Treatment of a Large Defect Induced by Atrophic Nonunion of Femoral Fracture in a Dog with Autogenous Coccygeal Bone Grafting

Abstract

An 11-month-old castrated male Pomeranian presented with nonunion following a femoral fracture that occurred after femoral head and neck osteotomy. Radiography and computed tomography revealed severe atrophy of the proximal bone fragment and retardation of the ipsilateral distal fragment and tibia. An autogenous bone graft using coccygeal bone was performed, in which three and a half coccyges were placed in succession and fixed using an orthogonal locking plate. To promote bone healing and facilitate proper weight bearing and ambulation, bone morphogenetic proteins, biphasic calcium phosphate, platelet-rich plasma, passive-range-of-motion exercises, transcutaneous electrical nerve stimulation, neuromuscular electrical stimulation, and low-level laser therapy were applied. During the four-year follow-up, it was observed that the previously engrafted bone healed well and maintained stability over a prolonged period, resulting in the patient being able to walk comfortably with good outcomes. However, some degree of lameness was noted in the dog when running owing to limb shortening and joint contracture.