement of femurs, using dual-energy X-ray absorptiometry (DXA) was determined in a canine model. Six regions of interest were measured, including the entire femur, the diaphysis of the femur, and small regions centered over the middiaphysis of the bone (lateral middiaphyseal cortex, medial middiaphyseal cortex, middiaphyseal medullary canal, and total middiaphysis). Eight unpaired femurs were collected and scanned by use of DXA before (5 separate scans/femur) and after (5 separate scans/femur) fixation by use of 1 of 5 fixation methods. These fixation methods included: intramedullary (IM) nail; IM nail and cerclage wires; IM nail and external skeletal fixation; locked IM nail; and a dynamic compression plate (DCP). All implants were made of stainless steel. The IM nail fixation devices caused significant decreases in the DXA measurement of BMD in the small regions of interest, compared with femurs without fixation devices (mean decrease, 37.3%; P < 0.05). The locked nail caused similar, but larger, decreases in the DXA measurement of BMD, compared with the IM nail fixation methods (P < 0.05). Plate fixation caused a small, but significant (P < 0.05), decrease (2.8%) in the DXA measurement of BMD in the large regions of interest, but when all regions were averaged, it did not cause significant change in this measurement, compared with femurs without fixation devices.(ABSTRACT TRUNCATED AT 250 WORDS)

A 9-week-old Thoroughbred x Holsteiner colt was referred for evaluation and treatment of lameness of the right hind limb. Radiography of the stifle revealed multiple bony fragments within the lateral portion of the femorotibial joint and a radiolucency of the distolateral portion of the femur in the area of the extensor fossa, which were consistent with avulsion of the origin of the extensor digitorum longus muscle. Arthroscopy of the lateral portion of the femorotibial joint revealed exposed subchondral bone in the area of the extensor fossa, and the origin of the extensor digitorum longus muscle was determined to be avulsed. The joint was lavaged, and fibrin and fragments of cartilage and bone were removed from the joint. Six months after surgery, the horse appeared normal during trotting and cantering.

A 3-month-old foal was examined because of lameness and fracture of the left lateral trochlear ridge of the femur. Arthroscopy of the left femoropatellar joint was elected. After induction of general anesthesia and placement of the foal in dorsal recumbency, it was noticed that the left hind limb was extended at the tibiotarsal joint and flexed at the femorotibial joint. Avulsion fracture at the origin of the peroneus tertius tendon was diagnosed. Fracture fragments were excised. The horse had mild left hind limb lameness at the time of follow-up evaluation 1 year after discharge.

Modular, porous-coated, titanium segmental endoprostheses were implanted bilaterally in the femoral diaphysis of 7 adult mixed-breed dogs. Autogenous bone graft in particle form was placed around the implant and bone. In 1 limb, homologous fibrin adhesive was mixed with the graft in situ before soft tissue closure. The contralateral limb was grafted in identical manner, but without fibrin adhesive, and served as a control. Radiography was performed immediately after surgery and 1, 2, 3, 4, 6, 8, 10, and 12 weeks later to assess callus area and bone remodeling. At 12 weeks, dogs were euthanatized and bone/implant fixation strength was tested under torsion and compared with values for 6 in vitro controls. Histomorphometric and microradiographic analyses of transverse sections of the distal portion of the implanted femurs were performed. Radiographic callus area was significantly (P < 0.05) smaller in the femurs grafted with fibrin adhesive, compared with the contralateral control. New bone formation (21.4 +/- 1.8% vs 19.2 +/- 2.4%), unlabeled bone (64.8 +/- 3.0% vs 67.9 +/- 4.2%), porosity (13.9 +/- 0.7% vs 12.9 +/- 0.8%), and bone ingrowth into the porous coating (10.3 +/- 0.9% vs 10.0 +/- 1.2%) were not significantly different between fibrin- and nonfibrin-grafted implants, respectively. There were no significant differences in torsional strength of implant fixation between the fibrin- and nonfibrin-grafted femurs or between the in vivo implanted femurs and the in vitro controls.(ABSTRACT TRUNCATED AT 250 WORDS)

A Salter-Harris type-II fracture of the proximal portion of the right femur in a 2-month-old filly was reduced and stabilized with three 6.5-mm-diameter, 100-mm-long cancellous bone screws through a dorsal approach to the right coxofemoral joint. The screws were removed after 11 months because the filly became lame in the affected limb. The surgical wounds dehisced despite preventive measures, most likely because of tightness of skin in the coxal region. Seven years after the original injury, the horse could perform vigorous paddock exercise without any disability. Early internal fixation of proximal femoral physeal fractures in foals can provide a good long-term prognosis.

Repair of a comminuted, spiral oblique, proximal diaphyseal femoral fracture in a 7-day-old calf was achieved by use of an intramedullary pin, cerclage wires, and external fixator. Six stainless steel wires were used for full cerclage to secure a long butterfly fragment and multiple incomplete and complete nondisplaced fragments to the femur in order to create 2 principal fragments. Axial alignment and resistance to bending was provided by a round, double-pointed, end-threaded intramedullary pin (6.35 mm in diameter), which was inserted in a retrograde fashion. A type-1, double-connecting-bar external fixator, using 4 round pins (4.8 mm in diameter), was used to provide supplemental stabilization against shear and torsional forces. At 45 days after surgery, healing at the fracture site was seen on radiography of the limb, and the external fixator was removed. Eight months after surgery, the calf had a normal gait.

