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Femoral fractures are often considered lethal for adult horses because femur osteosynthesis is still a surgical challenge. For equine femur osteosynthesis, primary stability is essential, but the detailed physiological forces occurring in the hindlimb are largely unknown. The objective of this study was to create a numerical testing environment to evaluate equine femur osteosynthesis based on physiological conditions. The study was designed as a finite element analysis (FEA) of the femur using a musculoskeletal model of the loading situation in stance. Relevant forces were determined in the musculoskeletal model via optimization. The treatment of four different fracture types with an intramedullary nail was investigated in FEA with loading conditions derived from the model. The analyzed diaphyseal fracture types were a transverse (TR) fracture, two oblique fractures in different orientations (OB-ML: medial-lateral and OB-AP: anterior-posterior) and a "gap" fracture (GAP) without contact between the fragments. For the native femur, the most relevant areas of increased stress were located distally to the femoral head and proximally to the caudal side of the condyles. For all fracture types, the highest stresses in the implant material were present in the fracture-adjacent screws. Maximum compressive (-348 MPa) and tensile stress (197 MPa) were found for the GAP fracture, but material strength was not exceeded. The mathematical model was able to predict a load distribution in the femur of the standing horse and was used to assess the performance of internal fixation devices via FEA. The analyzed intramedullary nail and screws showed sufficient stability for all fracture types., (© 2024. The Author(s).)

Background: The bone regeneration potential of erythropoietin (EPO) is not yet fully investigated, but some previous experimental studies demonstrated that its application activated the differentiation of osteoblasts and promoted bone formation., Aim: The aim of the present study was to evaluate the effects of recombinant human erythropoietin (rhEpo) on bone healing in cats with fragmented long bone fractures., Methods: Twelve cats were divided into two groups-control ( n = 6) in which physiological saline was applied at the fracture gap site and EPO ( n = 6) with the application of 1,000 IU rhEpo. The effects of EPO on blood erythrocyte counts, hemoglobin content, and hematocrit were monitored by serial complete blood cell tests, whereas bone formation was evaluated by clinical and radiographic examinations on post-operative weeks 1, 2, 3, 4, 6, and 8., Results: All tested blood parameters were within the reference range. A faster fracture healing and full limb weight-bearing were observed in the EPO group, with statistically significant differences with respect to the control group., Conclusion: The obtained results confirmed that the local application of rhEpo promoted bone healing in cats with fragmented femoral fractures and increased bone callus strength without having significant systemic effects., Competing Interests: The authors declare no conflict of interest.

Objectives: To report the short-term clinical and radiographic outcomes in cats with femoral capital physeal fractures stabilised with transcervical pinning., Materials and Methods: Medical records of cats diagnosed with femoral capital physeal fractures and treated with transcervical pinning were reviewed. The collected data included signalment, weight, time from lameness to surgery, reported trauma, affected side, concomitant orthopaedic injuries, radiographs, osteoarthritis, femoral neck osteolysis, proximal femoral epiphysis to femoral neck ratio, fracture reduction, implants, complications and clinical evaluation results. An owner questionnaire was used for long-term follow-up., Results: Nineteen cats with a total of 21 fractures met the inclusion criteria. Fifteen of the 19 cats showed no signs of lameness at the 1-month follow-up. Major and catastrophic complications occurred in 9.5% and 23.8% of the fractures, respectively. All catastrophic complications occurred in fractures with a high preoperative osteolysis grade (2 or 3)., Clinical Significance: In our study, transcervical pinning was found to be a reliable fixation method for the treatment of femoral capital physeal fractures in cats with minimal preoperative femoral neck osteolysis. High rates of implant failure with loss of fracture reduction were observed in cats with high-grade preoperative osteolysis., (© 2023 British Small Animal Veterinary Association.)

Objective: To describe the success rate and associated complications of external skeletal fixator/intramedullary pin tie-in for calf femoral fracture fixation., Study Design: Clinical retrospective., Animals: Ten calves, less than 30 days old, with diaphyseal/metaphyseal femoral fractures., Methods: Medical records were reviewed from the University of Wisconsin from 2000 to 2020. Fractures were repaired using open reduction and fixation. An intramedullary Steinman pin was placed, exiting near the greater trochanter, and utilized for fracture reduction. Bicortical transfixation pins were placed distal and proximal to the fracture site. Poly(methyl methacrylate) (PMMA)-filled tubing connected the transfixation pins and proximal intramedullary pin, creating a Type 1a external skeletal fixator (ESF) tie-in. Follow up was obtained via medical records and phone interviews., Results: Short-term survival rate was 7/10 (70%). Postanesthetic death occurred once. Postoperative complications occurred in all remaining cases. The most common findings were transfixation pin tract lucency and lameness (6/9 cases), implant dysfunction (5/9 cases), and infection (4/9 cases). Three of five cases with long-term follow up survived; all went on to productive careers., Conclusion: Although patients were prone to postoperative complications, short-term survival was comparable to previous reports., Clinical Significance: The external skeletal fixator/intramedullary (ESF/IM) pin tie-in is less expensive and offers comparable success rates to other methods, providing a lower cost option for calf femoral fracture repair., (© 2023 The American College of Veterinary Surgeons.)

Objective: Assess the accuracy and efficiency of reduction provided by application of plates precontoured to 3-dimensional (3D)-printed femoral bone models using a custom fracture reduction system (FRS) or intramedullary pin (IMP) to facilitate femoral minimally invasive plate osteosynthesis (MIPO) in dogs., Study Design: Experimental cadaveric study., Sample Population: Seven dog cadavers., Methods: Virtual 3D femoral models were created using computed tomographic images. Simulated, virtual mid-diaphyseal femoral fractures were created and reduced. Reduced femoral models were 3D-printed and a plate was contoured. Custom drill guides for plate screw placement were designed and 3D-printed for the FRS. Mid-diaphyseal simulated comminuted fractures were created in cadavers, and fractures were aligned using FRS or IMP and stabilized with the precontoured plates. Number of fluoroscopic images acquired per procedure and surgical duration were recorded. Computed tomographic scans were repeated to assess femoral length and alignment., Results: Compared to the preoperative virtual plan, median change in femoral length and frontal, sagittal, and axial alignment was less than 3 mm, 2°, 3°, and 3° postoperatively, respectively, in both reduction groups. There was no difference in length or alignment between reduction groups (P > .05). During FRS, fewer fluoroscopic images were taken (P = .001), however, surgical duration was longer than IMP procedures (P = .011)., Conclusion: Femoral alignment was accurate when using plates precontoured to 3D printed models, regardless of reduction method., Clinical Significance: Accurate plate contouring using anatomically accurate models may improve fracture reduction accuracy during MIPO applications. Custom surgical guides may reduce fluoroscopy use associated with MIPO., (© 2022 American College of Veterinary Surgeons.)

