Broken bones take 6 – 8 weeks for sufficient healing to occur. During this time cells lay down bone between and around the fracture ends, so bones can only heal if this is allowed to happen. Your input at this stage is a vital contribution to the overall success of the treatment.
What factors delay bone healing?
1. movement and non-alignment of the fracture ends
2. infection
3. calcium deficiency
4. blood supply to the fracture
Let's look at these 4 factors more closely
MOVEMENT:
is what we are trying to prevent with:
a) internal supports such as plates, pins, wires & screws
b) external supports such as casts, splints, Kirschner apparatuses
No two fractures are the same – some can heal without treatment, while others can resist ALL attempts to fix them. By far the majorities need stabilising and heal well with it. Because no two fractures are the same, a method that works well for one fracture doesn’t necessarily work well for another.
Please remember, although the support applied is strong, it can never be as strong as the original bone. Often the bone is weakened after the fracture and can contain extensive “micro-fractures” which don’t show up on the x-ray or at surgery. This is where your input comes in. Boisterous pets should be kept confined (kennel or crate) or if necessary, sedated.
ALIGNMENT
Alignment is how well the fracture ends come together and how accurately the bone is held in its original position for healing. If alignment is not good it usually leaves spaces that must be filled with bone before healing. This will obviously take longer to heal, and be dependent on the stabilising device for longer.
INFECTION
Infection is a major problem in bone healing and MUST be carefully handled if present. It is most commonly encountered when the bone has penetrated the skin (a COMPOUND fracture) at the time of the accident.
CALCIUM
Calcium deficiency most commonly occurs with young, growing pets where the demand for calcium is the highest. Fractures associated with this are quite delicate because ALL the bone is weak and the anchor for any stabilising device depends on this bone holding the weight.
BLOOD SUPPLY:
Poor blood supply to the fracture is associated with old age as well as particular areas of the body such as the tibia in its lower third. Young pets have particularly good blood supply in their bones (due to growth) and these bones can sometimes heal in as little as 10 days!
Obviously, the day you take your pet home, the fracture has not been healed and in most cases will need around 2 months of rehabilitation and managing.
Management after fracture fixation:
Please keep your pet strictly rested for 2 weeks. This can be followed with gentle lead WALKING for a further 2 weeks. Note that exercise restriction is important until healing is complete. Revisits are advisable at regular intervals to ensure that problems are picked up early (every 2 weeks may be advisable). You should contact us especially if your pets’ condition worsens at any point i.e. should your pet stop eating or if a steadily improving fracture becomes suddenly painful again.
Should internal fixation devices be removed?
- Wires are mostly left in.
- Pins are mostly removed at about 8 weeks.
- Plates and screws are best removed after 4-6 months, however they are often left in.
- Kirschner apparatuses are removed in 6-8 weeks.
X-rays are usually employed prior to removal to ensure that healing has been sufficient.
One anesthetic is required to perform both these procedures. Please enquire about the cost of these procedures.