Medical records of 12 calves less than or equal to 1 month old, with fracture of the femoral diaphysis, were reviewed. Ten calves were within 1 week of birth at the time of diagnosis. Open reduction was accomplished by use of a lateral approach. Retrograde intramedullary pinning was accomplished in all calves, using 2 (n = 4 calves) or 3 (n = 8 calves) pins. Cerclage wire was used to supplement fixation in 7 calves. A closed continuous suction drain was placed along the lateral aspect of the femur in every calf. Postsurgical complications included seroma formation over the middle gluteal musculature (n = 5 calves), pin migration (n = 6 calves), and osteomyelitis (n = 1 calf). Pin migration was observed in 4 calves that had been treated with nonthreaded trochar point pins. Fractures in 10 of 12 calves (83%) were considered to have healed satisfactorily. One calf was euthanatized because of septic osteomyelitis of the femur. One calf was euthanatized because of persistent lameness and pin migration. Pins were removed in 8 of 12 calves (67%) between the 13th and 90th postoperative days. Results of this study indicate that application of intramedullary pins may be a useful solution for management of femoral diaphyseal fracture in young calves.

A new radiographic projection of the femur was evaluated for use in the assessment of fracture or osteotomy repair in small animals. The view is obtained by directing the x-ray beam horizontally through the hind limb, from caudad to craniad, with the animal positioned in lateral recumbency, the hip flexed, and the stifle extended. Views obtained, using the new projection, were compared with the standard ventrodorsal views of the pelvis, with hind limbs extended. Osteotomy lines in the femoral shaft were significantly (P less than 0.01) more visible on the horizontal beam view. Significant difference was not evident in visibility of fracture lines between the 2 radiographic projections. The horizontal beam view was easily obtained, and equivalent to the standard ventrodorsal view for radiographic evaluation of femoral fracture and osteotomy repair.

An immature jaguar was surgically treated for severe constipation caused by a narrow pelvic canal. This narrowing was attributed to nutritional secondary hyperparathyroidism. The ventral floor of the pelvis was widened by placing a piece of high density polyethylene between the 2 sides of the pubis after symphysiotomy and stabilizing the implant with orthopedic wires. This procedure provided stable fixation and permanent enlargement of the pelvic canal. The technique was easy to perform and could be used to treat pelvic collapse in other species.

A Salter-Harris type-II fracture of the distal portion of the femur in a 1-year-old Pony of America was repaired by use of lateral plating combined with interfragmentary compression. The configuration of the fracture and the method of internal fixation with a condylar buttress plate were unique and resulted in primary bone healing, seen at the 5-month follow-up examination.

High-density, polysulfone rods were used to repair 4 comminuted and 4 short-oblique, mid-diaphyseal femoral fractures in 8 dogs. Bony union was achieved in 2 dogs at 10 and 12 weeks after surgery. In one dog, the femoral fracture was healing when amputation of the limb became necessary because of sciatic nerve damage secondary to an ipsilateral pelvic fracture. In a fourth dog, fracture repair resulted in nonunion, despite normal clinical function at 18 months after surgery. In the remaining 4 dogs (50%), the rods failed at 3.5, 4, 6, and 22 weeks after surgery. These fractures were then stabilized by use of other methods. Although several factors may have contributed to failure of the rods, multiple autoclaving of the thermoplastic implants may have caused embrittlement and subsequent breakage.

Quadriceps contracture associated with a healed malunion fracture of the left femur was diagnosed in a 1-year-old cat. The proximal portion of the distal fracture piece protruded through the skin of the thigh. The protruding bone was removed surgically and the area of ulcerated skin was debrided. Because the fracture was stable and the cat was able to bear weight on the affected limb, surgical correction of the malunion was not performed. Quadriceps contracture is uncommon in the cat.

The transfusion of only 4 ml of group A blood resulted in sudden death of a cat that was recovering from surgery. The clinical signs were similar in many respects to those exhibited by tranquilized group B cats when challenge exposed for the 1st time with incompatible A cells. The distribution of the A and B blood group antigens and the occurrence of naturally occurring isoantibodies in the cat were considered in relation to the probability of producing transfusion reactions. The results obtained with tranquilized and anesthetized cats demonstrated that immediate reactions can occur following the 1st transfusion of incompatible red blood cells. Cross matching with respect to the AB system is recommended before giving blood transfusions to cats.

A comminuted, mid-diaphyseal femoral fracture was diagnosed radiographically in a 4-month-old Quarter Horse colt. Disruption of the distal blood supply was suspected, as evidenced by coolness and diminished pulses of the distal portion of the limb. The fracture was repaired by compression plating but the foal's condition continued to deteriorate. A femoral arteriogram of the affected limb was obtained. Positive contrast agent was visible only as far as the mid-shaft of the femur. The foal was euthanatized and the postmortem examination revealed a transected popliteal artery accounting for ischemic necrosis of the distal limb.