What happens if my dog breaks a leg? (How a specialty orthopedic surgeon repairs fractures)

What happens if my dog breaks a leg? (How a specialty orthopedic surgeon repairs fractures)

One of the scariest things we will face as pet owners is an emergency. A broken leg is one of those situations that requires urgent veterinary care, and while we can’t always plan for emergencies, we can be prepared by recognizing and understanding the signs and symptoms.

Fractured legs come in a variety of forms and have an assortment of causes. No matter how the leg was broken and what type of fracture it is, your pet should be seen as soon as possible. The sooner you can bring your pet to see a veterinarian, the easier it will be to minimize complications.

At Boundary Bay Veterinary Specialty Hospital, we see many complex pet trauma cases, including fractures. Pets are referred to us because we have board-certified specialty surgeons on call 24/7 for emergency surgeries and other issues, and we are VECCS-level 1 certified – the highest level of certification possible for an ER. We are specially staffed, equipped & trained to handle the most severe traumas & emergencies for your pets.

How do I know if my pet has a fracture?

Most broken bones occur after some sort of activity or accident. Not only will there be signs of a broken bone, as noted below, but there may be other injuries that can be attributed to the accident. For instance, a dog that has been hit by a car may have a broken leg but also experience internal bleeding and have difficulty breathing.

Signs most often associated with broken bones in dogs include:

  • Lameness, often seen with the affected limb held up
  • Pain
  • Joint swelling
  • Crepitus (crunching within the joint) or increased looseness of the limb
  • Abnormal conformation (angularity or shortening) of the affected limb
  • Broken bone protruding from the skin
  • Swelling or bruising of the limb/body part

What kinds of fractures can happen in dogs and cats?

Fractures can be classified into different categories. Common types of fractures are:

Complex, compound fracture, lateral view

    1. Closed – a closed fracture is contained within the skin; the bone is broken, but the skin is intact.
    2. Open – An open fracture pierces through the skin and is exposed.
    3. Comminuted fracture – the bone is splintered, crushed, or broken into pieces.
    4. Epiphyseal or physeal (growth plate) – (most commonly) seen in young dogs and cats. These happen most often on the growth plates or epiphyseal plates. In young animals the growth plate fractures because it’s the weakest part of the bone. Veterinary surgeons use the Salter-Harris system to categorize these fractures into grades or types.
    5. Greenstick (hairline) – a small crack/partial fracture in which the bone is essentially left intact, the bone isn’t completely broken.
    6. Pathologic – a fracture caused from a disease that weakens the bone.

 

What should I do if I think my pet has a fracture?

Fractured legs come in a variety of forms and have an assortment of causes. If you determine or suspect that your dog has a fracture, seek emergency veterinary medical care immediately.

The sooner you can bring your pet to see a veterinarian, the easier it will be to minimize complications. Broken legs are very painful, and your vet will be able to ease the pain quickly and efficiently. Because there are so many different causes and types of fractures, there are also a variety of different repair techniques.

How does an orthopedic veterinary surgeon fix a compound fracture? – Lucy’s Story

At Boundary Bay Veterinary Specialty Hospital, our board-certified veterinary orthopedic surgeons are specially trained to handle the most complex fractures. Many of the trauma cases we see involve fractures that require implants, including inserts, plates, screws, or other types of specialized stabilizing equipment to help the fracture heal. The procedures and equipment our surgeons use require years of training and experience.

X-ray of Lucy’s fracture

Dr. Alvarez

We spoke with by Dr. Alex Alvarez, one of our board-certified surgeons, about one of his recent cases to find out more about how he treats complex fractures. This is Lucy’s story:

Lucy was hit by a car in February of this year.  She was stabilized at another clinic, then transferred to see our board-certified surgeons at Boundary Bay. Dr. Alvarez quickly assessed the large open fracture on her front left leg. On top of the complex fractures of her radius and ulna, she had also sustained a severe degloving injury on the same leg. Degloving means there was loss of skin, underlying tissue and muscle over the fracture, which left the bones exposed.

Degloving injuries are not very common. Lucy was the first one Dr. Alvarez had seen at BBVSH, and during his three-year residency, he saw only three or four. An open wound of this kind leads to higher chance of infection and meant that the healing time for Lucy would be significant.

X-ray taken post-operation; note extensive metal used to repair fracture

Dr. Alvarez determined that the complex fracture on her leg could not be repaired with more conventional internal implants, like bone plates and screws, because of the high infection risk. Instead, Lucy required an external fixator – an alternative way to fix the fracture that uses temporary implants outside of the skin. The external fixator allowed the broken bones to be held in place from the outside, while giving the care team access to deal with the very large open wound outside of the fracture. Because Lucy was young, Dr. Alvarez felt the healing process would go very well.

Fracture with external fixator, immediately post-op

After the two-and-a-half-hour surgery, Dr. Alvarez moved Lucy to the ICU for recovery, where our ICU team cared for her throughout the rest of the day and overnight. While in the ICU, her vitals were closely monitored as she had just undergone general anesthesia, and she received pain relievers and antibiotics. The following day, Lucy underwent a bandage change to clean the degloving wound and Dr. Alvarez checked the construction of the external fixator. This check after surgery is important to make sure the implant components continue to be strongly attached to each other.  After Lucy’s bandages were changed and Dr. Alvarez was satisfied his external implants were solid, she was allowed to go home.

Lucy’s guardians brought her back for several check-ups with Dr. Alvarez to monitor wound healing and to check how the external fixator was holding up. In April, Lucy underwent some wound debridement (the removal of damaged tissue from a wound) to help the healing continue, and the fixator was also removed.

Lucy, 3 months post operation, fully healed!

X-ray of Lucy’s healed fracture

By mid-May, Lucy was fully healed, and happily romping around her yard. It was recommended to her guardians that Lucy receive some rehabilitation work, either with BBVSH’s rehabilitation team, or with a team closer to their home.

Overall, Lucy took about four months to heal and get back on her feet.

 

 

Some last thoughts about small animal surgery from Dr. Alvarez

“Small animal surgery is very exciting for me,” says Dr. Alvarez. “I love that every day brings a new challenge and that sometimes we have to think outside the box to figure out how to help peoples’ pets. Through our emergency service we see a variety of patients with different needs. A large number of them consist of patients with fractures. At BBVSH, we have a team of board-certified surgeons and the equipment required to repair different types of fractures, including complex ones like Lucy’s. I feel lucky to be part of the BBVSH family alongside such knowledgeable teammates, and with the necessary array of tools readily available to help our furry friends.”

 

 

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