Objectives: To report the short-term clinical outcome and complications in dogs that underwent surgical repair of femoral capital physeal or neck fractures via fluoroscopic-guided percutaneous pinning (FGPP)., Study Design: Retrospective case series., Animals: Client owned dogs (n = 11) with femoral capital physeal or neck fractures (n = 13)., Methods: Records (July 2018-July 2021) of dogs that underwent surgery for femoral capital physeal or neck fracture repair with FGPP from two hospitals were reviewed. Data collected included signalment, age, weight, preoperative lameness severity, fracture factors (etiology, Salter-Harris classification, time from injury to surgery, radiographic displacement), surgical factors (surgery time, number/size of implants, reduction quality) and outcome (follow-up examination findings, radiographic findings, complications)., Results: Most fractures (11/13) occurred secondary to trauma. The median time from injury to surgery was 5.5 days. There was mild radiographic displacement preoperatively in 10/13 fractures. Satisfactory fracture healing and limb function was achieved in 10/13 femurs. Complications occurred in 5/11 cases and included intra-articular implants, implant failure/nonunion, implant migration (2), and malunion. Of these five complications, two resolved with implant removal, and a salvage procedure was recommended in the remaining cases. Of the three cases requiring salvage procedures, two originally presented with radiographic evidence of fracture chronicity., Conclusions: FGPP can be used to successfully treat femoral head and neck fractures with appropriate case selection and precise surgical technique., (© 2022 American College of Veterinary Surgeons.)

Objective:  Our objectives were to report complications associated with stabilization of long-bone fractures in cats using a 3.5-mm titanium interlocking nail and to examine the influences of signalment, fracture type and fixation evaluations on the occurrence of complications., Study Design:  Retrospective clinical study., Material and Methods:  Medical and radiographic records of cats with long-bone fractures treated with an interlocking nail were reviewed. Data included age, sex, weight, cause of the fracture, fractured bone(s) and fracture type. Complications were classified as minor and major complications. Fisher's exact tests and logistic regression analysis were used to test whether certain variables of signalment and interlocking nail configuration had an effect on the occurrence of complications., Results:  Sixty-seven fractures of 67 cats were examined in this study. Forty-eight femora, sixteen tibiae and three humeri were included. Complications occurred in 11/67 fractures. Major complications occurred in 8/67 fractures and included screw breakage ( n  = 3), nail breakage ( n  = 2), nail bending ( n  = 1), screw loosening ( n  = 1), non-union (n = 1). Statistical analysis showed a significant difference between fracture types and the occurrence of major complications ( p  = 0.02)., Conclusion:  In conclusion, use of this commercially available standard 3.5-mm titanium interlocking nail for stabilization of comminuted and oblique humeral, femoral and tibial fractures in cats is feasible., Competing Interests: None declared., (Thieme. All rights reserved.)

Objective: To evaluate the clinical outcomes of total hip replacements (THR) utilizing a BFX lateral bolt stem in dogs with coxofemoral joint disease., Study Design: Retrospective study., Sample Population: A total of 149 dogs representing 195 THR., Methods: Consecutive THRs utilizing a BFX lateral bolt stem were studied. Preoperative, immediate postoperative, 1-, 2-, 3-, 4-, and 12-month postoperative radiographs were performed. All major and minor complications, revisions, outcomes, subsidence, canal flare index (CFI) were recorded., Results: An intraoperative complication rate of 11.8% was observed. The postoperative complication rate was 13.6%, with 9.2% major and 4.4% minor complications. Complications included: postoperative femur fractures (3.6%), coxofemoral luxation (3.6%), stem failure (0.5%), septic loosening (0.5%), aseptic loosening (0.5%), and acetabular fracture (0.5%). Three dogs underwent prophylactic plating after subjective assessment of cortical thickness. Five of 195 (2.6%) cases underwent explant of their prostheses (median = 3 months). Mean stem subsidence at 1 month postoperatively was 1.22 ± 0.16 mm. An increased CFI was associated with postoperative femur fractures (p < .05). A total of 190 of 195 (97.4%) cases returned to normal function in the long-term follow-up period., Conclusion: Use of the BFX lateral bolt stem resulted in minimal postoperative subsidence, a low femoral stem complication rate, and a high rate of achieving normal limb function., Clinical Significance: The BFX lateral bolt stem should be considered in canine THR as the femoral failure rate is low and the long-term success rate is high., (© 2022 American College of Veterinary Surgeons.)

Objective:  The aim of this study was to report the short-term clinical and radiographic outcome for the treatment of femoral capital physeal fractures with cortical positional screws in cats., Study Design:  Medical records and radiographs of cats with femoral capital physeal fractures stabilized with cortical positional screws were retrospectively reviewed. Signalment, bodyweight, femoral head affected, fracture classification, fracture reduction, implants, concurrent orthopaedic injuries, osteoarthritis, femoral neck osteolysis, complications and 6-week follow-up clinical results were recorded. A short- to long-term follow-up was performed by telephone questionnaire with the owners., Results:  Forty-six fractures in 39 cats met the inclusion criteria. In 45/46 fractures, radiographic signs of bone healing were present and 35/39 cats were assessed as walking normally by a veterinarian at 6-week follow-up. There was a significant increase in radiographic signs of osteoarthritis ( p =0.037) and femoral neck osteolysis ( p =0.001) on 6-week follow-up radiographs. Pre- and postoperative osteoarthritis and femoral neck osteolysis were not associated with clinical outcome. The mean follow-up period for the telephone questionnaire was 48 months (range, 5-147 months). Seven out of 25 owners reported a gait abnormality in the short- to long-term., Conclusion:  Femoral capital physeal fractures in cats can be treated successfully with the use of cortical positional screws. This technique may be considered as an alternative to other primary fixation techniques and salvage procedures for the treatment of femoral capital physeal injuries in cats. This technique seemed successful in cats with a low-grade preoperative femoral neck osteolysis., Competing Interests: None declared., (Thieme. All rights reserved.)

