Surgical management of large segmental femoral and radial bone defects in a dog

Abstract

SummaryIn this case report, we describe the use of a cylindrical titanium mesh cage combined with cancellous bone graft to surgically manage large segmental bone defects in a dog. A seven-year-old, neutered male cross-breed dog, with highly comminuted fractures of the right femur and the left radius and ulna, was referred for treatment. Previous open reduction and internal fixation of these fractures had failed. Following implant removal and debridement of each bone, a 71 mm segmental femoral defect and a 27 mm segmental radial defect were present. A commercially available cylindrical titanium mesh cage was filled with ß-tricalcium phosphate crystals mixed with an equal volume of autogenous cancellous bone graft. The mesh cage was aligned with the proximal and distal parts of each bone using an intramedullary pin passing through the cage, and a locking plate was applied to the proximal and distal fracture fragments to produce compression against the titanium cage. The dog had a successful long-term clinical outcome, and radiographic examination at 22 and 63 weeks after surgery showed the formation of remodelling bridging callus that was continuous across the titanium cage in each of the fractures. Due to the relative simplicity of the technique and the favourable outcome in this case, it should be considered an option when managing comminuted fractures with large bone defects.