Closed reduction and fluoroscopic-guided percutaneous pinning of femoral capital physeal or neck fractures: Thirteen fractures in 11 dogs

Vet Surg. 2022 Aug 2. doi: 10.1111/vsu.13867. Online ahead of print.

Abstract

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.