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.

Animal posture, limb gait, and body weight-bearing in dogs can be evaluated by limb gait score. In this study, nine adult male dogs of local breed were used to induce a complete transverse femoral mid-shaft fracture fixed internally by intramedullary pining under general anesthesia with the aseptic technique and followed for 60 days postoperative. The data were analyzed, including five degrees that indicate the correlation among animals' posture, limbs, and body weight tolerance per day. The results demonstrated that in grade 5, the animals completely hold the affected limb during standing position 1 st -3 rd day postoperative. From the 4 th -10 th day postoperative, in grade 4, the animals supported the body weight on the affected limb in the standing position and hold it during waking. In grade 3, from 11 th -21 th day postoperative, the operated animals supported body weight on the affected limb in slow waking and hold it in speed waking and running. From the 22 nd -28 th day postoperative, in grade 2, the animals used the limb in speed walking, from the 29 th -35 th day postoperative. In grade1, the animals could use the limb in running from the 36 th -2 nd day postoperative. In grade 0, the animals used the limb normally in walking, running, and jumping until the end of experimental periods (60 th day postoperative). The results indicated that limb gait scores in dogs can be used for the evaluation of the relationships among animals' posture, limb gait, and body-weight bearing per day during bone regeneration processing of femur fracture fixed by intramedullary pining.

Practical Relevance: The femur is the most commonly fractured bone in cats. Femoral fractures usually result from high-velocity trauma such as a road traffic accident or fall from a height and, as such, are associated with a wide variety of concurrent injuries. The initial focus of treatment should always be on assessment and stabilisation of the major body systems. Once any concurrent injuries have been addressed, all femoral fractures need surgical stabilisation, with the notable exception of greenstick fractures in very young cats, which can heal with cage rest alone. A number of different surgical options are available depending on the fracture type, location, equipment, surgeon experience and owner finances., Clinical Challenges: Femoral fractures can vary hugely in complexity and the small size of feline bones can limit the choice of implants. Furthermore, cats can present unique challenges in the postoperative period due to their active nature and the limited means to control their exercise level., Audience: This review is aimed at general and feline-specific practitioners who have some experience of feline orthopaedics, as well as those simply wishing to expand their knowledge., Aims: The aim of this review is to help clinicians assess, plan and manage feline femoral fractures. It provides an overview of diagnostic imaging and a discussion of a range of suitable surgical options, including the principles of different types of fixation. It also highlights cat-specific issues, approaches and implants pertinent to the management of these cases., Evidence Base: A number of original articles and textbook chapters covering many aspects of femoral fractures in cats and dogs have been published. Where possible, this review draws on information from key feline research and, where necessary, extrapolates from relevant canine literature. The authors also offer practical guidance based on their own clinical experience.

Objective: To report outcomes of cementless collared stem total hip replacement (THR) with proximal femoral periprosthetic cerclage application in dogs., Study Design: Retrospective case series., Animals: Client-owned dogs (n = 150) with THR (n = 184)., Methods: Serial postoperative radiographs and medical records of dogs that underwent consecutive index cementless THR, with a single full cerclage wire placed distal to the femoral neck osteotomy line and proximal to the lesser trochanter, were reviewed for intraoperative and postoperative complications., Results: No proximal femoral fractures occurred. No complications associated with the use of the cerclage wire were encountered. A fissure (n = 1) or fractures (n = 2) occurred near the tip of the femoral stem in three cases postoperatively. All three cases required plate and screw fixation. All dogs returned to subjectively normal function at home and all owners were satisfied with the outcome., Conclusion: A single full cerclage wire may minimize the risk of a proximal femur fracture following cementless collared stem total hip replacement in dogs. No complications were encountered with the cerclage wire., Clinical Significance: Application of a cerclage wire is a simple and economically feasible procedure that requires minimal additional instrumentation, takes little time, and may decrease the risk of proximal femur fractures after cementless press-fit THR., (© 2021 American College of Veterinary Surgeons.)

The cross-pin technique for the treatment of distal femoral physis fractures (specifically, Salter-Harris Type I fractures) was investigated using femurs collected from beagle cadavers. The pin was inserted from the medial surface of the femur at an inclination of approximately 30 to 45° relative to the long axis of the femur in the anteroposterior direction; the pin exit was set proximal to the origin of the long digital extensor tendon. Digital and radiographic images of the femur in the anteroposterior and lateral directions were obtained. In both types of images, the insertion angle of the pin relative to the long axis was measured. Results suggest that when inserting a pin proximal to the fracture line, the ideal position can be achieved by inclining the pin approximately 20° cranially relative to the long axis of the lateral direction of the femur, in addition to the previously described criteria., (Copyright and/or publishing rights held by the Canadian Veterinary Medical Association.)

The use of lag screws to treat femoral condyle fractures is common, and their placement in surgery is technically demanding. Intra-articular screw impingement is a serious complication that may occur during surgical treatment of femoral condyle fractures. Here, we describe the case of a 3-year-old 40-kg dog which experienced recurrent lameness 6 mo after successful surgical treatment of a comminuted medial femoral condyle fracture due to an intra-articular non-loosening screw causing joint impingement. Removal of the conflicting screw was performed arthroscopically, based on its ability to offer minimally invasive access to the stifle joint. Six months after removal of the screw, the dog had full recovery without limitations to range of motion or stifle pain. To our knowledge, this is the first report on the use of arthroscopy to remove an intra-articular screw causing joint impingement after distal femoral fracture repair in a dog., (Copyright and/or publishing rights held by the Canadian Veterinary Medical Association.)

