Long bone fracture as a complication following external skeletal fixation: 11 cases

Knudsen, C. S.; Arthurs, Gareth; Hayes, Galina; Langley‐Hobbs, Sorrel

doi:10.1111/j.1748-5827.2012.01306.x

Cited by 13 publications

(15 citation statements)

References 30 publications

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“…21,34 The conventional pin size recommendation is between 20 -30% of bone diameter which should be accurately measured on preoperative radiographs. 21,11,34 Even small pins of only 20% of bone diameter can cause a 38% reduction in bone strength. 35 Unfortunately, the surgeon must balance a safer, narrower pin diameter, against decreased construct stiffness and thus the potential for greater fracture instability, higher gap strain and impaired fracture healing.…”

Section: Discussionmentioning

confidence: 99%

“…This serious complication usually has contributing factors such as multiple injuries, the presence of empty drill holes and inappropriate postoperative exercise restriction. 34 A key feature of the ESF is its flexibility in design, and there are numerous frame configurations, implant types, sizes and materials available which can affect construct strength and stability. 43 The use of an IM pin was show to be associated with complication development, however the vast majority of IM pins used were in the femur and the humerus, which had a higher risk of FAC development.…”

Section: Discussionmentioning

confidence: 99%

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Postoperative complications associated with external skeletal fixators in cats

Beever

Giles

Meeson

2017

Journal of Feline Medicine and Surgery

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(300 words max): 227 Objectives:The objective was to quantify external skeletal fixator (ESF) associated complications in cats and to identify potential risk factors. Methods:A retrospective review of medical records and radiographs following ESF placement was performed. Results:Case records of 140 cats were reviewed; fixator associated complications (FAC), occurred in 19% of cats. The region of ESF placement was significantly associated with complication development.Complications developed most frequently in the femur (50%), tarsus (35%) and radius/ulna (33%). Conclusions and relevance:Complication development is not uncommon in cats following ESF placement. The higher complication rate in the femur, tarsus and radius/ulna should be considered when reviewing options for fracture management; however cats appear to have a lower rate of pin tract infections than that reported in dogs.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Postoperative complications associated with external skeletal fixators in cats

Beever

Giles

Meeson

2017

Journal of Feline Medicine and Surgery

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“…Failure to comply with activity restriction may lead to protracted recovery or even surgical treatment failure, necessitating a second surgical procedure. 2 …”

Section: Introductionmentioning

confidence: 99%

Use of trazodone to facilitate postsurgical confinement in dogs

Gruen¹,

Roe²,

Griffith³

et al. 2014

javma

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Objective To investigate the safety and efficacy of the oral serotonin antagonist/reuptake inhibitor trazodone hydrochloride to facilitate confinement and calming after orthopedic surgery in dogs. Design Prospective open-label trial. Animals 36 client-owned dogs. Procedures Healthy dogs were recruited when presented for pre-surgical evaluation for orthopedic procedures. Starting the day after surgery, dogs were administered trazodone (~3.5 mg/kg, per os (PO), q12h) with tramadol (4–6 mg/kg, PO, q8–12h) for pain management. After 3 days, tramadol was discontinued and trazodone was increased (~7 mg/kg, PO, q12h) and maintained for at least 4 weeks. If needed, trazodone dosage was increased to 7–10 mg/kg, PO, q8h. Clients completed electronic surveys rating their dogs’ confinement tolerance, calmness/hyperactivity level, and responses to specific provocative situations, prior to surgery and at 1, 2, 3, and 4 weeks and at the post-surgical evaluation (8–12 weeks). Results The majority of clients (~90%) reported that, when given trazodone during the 8–12 weeks following orthopedic surgery, their dogs improved moderately or extremely with regard to confinement tolerance and calmness. Trazodone was well tolerated, even in combination with non-steroidal drugs, antibiotics, and other medications; no dogs were withdrawn from the study due to adverse reactions. Client-reported median onset of action of trazodone was 31–45 minutes and median duration of action was four or more hours. Conclusions and Clinical Relevance The results suggest that oral trazodone is a safe and efficacious medication that may be used to facilitate confinement and enhance behavioral calmness of dogs during the critical recovery period following orthopedic surgery.

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“…medicine, drainage after ESF is particularly common in the proximal aspect of the antebrachium and crus, compared with results after ESF in the middle and distal aspects of the antebrachium and crus. 10,11 Although complications associated with ISI inflammation during ESF are described in human [2][3][4][7][8][9]12 and veterinary 1,[13][14][15][16] medicine, validated scoring systems that describe the condition of that interface are lacking. Development of a validated scoring system for inflammation at the ISI is an essential step to enable clinicians to reach evidence-based conclusions about outcomes and complications in clinical studies involving ESF.…”

mentioning

confidence: 99%

Assessment of an implant-skin interface scoring system for external skeletal fixation of dogs

McDonald-Lynch

Marcellin‐Little

Roe

et al. 2015

ajvr

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OBJECTIVE To assess intraobserver repeatability and interobserver and in vivo versus photographic agreement of a scoring system for the implant-skin interface (ISI) of external skeletal fixation (ESF). SAMPLE 42 photographs of ISIs from 18 dogs for interobserver agreement and intraobserver repeatability and 27 photographs of ISIs from 6 dogs for in vivo versus photograph agreement. PROCEDURES An ISI inflammation scoring system was developed. It included scales for 6 metrics (erythema, drainage amount, drainage type, swelling, hair loss or lack of hair regrowth, and granulation tissue). Photographs of the ISI of ESF were obtained by use of a standard protocol and evaluated to determine intraobserver repeatability and interobserver agreement (Cronbach α; 4 raters) of the ISI score. Agreement between in vivo and photographic ISI scores (2 raters) and correlation between median scores across metrics were evaluated. RESULTS 42 photographs met the inclusion criteria. Overall intraclass correlation coefficients ranged from 0.922 to 0.975. Interobserver overall Cronbach α ranged from 0.835 to 0.943. For in vivo versus photographic assessment, 27 ISIs in 6 dogs and their photographs were evaluated. The Cronbach α for both raters ranged from 0.614 to 0.938. Overall, the Cronbach α ranged from 0.725 to 0.932. Mean photographic scores were greater than mean in vivo scores for each metric. Pearson correlation coefficients ranged from 0.221 to 0.923. Erythema, swelling, and granulation were correlated with all other metrics. CONCLUSIONS AND CLINICAL RELEVANCE In this study, an ISI scoring system used in this study had high repeatability and agreement and may therefore be considered for use in clinical situations. Photographic scores were not equivalent to in vivo scores and should not be used interchangeably.

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Long bone fracture as a complication following external skeletal fixation: 11 cases

Cited by 13 publications

References 30 publications

Postoperative complications associated with external skeletal fixators in cats

Postoperative complications associated with external skeletal fixators in cats

Use of trazodone to facilitate postsurgical confinement in dogs

Assessment of an implant-skin interface scoring system for external skeletal fixation of dogs

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