A CLINICAL STUDY ON THE USE OF STRING OF PEARLS PLATE SYSTEM IN STABILIZATION OF LONG BONE FRACTURES IN DOGS
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Date
2022-03-11
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PVNRTVU, HYDERABAD
Abstract
The present clinical study was conducted on eight dogs presented with long bone fractures to Department of Surgery and Radiology at College of Veterinary Science Rajendranagar, Hyderabad. The age of the seven dogs ranged from 4 -18 months. Out of these eight dogs, five were male and three were female. Among the eight dogs, four dogs belonged to non-descript breed, two dogs belonged to Labrador breed and Two dogs belonged to Pomerarian breed. The body weight of the dogs ranged from 4.5 to 12 kg.
The eight cases of long bone fractures were diagnosed by clinical signs, orthopaedic examination and survey radiography. The symptoms observed in the dogs presented for treatment were pain on manipulation, abnormal angulation, and lameness immediately after traumatic injury, swelling, non-weight bearing, dangling of the limb and crepitation at the fracture site. Pre-operative radiographic examination in two orthogonal views, i.e., anteroposterior and mediolateral radiographs revealed proximaldiaphyseal fracture in one dog, mid diaphyseal fractures in four dogs and distal diaphyseal fractures in three dogs. Pre-operative radiographs also showed the type of fractures as transverse fracture in five dogs and oblique fracture in three dogs. All the eight dogs had closed fractures.
These fractures stabilized with 2.7 mm and 3.5 mm String of Pearls Locking Plates (SOP) resulted in good fracture fixation and immobilization. The length of the plates to be used was determined by the length of the bone as measured from the radiographs. The lengths of screws were determined by measuring the transcortical diameter of the bone at different regions from the Antero-posterior and Medio-lateral
radiographs obtained pre-operatively. Cranio-medial approach used provided good exposure of the fracture site and enabled good fracture fixation in dogs with radial fracture, Cranio-lateral approach provided satisfactory exposure of fractured diaphyseal region of humerus and craniomedial approach provided satisfactory exposure of fractured distal diaphyseal and mid diaphyseal region of tibia to perform bone plating using String of Pearls Locking plates.
Post-operative radiographic evaluation confirmed proper placement of the plates and screws, apposition and alignment of the fracture fragments in all the eight dogs. Immobilization was considered satisfactory in all the cases. The plate length, size and position were appropriate in all cases. Screw length, size and position were considered appropriate in all cases. Follow-up radiographs taken on 15th, 30th, 60th and 90th post-operative days revealed secondary bone healing with periosteal callus formation. Good implant stability throughout the treatment period without any complications could be achieved in six dogs. In one dog, plate breakage was observed at the fracture site by 15th post-operative day and plate bending was observed in at the fracture site by 30th postoperative day in another dog. However, intermittent weight bearing was noticed by 45th post- operative day in both the dogs.
All the dogs which were diagnosed for long bone fractures showed grade V lameness before surgical treatment. Post-operatively, six dogs progressed to grade I lameness and two dogs progressed to grade II lameness by the end of 45th post- operative day. Haematological evaluation revealed that the progressive increase of haemoglobin level, packed cell volume and total erythrocyte count on post-operative days indicated erythropoiesis. The total leukocyte count was significantly decreased on post-operative days indicated leucocytopenia which is suggestive of gradual decrease in inflammatory reaction. The differential leucocyte count like neutrophil was significantly decreased on post-operative days indicated neutropenia. Contrary to this, the lymphocyte count was statistically increased on 30th and 60th post-operative days indicated gradual decrease of inflammatory reaction.
Serum biochemical evaluation revealed that the serum alkaline phosphatase values significantly increased from pre-operative day to 30th day and there after the levels decreased to normal by 60th day and serum calcium values significantly increased from day 0 to 15th day and thereafter reached to normal values by 30th postoperative day. The increased serum alkaline phosphatase levels during the first two weeks indicated increased chondroblastic proliferation to cause bone formation during fracture repair. The serum phosphorous values showed no significant variation and the values were within the normal range.
Based on present study, it was concluded that String of Pearls Locking plates (SOP) was successful in the treatment of femoral fractures and offered good recompense and remarkable improvement in limb function in six out of eight dogs. The application of SOP plates was found to be effective with features like being light in weight, versatile owing to its ability to contouring to any shape of bone, high bending strength and maintaining limited contact with bone. The implant used in this technique is economical, making it amenable to use in veterinary practice. In the opinion of the author, SOP locking plate has potential for application in radius ulna and tibia .