Objective: To review the outcome of dogs that underwent Zürich cementless total hip arthroplasty (Z-THA) for the repair of acute and chronic capital physeal fractures (CPF) and document the CPF-related hip remodeling., Study Design: Retrospective study., Sample Population: Fifty-three Z-THA in 53 dogs., Methods: Medical records of dogs (2006-2019) that underwent Z-THA for CPF management were reviewed. Dogs were divided into two groups on the basis of the days elapsed between CPF diagnosis and Z-THA, acute (≤30 days) and chronic (>30 days). Hip remodeling variables were determined from preoperative radiographs or intraoperatively. Descriptive statistics were performed, and the complication rates, outcome, and coxofemoral remodeling were recorded. Comparisons of remodeling variables and rates between groups were performed by using Fisher's exact test., Results: In total, 23 of 53 (43.4%) cases were acute, and 30 of 53 (56.6%) cases were chronic. There was no difference in the femoral remodeling rates between the acute and chronic groups (P = .184), whereas acetabular remodeling was more prevalent in the chronic group (P < .001). Intraoperative complications occurred in four of 53 (7.5% [1/23 acute, 3/30 chronic]) cases, and postoperative complications occurred in six of 53 (11.3% [2/23 acute, 4/30 chronic]) cases. Good clinical outcomes were achieved in 51 of 53 (96.2% [21 acute, 30 chronic]) cases., Conclusion: Complication rates of Z-THA for CPF repair were similar to the complication rates reported for Z-THA of dysplastic hips. Hip remodeling was common regardless of CPF chronicity., Clinical Significance: Zürich cementless total hip arthroplasty is viable for surgical management of CPF. There is a high likelihood that hip remodeling will be encountered, even in fractures treated within 30 days of presenting for hind limb lameness., (© 2021 American College of Veterinary Surgeons.)

A retrospective study was performed to describe patient and fracture characteristics, treatments, complications, and outcomes associated with femoral fractures in free-ranging birds of prey. Cases were identified from the electronic database and included raptors admitted with femoral fractures at the Bird of Prey Clinic of the Université de Montréal, from 1986 to 2018. In total, 119 individuals from 24 species, with 123 femoral fractures, were included in the study. Twenty-seven birds (23%) were declared dead upon arrival. Ninety-two birds (77%) were admitted alive; 80 with acute fractures and 12 with a fracture that had already healed. A conservative treatment (cage rest) was used to manage eight fractures. Surgical repair was attempted on 34 femoral fractures in 33 birds. An intramedullary pin alone was used in 28 cases (82%), and an external skeletal fixator-intramedullary pin tie-in fixator was used in 6 cases (18%). For surgically treated fractures, 19 healed (in 18 birds), 4 did not heal, and 11 birds died or were euthanized before healing could be achieved. Of the 23/34 fractures where the healing process could be assessed, healing rate for comminuted fractures (11/23) was 91% (10/11). Surgical complications occurred in 10 cases (including 7 cases of migration and loosening of the pin, and 1 case of osteomyelitis), leading to euthanasia in 4 cases. Out of the 21 birds with acute femoral fracture upon presentation that were released, 14 had received a surgical treatment and 7 had received a conservative treatment. Nine of the 21 released birds (43%) had at least one other fractured bone. The majority of deaths and euthanasia occurred within 2 wk after admission (51/59; 86%). Thirteen birds were euthanized primarily because of their femoral fracture. Thirteen birds died in treatment and 33 were deemed nonreleasable and euthanized because of a comorbidity not related to the femoral fracture.

Objective: To describe medium-term functional outcome after nail osteosynthesis in feline traumatology and report clinically relevant recommendations for I-Loc angle-stable interlocking nail use in cats., Study Design: Prospective clinical study., Sample Population: Client-owned cats (n = 29)., Methods: Consecutive cases with femoral, tibial, or humeral fractures were included. Outcome measures included fracture and surgical procedure description, limb alignment, nail size vs body weight (BW), percentage of nail medullary canal (MC) fill, time to limb function at clinical union (CU), and complications. Descriptive statistics were reported and compared with historical data., Results: Bone distribution was 53.3% femora, 30% tibiae, and 16.7% humeri. There were six epimetaphyseal and 24 diaphyseal fractures. Overall, 67% of fractures were comminuted. Open reduction and minimally invasive techniques were used in 73% and 27% of cases, respectively. Seventeen I-Loc 3 (cat mean BW 4.4 ± 2.2 kg) and 13 I-Loc 4 (cat mean BW 5.2 ± 1.2 kg) nails were placed with mean MC fill of ≤50%. Average time to CU was 7.2 weeks. At CU, lameness had resolved or was mild in every cat, and all cats ultimately regained full limb function. No major complications were encountered., Conclusion: Because of improved CU times, excellent functional outcomes, and low complication rate, our results provide evidence that I-Loc nails are safe and effective for feline traumatology., Clinical Significance: The I-Loc may be advantageous for fixation of epimetaphyseal fractures. Because of feline bone specific dimensional constraints, I-Loc 3 is likely appropriate for all feline humeri and most tibiae, while I-Loc 4 is well sized for feline femora., (© 2021 The American College of Veterinary Surgeons.)

Background: Fractures of the distal femoral physis are the most common physeal fracture sustained by skeletally immature dogs. Reduction and stabilization of these fractures can sometimes be achieved through closed reduction, primarily in fractures that are nominally displaced. Circular external fixator constructs have been used to assist in indirect, closed reduction of fractures at other anatomic locations in dogs and this report describes application of this method to reduce a displaced Salter-Harris type II fracture of the distal femur in a 1-year-old dog., Case Description: A 1-year-old female spayed Akita was referred for treatment of a Salter-Harris type II fracture of the right distal femur. The epiphyseal segment was laterally and slightly caudally displaced. Multiple attempts to manually reduce the fracture during surgery were unsuccessful, so a two-ring circular external fixator construct was applied to facilitate distraction and reduction. The construct was applied by placing a medial-to-lateral Kirschner wire in both the mid-femoral diaphysis and in the distal femoral epiphysis. Distraction of the construct provided sufficient separation of the fracture segments to facilitate near anatomic reduction. The fracture was stabilized with two percutaneously placed Steinmann pins placed in Rush fashion. Radiographic union was confirmed 5 weeks after surgery. The dog was not lame and was bearing more weight on the right pelvic limb, as assessed using force plate analysis, 9 months following surgery. Goniometric measurements of stifle range of motion and thigh muscle circumference were similar between the pelvic limbs., Conclusion: Application of a two-ring circular construct would appear to be useful to facilitate closed reduction and percutaneous stabilization of distal femoral physeal fractures., Competing Interests: The corresponding author teaches continuing education courses for IMEX Veterinary Inc. The other authors have no conflict of interest to declare relative to the work presented here.

