Combined Intramedullary Pinning for the Stabilisation of Distal Diaphyseal and Metaphyseal Femoral Fractures in Five Skeletally Immature Dogs

Abstract

AbstractThe aim of this retrospective case series was to evaluate outcomes of distal normograde intramedullary pinning combined with dynamic intramedullary pinning for the stabilisation of distal diaphyseal and metaphyseal femoral fractures in five juvenile dogs. Medical records and radiographs were reviewed to evaluate signalment, interval from injury to surgery, fracture classification, concurrent injuries, apparatus, fracture healing and any complications. Final follow-up at skeletal maturity consisted of orthopaedic examination and orthogonal radiographs of bilateral femurs. Radiographs were evaluated for osteoarthritis, femoral length and alignment. Three of four dogs that returned for short-term follow-up healed without complication at 4 weeks postoperatively. One dog experienced pin migration and delayed union, requiring pin removal. All four dogs that returned for final follow-up demonstrated excellent limb function based on owner assessment and orthopaedic examination. Radiographic evaluation revealed mild stifle osteoarthritis in two dogs. All dogs demonstrated continued growth of the affected femur with mild discrepancies in length compared with the contralateral femur at skeletal maturity. Two dogs developed subclinical femoral neck retroversion relative to the normal contralateral limb. Combined intramedullary pinning may be an appropriate treatment option for select distal femoral fractures in skeletally immature dogs; however, more rigid fixation methods should be considered when possible, to effectively counter rotational forces during fracture healing.