Dr.V.GIREESH KUMARDr. J. RADHAKRISHNA RAO2016-12-312016-12-312016-12-31http://krishikosh.egranth.ac.in/handle/1/93802The present study was undertaken in 24 dogs presented with fractures of radius-ulna, tibia, femur and humerus for treatment at Teaching Veterinary Clinical Complex, Veterinary Hospital, Bhoiguda, Secunderabad and Department of Veterinary Surgery and Radiology, College of Veterinary Science, Rajendranagar, Hyderabad, Telangana. All the fractures of long bones were included in the present study as external skeletal fixation is suitable in treatment of fractures of these bones. For surgical treatment by External Skeletal Fixation (ESF), the 24 dogs with fractures of radius-ulna, tibia, femur and humerus were assigned into four groups of six dogs in each group irrespective of breed, sex and age, based on the bone involved, type and location of fracture and the surgical procedure adopted for fracture fixation. The dogs of the Group-I were treated with Type Ia Linear ESF. The dogs of Group- II were treated with Type IIa Linear ESF. The dogs of group III were treated with Tie-in configuration and the fractures of long bones in group IV were treated with Hybrid external xvii fixator type Ia. In the present study fractures of radius-ulna were encountered in 13 dogs, tibial fractures were seen in 3 dogs, bilateral humerus fracture was seen in 1 dog and femoral fractures were observed in 7 dogs. All the fractures were closed fractures. Pre-operative radiographs revealed transverse fractures in 12 dogs, short oblique fractures in 2 dogs, long oblique fractures in 4 dogs, comminuted fractures in 4 dogs, femoral neck fracture in one pup and supracondylar fracture in one pup. Limited open approach in 15 dogs, open approach in 7 dogs and closed approach in 2 dogs were adopted. For reduction of fracture fragments, hanging limb technique with the animal in dorsal recumbency facilitated reduction and alignment of the fracture fragments. Cerclage wiring and intramedullary pin was used for anatomical reconstruction of fractured bones wherever necessary. Clinical evaluation was routinely carried out at periodical intervals for the signs of swelling, exudation, weight bearing and stability of the fixator in all the dogs. Medio-lateral and anterio-posterior radiographs of the operated bones were obtained immediately after surgery and on the th, 30th, th and th post-operative day and 15 45 60 whenever needed on later dates to assess the progress of bone healing. Post-operative radiographs taken immediately after the surgery revealed good fracture reduction and immobilization of the fracture fragments in all the dogs of four groups. Postoperative radiographs showed progressive healing of the fractures. In group I out of 6 dogs, 5 dogs showed partial weight bearing from 5th postoperative day. Complete limb usage was noticed from 45th-55th post-operative day. The mean weight bearing time was 43.66±8.03 day. In group II partial weight bearing was observed from 3-7th postoperative day. Complete weight bearing was noticed from 32nd day onwards. The mean time for complete limb usage was 51.08±8.71 day. In group III Partial weight bearing was noticed from 3rd -5th postoperative day in all the dogs except in one dog xviii which had showed only partial weight bearing till the removal of fixator. Complete weight bearing was seen from 30th day -60th post-operative day with a mean of 41.33±4.33 day. The dogs in group IV showed partial weight bearing from 3rd – 6th post-operative day in all the dogs except in two dogs. The complete weight bearing was ranging from 34th -60th postoperative day. The mean of complete weight bearing was ranging from 42.16 ± 4.54 day. The fixator was well tolerated by all the dogs of group I and it was stable in all dogs except in two dogs where in one dog there was caudal angulation of the fracture fragments of the radius and in other dog there was medial angulation of the radius observed due to the less rigidity of the fixator. In group II the fixator stability was good in all the dogs. In group III, Tie-in configuration counteracted torsional forces acting on the fracture fragments and provided good fixator stability throughout the observation period in almost all the dogs which suffered femoral and humeral fractures. All the dogs exhibited pain because of the movement of the IM pin as it was loose and tied to the ESF. In group IV the fixator was found rigid and stable till the completion of bone healing in all the dogs Post-operative radiographs revealed that immobilization of fracture fragments was good in all the cases except in two cases with radius-ulna fractures in group I, one case in group II, and in one case in group IV. In all the dogs of four groups, the fractures healed well with proper callus formation. In all the groups, bone healing was seen discernible as early as 15th day onwards. In all the groups callus formation with adequate radio-density was noticed on 45th post-operative day. It is vividly delineated that fracture line disappeared and showing distinct restitution of cortico-medullary continuity by 50th and 60th post-operative days respectively. Progressive bone healing was observed from post-operative radiographs in all the groups. The external skeletal fixators were removed in the six dogs of group I between 52 days to 65 days with mean time of 59.33± 2.41 days. While in the dogs of group II, the fixator was removed between 37 days to 80 days with mean time of 54.33 ± 6.60 days. In xix group III the tie-in configuration was removed between 30 days to 55 days with mean time of removal 43.16± 4.46 days. In the present study, the entire tie- in construct was removed in 4 cases without staged disassembly under general anesthesia whereas, staged disassembly was performed in two cases on 30th and 45th postoperative day, where linear external skeletal fixator was removed after formation of primary callus and the intramedullary pin was removed 2 weeks thereafter. In group IV, the HEF Type Ia was removed when sufficient callus formation was radio graphically visible in all the dogs without any staged disassembly. The mean time of the fixator removal was 45.33 ± 5.10 days, with a range of 30 days to 60 days. Complications noticed were slight pin tract discharge, minor pin tract infection, loosening of proximal most pin, slight osteolysis, serous discharge from the exit site of intramedullary pin, and wounds due to pressure exerted by fixator, malunion resulting in synostosis among a few dogs across all the four groups. Slight valgus deformity of radiusulna was seen in one dog each in Group I, and IV. These findings did not disturb the stability of the fixator in dogs belonging to all four groups. All the fractures healed well in all the dogs of four groups. Results of the present clinical study revealed that the Type Ia ESF and Type IIa ESF, Tie-In Configurations and Hybrid External Fixators Type Ia can be used with excellent outcome for treatment of long bone fractures of radius-ulna, tibia, femur and humerus in dogs. All the ESFs produced remarkable improvement in the normal limb function and maintained good fixator stability, throughout the observation period in all the dogs of the four groups. However, the decision whether to use the suitable external skeletal fixation was made depending up on the long bone involved and type of fracture of the bone.Thesis