A 4-week-old, female Simmental calf was referred due to severe, non-weightbearing lameness (grade 5/5) of sudden onset in the right hind limb that had been present for 3 days. Clinical examination revealed a painful swelling in the right coxofemoral joint region, but characteristic signs of a fracture, such as crepitus, deviation in the bone axis and increased mobility of the implicated bone, were not observed. Transcutaneous ultrasonographic examination using a 7.5 MHz linear probe revealed a characteristic interruption of the physiologic bone contour, with a slight step formation and increased mobility in the area of the femoral capital physis (growth plate). Radiography showed a Salter-Harris type 2 fracture of the femoral capital physis. Due to a fracture displacement of merely 2 mm, conservative treatment was instigated by means of a modified Ehmer-sling which was applied for 28 days. The sling was changed twice within this period. The calf coped well with the sling and was fully ambulatory. This conservative treatment resulted in complete healing of the femoral capital physeal fracture, and the higher costs for surgical treatment and its potentially associated risks were avoided. Ten weeks following treatment initiation the calf was weight-bearing on the affected limb and showed no signs of lameness., Competing Interests: Die Autoren bestätigen, dass kein Interessenkonflikt besteht., (© Georg Thieme Verlag KG Stuttgart · New York.)

This case reports the successful management of a traumatic diaphyseal femoral fracture in an infant Western chimpanzee (Pan troglodytes verus) from a rescue centre in Sierra Leone using a 2.4-mm intramedullary pin and two 2.7-mm String of Pearls ™ locking plates. Locking plate use has not been previously described in chimpanzees., (© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Signalment, clinical features, fixation techniques, complications, and outcome for dogs presenting with distal diaphyseal and supracondylar femoral fractures were retrospectively reviewed. A total of 45 dogs with unilateral femoral fractures were included. Supracondylar femoral plates were the most popular method of fixation. However, various fixation techniques resulted in favorable outcomes in most dogs with 19/45 cases achieving full function and 22/45 achieving acceptable function. Degree of fracture comminution did not appear to affect complication rate or be a surrogate for worse clinical outcome., (Copyright and/or publishing rights held by the Canadian Veterinary Medical Association.)

Objective: To develop and evaluate a novel fracture fragment stabilization system, the Sirius minimally invasive bone reduction handle system (SMH), in an artificial fracture model (FxM) simulating a canine femoral fracture repair with a minimally invasive orthopedic approach., Study Design: In vitro experimental study., Sample Population: Synthetic fractured femurs with soft-tissue coverage analog (n = 8)., Methods: The developed SMH consisted of modified Kern forceps connected with existing external skeletal fixation components. Intramedullary Steinman pin placement with the SMH or traditional Kern forceps only (KO) was performed by 16 participants in randomized order. Demographics and surgical experience of participants and outcome variables (fragment movement, early/final gap formation, time of procedure, assessed practicability by visual analog scale) were recorded and statistically evaluated., Results: The SMH was more difficult and took longer to assemble (P = .031 and P = .008); SMH resulted in a smaller final reduction gap (P = .008). More surgical experience resulted in faster surgery times (R 2 = 0.766) but was not correlated with final fracture gap formation., Conclusion: The SMH was associated with reduced fragment gap formation in this simulated setting., Clinical Significance: The SMH may be helpful for maintaining reduction of femoral fractures in dogs. Additional studies of the SMH should be conducted to fully assess the effectiveness and practicality in clinical cases., (© 2020 The American College of Veterinary Surgeons.)

Objective:  The aim of this study was to report outcomes in dogs with periprosthetic femoral fractures associated with a press-fit cementless femoral total hip replacement implant., Materials and Methods:  Electronic medical records and digital radiographs were used to identify dogs with periprosthetic femoral fractures associated with press-fit cementless total hip replacement. Data collected included signalment, weight, time of fracture, cause of fracture, presence of intra-operative fissure, fracture type, repair technique, and clinical and radiographic outcomes. Long-term patient outcome was assessed by communication with owners or referring veterinarians., Results:  Twenty-eight dogs with femoral fracture repair associated with cementless press-fit total hip replacement were identified. Eight of the fractures occurred intraoperatively and 20 occurred at a median of 2 days postoperatively. An oblique or spiral configuration was noted in 19 cases and 15 occurred at the distal end of the femoral stem (type B), with thirteen type B1, one type B2 and one type B3 fractures. Fractures were repaired with non-locking (18/28) or locking-plate fixation (10/28). Cerclage wire was applied around the plate and proximal bone segment in 17/28 dogs. Major complications occurred in 7/28 cases (five deep infection, two mechanical failures). Bone healing was noted in 21/23 cases, for which follow-up radiographic interpretation was available. Return to function was complete in 17 cases, acceptable in 8 cases and unacceptable in 3 cases., Conclusions:  While cementless total hip replacement periprosthetic femoral fractures can be successfully repaired with lateral plate fixation, the risk of infection appears to be high., Competing Interests: Disclosure The authors report no conflicts of interest in this work., (Thieme. All rights reserved.)

Objective:  The aim of this study was to prospectively evaluate postoperative alignment when using fracture reduction under the plate (FRUP) during a minimally invasive plate osteosynthesis in tibial and femoral fractures, without intraoperative imaging, and report immediate postoperative complications., Materials and Methods:  After precise plate contouring and preoperative planning, FRUP was obtained with one cortical screw per fragment. Fractures were stabilized with a plate or plate rod. Tibial/femoral lengths, tibial plateau angles, mechanical medial proximal and distal tibial angles, anatomical lateral distal femoral angles, femoral curvatum and neck anteversion were evaluated on postoperative radiographs and contralateral bone. Tibial torsion was evaluated visually. Paired t -test were used to compare data. Immediate postoperative complications were recorded., Results:  Twenty-one tibial and 20 femoral fractures were stabilized (14 plate rod cases). Mean postoperative operated tibial length was 1.4% shorter ( p  = 0.001). Mean postoperative operated femoral length was 2% shorter ( p  = 0.04). Mean operated tibial plateau angle was 1.1° lower ( p  = 0.02). No difference in tibial torsion was noticed. No significant difference in mechanical medial proximal tibial angle, mechanical medial distal tibial angle, anatomical lateral distal femoral angle and femoral neck anteversion was observed. Mean operated femoral curvatum angle was 5.6° less ( p  = 0.01). Five cases (3 plate rod cases) required an immediate revision., Clinical Significance:  Minimally invasive plate osteosynthesis with FRUP leads to acceptable postoperative alignment. Correct pin placement should be evaluated., Competing Interests: None declared., (Georg Thieme Verlag KG Stuttgart · New York.)

A 4-year-old, neutered male European shorthair was presented for evaluation of right hind limb lameness. Radiographs revealed bilateral femoral capital physeal fractures, widened vertebral growth plates and constipation. Physical findings included lethargy, mental dullness, mild hypothermia, retarded growth, pharyngeal stridor, moderate muscle atrophy of pelvic limbs, hair coat abnormalities, and lack of defecation and urination. A thyroid panel revealed thyroid hormone values below detection limits and high thyroid stimulation hormone values. A presumptive diagnosis of congenital primary hypothyroidism was made, however also an early onset acquired primary hypothyroidism could not be ruled out. Results of the insulin-like growth factor (IGF-1) and the parathyroid hormone as well as an adrenocorticotropic hormone stimulating test were normal. A bilateral femoral head and neck excision was performed. Levothyroxine supplementation was started at a dosage of 50 µg (11 µg/kg) BID and later adjusted to 100 µg (22 µg/kg) BID based on total thyroxine concentrations. The tomcat showed full clinical recovery and normal clinical behaviour. The case shows that primary hypothyroidism may be considered in cats presented with femoral capital physeal fractures., Competing Interests: None of the authors of this article has a financial or personal relationship with other people or organisations that could inappropriately influence or bias the content of the paper., (© Georg Thieme Verlag KG Stuttgart · New York.)

Objective:  This study evaluated retrospectively the effectiveness of the veterinary cuttable plate (VCP) in a plate-rod construct, for the treatment of diaphyseal femoral fractures in cats., Materials and Methods:  A total of 29 cats with diaphyseal femoral fracture underwent stabilization with a VCP-rod construct., Results:  Fractures were classified as type A (7/29), type B (11/29) and type C (11/29) following the AO classification. Biological osteosynthesis was elected in three type B and 10 type C fractures, and open approach in the other cases. Pin diameter was 2 mm ( n  = 16) or 2.5 mm ( n  = 13); this corresponded to a percentage of pin occupation of 39.9 and 53.0% of the intramedullary cavity respectively. The 2.0/2.7-mm VCP and 2-mm screws were used in all cases. The median length of the VCP was 12 holes, and the median number of screws placed in the plate was 6. The median number of cortices engaged per fragment was 6. Ninety-nine percent of the screws were bicortical. Quadriceps contracture was an unacceptable functional outcome in one cat. Follow-up was available in 20 cases. Complete bone healing was assessed in 16/20 cases with a functional outcome considered as full in 17/20, acceptable in 2/20, and unacceptable in 1/20. Telephonic owner outcome assessment was available for five more cats and was considered as full in all cases., Clinical Significance:  The VCP-rod construct is effective to manage all configurations of diaphyseal femoral fracture in cats. The high amount of screw holes per unit length of a VCP allows bicortical screws placement without interfering with the intramedullary rod., Competing Interests: None., (Georg Thieme Verlag KG Stuttgart · New York.)

Archaeozoology provides bones, which quite regularly present traces of fractures. These fractures are more or less at an advanced level of healing and bear witness to traumas or pathologies. These cases of palaeopathology are not always the subject of publications, which further restricts our knowledge about them. This short note allows the scientific community to be aware of an original case from an archaeological context in Jordan of a fracture on a hen's femur, consolidated by a callus and with displacement of the distal ends. Beyond the "anecdotal" aspect, and without imagining the circumstances in which the fracture occurred, the animal survived., (Copyright © 2018. Published by Elsevier Inc.)

Background: To investigate the effect of different fixation strategies of the intramedullary interlocking nail (IIN) on the mechanical behavior of a polymeric implant applied for femoral fracture fixation in calves, and to evaluate the performance of a glass fiber-reinforced polymer applied in a bovine femoral fracture reduction system, five Holstein male animals with a mean weight (±SD) of 62.8 ± 20.4 kg and aged 74 ± 15 were used to generate biomechanical parameters for this study. Twelve models of the fractured bovine femur, simulating a simple oblique fracture, were developed for use during the simulations. The models were divided into three groups, with each group of four models being associated with a different fixation strategy. Models were used to simulate the loading conditions corresponding to a calf in the transition (decubitus position to static position) condition. The maximum stresses found in each set (bone/implant) were compared with the reference stresses of each nail material., Results: Maximum implant stresses were found in the screws and at the interface between the screw and the nail. The performance of implants was influenced by the material and fixation strategy, which can be confirmed by the stress values found in the set. The analysis indicated that the composite nail is able to withstand the loading demands in all fixation strategies., Conclusions: The finite element analysis (FEA) demonstrated that all polymeric materials analyzed provided sufficient resistance to withstand the loading forces imposed to the femur when an adequate blocking strategy was applied., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

This report describes comminuted fractures in 2 cats repaired by stabilization with cortical bone allografts that had been preserved in honey. Both cats exhibited appropriate post-operative weight-bearing. Preservation of bone in honey is a simple and widely available alternative for bone banking. This is the first report of a bone defect in cats repaired with bone preserved in honey.

Objective: To investigate the changes in cell autophagy and the molecular mechanism of rapamycin affecting the fracture healing., Material and Methods: Sprague-Dawley (SD) rats were used to establish the right femoral shaft fracture models, and then underwent immunofluorescence assay to detect the autophagy level in bone tissues. After model establishment, SD rats were divided into two groups, the control group and the rapamycin group (1 mg/kg/d). Respectively, at the 2nd, 4th, and 6th week, rats were randomly selected from each group for X-ray and Micro-computed tomography (Micro-CT) examinations to determine callus growth, immunofluorescence assay to detect the protein expression of light chain 3 II (LC3 II), immunohistochemistry to evaluate the autophagy level through detecting the expression of Beclin1 in rats, Western blotting assay to detect cell apoptosis in tissues, hematoxylin and eosin staining (HE staining) to evaluate the osteoblastic activity through count of osteoblast in bone tissue at the end of fracture, and measure the expression of vascular endothelial growth factors (VEGF)., Results: Significant increases were seen in protein expression of cells in bone tissues at the end of fracture. In rapamycin group, callus formation and calcification level in rats were all higher than those in control group; compared with control group, for rats in rapamycin group, cell autophagy was significantly elevated in bone tissues, while cell apoptosis at the end of fracture was reduced with a significant increase in osteoblastic activity. The expression of VEGF in rapamycin group was higher than that in control group., Conclusions: Rapamycin can facilitate fracture healing through inducing cell apoptosis and suppressing cell apoptosis in bone tissues.

Physeal fractures are common musculoskeletal injuries in foals and should be included as a differential diagnosis for the lame or nonweightbearing foal. Careful evaluation of the patient, including precise radiographic assessment, is paramount in determining the options for treatment. Prognosis mostly depends on the patient's age, weight, and fracture location and configuration., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Many long bone fractures that are not considered repairable in the adult horse are repairable in the foal. This is largely because of reduced patient size and more rapid healing in the foal. When there is no articular communication, the long-term prognosis for athletic function can be very good. Emergency care and transport of the foal with a long bone fracture is different than the adult., (Copyright © 2017 Elsevier Inc. All rights reserved.)

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 report complications and clinical outcome of dogs and cats that underwent fluoroscopic-assisted percutaneous pinning (FAPP) of physeal fractures., Study Design: Retrospective study., Animals: Client-owned dogs (n = 37) and cats (n = 4)., Materials and Methods: Records (August 2007-August 2014) of physeal fractures treated with FAPP in 3 hospitals were evaluated. Data collected included signalment, fracture characteristics (etiology, location, duration, Salter-Harris classification, preoperative and postoperative displacement), surgical information (implant size, surgical duration), and outcome assessment information (functional outcome, radiographic outcome, and complications)., Results: The majority of animals (92%) were classified as full functional outcome. No significant predictors of functional outcome were identified. The overall complication rate was 15% (n = 6). Elective pin removal rate was 41% (n = 17). Goniometry and limb circumference measurements of the affected and contralateral limbs were not significantly different in dogs for which measurements were obtained. Seventeen of 18 animals (16 dogs, 2 cats) measured had bone length changes on follow-up radiographs., Conclusion: FAPP is associated with an excellent functional outcome in a narrow selection of fracture configurations, specifically those with minimal displacement and for which anatomical alignment can be achieved with closed reduction., (© 2016 The American College of Veterinary Surgeons.)

Objectives: To evaluate the effect of varying the number and configuration of locking bicortical and monocortical screws on a plate-rod construct using a mid-diaphyseal femoral ostectomy model., Methods: Thirty Greyhound femurs were assigned to six groups (A-F). An intramedullary pin was placed in each bone following which a 3.5 mm locking plate was applied with six differing locking screw configurations. Groups A to C had one bicortical screw in the most proximal and distal plate holes and one to three monocortical locking screws in the proximal and distal fragments. Groups D to F had no bicortical screws placed and two to four monocortical locking screws in proximal and distal fragments. Each construct was axially loaded at 4 Hz from a preload of 10 Newtons (N) to 72 N, increasing to 144 N and 216 N, each of 6000 cycles with a further 45,000 cycles at 216 N to simulate a three to six week postoperative convalescence period. Constructs were then loaded to failure., Results: No construct suffered screw loosening or a significant change in construct stiffness during cyclic loading. There was no significant difference in load to failure of any construct (p = 0.34), however, less variation was seen with monocortical constructs. All constructs failed at greater than 2.5 times physiological load, and failure was by bending of the intramedullary pin and plate rather than screw loosening or pull-out., Clinical Significance: Axially loaded locking monocortical plate-rod constructs applied to the canine femur may confer no difference biomechanically to those employing locking bicortical screws.

Periprosthetic femoral fractures are a common complication associated with cementless press-fit total hip arthroplasty. The use of prophylactic cerclage wire fixation has been advocated to reduce this complication. The objective of this study was to evaluate whether a double loop cerclage wire, used as adjunctive fixation, increased the peak torsional load to failure in femora implanted with press-fit cementless stems. Peak torsional load to failure was compared between femora without adjunctive fixation and femora receiving a 1 mm double loop cerclage wire placed proximally to the lesser trochanter. Femora treated with adjunctive cerclage wire fixation failed at 20% greater peak torque (P = 0.0001). In conclusion, a double loop cerclage wire may aid in the prevention of periprosthetic fractures associated with press-fit cementless femoral stems., (Copyright © 2016. Published by Elsevier Ltd.)

A 2-year-old, egg-laying maroon-bellied conure (Pyrrhura frontalis) was referred for treatment of bilateral femoral fractures believed to be secondary to recent egg laying and nutritional and husbandry deficiencies. On radiographs, all skeletal components were diffusely osteopenic, precluding surgical fixation. A novel device to stabilize the bilateral femoral fractures was manufactured with polyvinyl chloride piping, which braced the bird's feet at the level of the perch and supported its upper body weight via a breast plate, thus maintaining the bird in a physiologically appropriate perching position. The conure was ambulatory and returned to normal function after 3 weeks of external coaptation with this device. After 6 weeks, callus formation was palpable over both fracture sites even though minimal bone remodeling was visible radiographically. This body splint device may present a viable alternative to euthanasia in select cases of bilateral femoral fractures in companion birds.

Objective: To compare the biomechanical properties of locking compression plate (LCP) and a limited contact dynamic compression plate combined with an intramedullary rod (LC-DCP-R) in a cadaveric, canine, femoral fracture-gap model., Study Design: In vitro biomechanical study; nonrandomized, complete block (dog)., Sample Population: Paired cadaveric canine femora (n = 10 dogs)., Methods: Paired femurs with a mid-diaphyseal 20 mm gap were stabilized with either LCP or LC-DCP-R. Nondestructive testing up to 60% of body weight (BW) was followed by a continuous destructive test. Comparative structural properties, 3-dimensional (3D) interfragmentary motion, and plate linear strain were evaluated. Paired comparisons were made between LCP and LC-DCP-R., Results: Stiffness after nondestructive testing was significantly lower for LCP with a mean (95% confidence interval [CI]) of 61 N/mm (46-76) versus 89 N/mm (67-110) for LC-DCP-R (P = .0072). Ultimate load to failure was significantly lower for LCP with a median (interquartile range [IQR]) of 270 N (247-286) versus 371.5 (353-385) for LC-DCP-R (P = .002). Axial motion at 60% BW was significantly higher for LCP with a median (IQR) of 1.01 mm (0.71-1.26) versus 0.36 mm (0.20-0.49) for LC-DCP-R (P = .002). Shear motion was significantly higher for LCP with a median (IQR) of 1.18 (0.78-1.58) versus 0.72 mm (0.45-1.00) for LC-DCP-R (P = .018). Strain was significantly higher for mid-LCP surface with a mean (95%CI) at 60% BW of 979 μdef (579-1378) versus 583 μdef (365-801) at mid-LC-DCP-R surface (P = .0153). The elastic limit strain of the plates was not different and was reached at a mean (95%CI) load of 241 N (190-292) for LCP versus 290 N (245-336) for LC-DCP-R (P = .12)., Conclusion: The LC-DCP-R showed higher stiffness and resistance to failure, lower interfragmentary motion, and lower plate strain and stress compared to LCP., (© Copyright 2016 by The American College of Veterinary Surgeons.)

Injuries involving the femoral third trochanter are an uncommon but important source of equine lameness; however, clinical localization can be challenging. The purpose of this retrospective study was to describe ultrasonographic and scintigraphic findings in a group of horses with presumed third trochanter injury. Medical records of an equine referral hospital were searched from 2004-2014, and 20 horses met the inclusion criteria. Lesions consistent with third trochanter fracture were identified with ultrasound in 14/20 horses. Onset of lameness was acute (11), insidious (2), or unknown (1). All but one horse was lame at presentation, ranging from Grade 2-4/5. Ultrasound was the primary diagnostic modality in 5/14 horses with fragmentation, while scintigraphic findings of intense (3), moderate (5), and mild (1) increased radiopharmaceutical uptake (IRU) prompted ultrasonographic examinations in 9/14 fractured horses. A nondisplaced fracture was suspected in an additional horse with intense IRU and negative ultrasound findings. In the remaining five horses, imaging findings included only mild IRU. Lameness was localized to other regions in these cases. Six of 12 fractured horses with available outcome data were returned to function after a prolonged rehabilitation of 8-18 months. Scintigraphic findings helped to direct focused ultrasound exams in the majority of fracture cases. Horses with evidence of third trochanter fracture had similar clinical characteristics to that reported for pelvic fractures and authors therefore recommend ultrasonographic examination of both regions, especially when scintigraphy is unavailable. Prognosis for return to function in horses of the current study was less favorable than previously reported., (© 2015 American College of Veterinary Radiology.)

The objective was to review surgical techniques and postoperative complications of surgical correction for patellar luxation (PL) in cats. A retrospective study evaluating 85 surgeries in 71 cats was performed. The records from four referral centres were searched for cats with surgical management of PL. Signalment, history, PL grade and direction, corrective surgical techniques and outcome were retrieved. Binary logistic regression analysis was used to interrogate relationships between case features, surgical correction methods and outcomes. The outcomes were classified as minor and major complications (requiring revision surgery), including continued PL (reluxation). Postoperative complications occurred in 26% of cases; 20% had major complications, including 5% patellar reluxation, and 6% had minor complications. Cats with previous ipsilateral femoral fracture were significantly more likely to suffer complications, including minor (P = 0.02, odds ratio = 12.67), major (P = 0.03, OR = 7.2) and patellar reluxation (P = 0.01, OR = 19.25). Minor complications were significantly more likely with grade 4 PL (P = 0.03, OR = 8.5). Major complications were significantly more likely with tibial tuberosity transposition (TTT; P = 0.03, OR = 5.57). Patellar reluxation was significantly more likely if stifle surgery had been performed previously (P = 0.05, OR = 8.00). The presence of bilateral PL, hip dysplasia, grade 1, 2 or 3 PL, corrective surgery using an anti-rotational suture or femoral sulcoplasty did not influence complications. Complications were more likely for grade 4 PL, previous ipsilateral femoral fracture, if TTT was performed and for cases with previous stifle surgery. This information allows consideration of risks and complicating factors., (© ISFM and AAFP 2014.)

A four-month-old, entire male guinea pig was presented for surgical repair of a closed oblique femoral fracture. Analgesia was provided with 30 µg/kg buprenorphine intramuscularly (im) four times a day and 0 · 3 mg/kg meloxicam subcutaneously once a day. The following day, anaesthesia was induced and maintained with 100 µg/kg medetomidine im, 20 mg/kg ketamine im, 30 µg/kg buprenorphine im and isoflurane in oxygen. Femoral and sciatic nerve blocks were performed with bupivacaine. The fracture was reduced and aligned using an intramedullary 1 · 4 mm K-wire and a 3 metric polydioxanone cerclage. Three weeks postoperatively remodelling and callus formation was documented, with no evidence of complications. Complete union was present 14 weeks postoperatively., (© 2013 British Small Animal Veterinary Association.)

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 describe a newly designed interlocking nail system (Targon® Vet System, TVS) tested in a model of diaphyseal femoral fractures in cats., Material and Methods: Introduction of the TVS and presentation of the system components. Evaluation of application range and biomechanical testing of the TVS in cadaver bones under cyclic loading until fatigue failure occurred. The first two test groups compared the influence of implantation and immediate removal of the TVS locking bolts and six holes created by 2.0 mm cortical screws on the stability of feline femora. In the third group the two fixation systems were compared to each other with implants in place in an osteotomy gap model. The failure mode was statistically compared for each group (p < 0.05)., Results: Femora after implantation and removal of the bolts of the TVS were significantly stiffer than after implantation and removal of the six 2.0 mm cortical screws. In the osteotomy gap model, femora with the TVS in place failed some- what later, but not statistically significant, than the opposite femur of the same cat with the 2.0 8-hole DCP in place., Conclusion and Clinical Relevance: Using this testing method, stability of the TVS seems to be biomechanically comparable to conventional osteosynthesis plate systems. Therefore the TVS may be an encouraging alternative to conventional osteosynthesis systems in diaphyseal fractures, offering several advantages without the need for extensive specialized equipment.