Submitted by

A.PRAKASH
BVN 03038
FINALBVSC
 Based on
2. Presence of communicating external
wound.(open & closed)
3. Extent of damage( complete ,
greenstick,fissure fracture)
4. Direction and location of fracture
(transverse, oblique, spiral,
communited, multiple, impacted,
avulsion, unicondylar, bicondylar
fracture.
5. Stable and unstable fracture.
 Tension

Fracture
Forces Bending

Shear

Rotation

Compression
SH EA R
Te ns ile an d com pres sive fo rce s
ac t pe rpen di cu lar or n or mal to a
struc ture' s surf ac e
 Principles of Internal
Fixation
 The Goals of fracture repair are

 Promote/enhance/allow bone healing

 Atraumatic technique
 Good reduction/alignment
 Stable fixation
 Early return to full function******
 Principles of Internal
Fixation

 Open reduction
 Surgical exposure of the fracture site for
fixation
 Fixation is usually internal

 Closed reduction
 Fracture site is not opened
 External fixation (casts, splints, etc.)
 Becoming more popular with advanced
imaging
 Principles of Internal
Fixation
 Advantages of internal fixation
 Rigid fixation usually
 Allows weight bearing during healing
 Health of the limb and joints
 Increases the circulation

 Promotes healing

 Hidden implants
 No extensive care
 Principles of Internal
Fixation
 Disadvantages of internal fixation

 Invasive
 Potential to slow healing
 Infection
 Longer procedure
 Higher cost
 Principles of Internal
Fixation
 Factors affecting fracture repair
 Type of fracture (simple/comminuted)
 Anatomical area
 Articular
 Which limb

 Where on the bone

 Extent of soft-tissue damage

 Duration of fracture
 Principles of Internal
Fixation
 Factures affecting fracture repair

 Animal’s age, weight and temperament

 Owner’s finances
 Available aftercare
 Equipment available
 Surgeon’s experience
Plates come in
a wide variety
of shapes and
sizes
 Screws
 Cortical Screws
 More threads, low
pitch, less thread
depth
 Only fully
threaded
 Used for cortical
bone
 Cancellous
Screws
 Less threads,
steep pitch, wide
thread
 Fully and partially
 Screws

 Used to secure bone plates to bone

 Used as primary means of fracture
repair
 Used to hold fracture fragments in
place
 Used to compress fracture fragments
 Used to form prosthetic ligaments
 Screws
 Lag principle

 Used to compress fracture fragments

 Used to hold plates on bone
 Threads only engage far cortex
 (Or they don’t engage the plate)
 Can be accomplished with
 Partially threaded screw
 Over drilling near cortex

 Articular fractures

 Sacroiliac luxations
 Bone Plates
 Bone plates and screws offer
versatile method of fracture of
stabilization.
 Necessary for many fractures.
 Requires specialized equipment and
training.
 Not readily available in many
practices.
 More expensive than pinning.
 Plates
 Plate placement

 Reconstruct the bone

 Contour plate
 Drill, measure, and tap screw holes (one
by one)
 Apply screws from the fracture site out,
alternating bone fragments
 Engage at least six cortices per a major
bone fragment
 More for comminuted fractures if possible
 Bone Plates

 Counteract

 Tension
 Compression
 Shear
 Bending
 Rotational forces
Bone plates should be placed on the
tension side of the bone
 Tension side of the bone

 Femur  Radius
 Craniolateral  Cranial
 Tibia*  Ulna*
 Craniolateral  Caudal
 Humerus  Mandible*
 Craniolateral  dorsal

Some are not plated on the tension side

due to impracticality and added difficulty
 Compression

 Mechanical
compression added to
the fracture site.
 The weight-bearing
load is shared by both
the plate and the bone.
 Primary bone healing
usually results.
 Plate is applied
eccentrically.
 Neutralization
 Plate protects primary
repair from weight-bearing
forces
 The weight-bearing load is
shared by both the plate
and the bone
 Stabilize with series of lag
screws and cerclege wires.
 Numer of cortices is allowed
is six.
 Buttress
 Spans a gap to prevent
collapse of a fracture
 All of the weight-
bearing forces are
transmitted through
the plate
 Minimum of cortices
applied is 8.
 For optimal strength
use broad plate and
stacked vcp plates..
 Plates
 Dynamic compression plates

 Allows compression of major bone

fragments
 External compression

 Screws must be LOADED in order to get

compression
(eccentric placement in screw hole)
 Plate can function in compression,
neutralization, and as a buttress plate
depending on how the screws are
applied
1) Load Drill Guide: Provides 1 mm
compression, screws are placed eccentrically

2) Neutral Drill Guide: Places the drill hole

centrally, thus little displacement is provided.
 Removing Implants

 In general, it is recommended that

all orthopedic implants be removed

 In practice, however, we rarely

remove orthopedic implants
 Removing Implants

 Why don’t we remove them

 Cost
 Post-op confinement required
 Traumatic surgery
 Anesthesia risk
 Potential for refracture
 Removing Implants

 When to recommend removal

 Interferes with function

 Loosening or breakage
 Infection
 Thermal conduction
 Biological reaction to implants
 Young dogs?????
 AGE Post operative time for
Plate removal
1. Under 3 months 4 weeks
2. 3-6 months 2-3 months
3. 6-12 months 3-5 months
4. Over 1 year 5-14 months
 Removing Implants

 Radiographs should document

healing prior to removal
 Unless implant failure
 Warn owners about potential for
bone breakage
 Cage rest required after plate removal
 Good idea to culture implants
Plating is superior over other method

 IM pins are cheaper than plates and

interfere with blood supply less
 Little equipment is required for pin
placement
 IM pins can migrate, especially if
motion is present
 IM pins are not ideal for comminuted
or transverse fractures
 Advantages of one over another
 Interlocking nails counteract all
fracture forces and may do it better
than plates

 Interlocking nails do require a lot of

equipment and some expertise to
place them, but are cheaper than
plates

 Interlocking nails are limited by the

 Plating advantage
 Plates counteract all fracture forces
 Plates are versatile and can be
applied to many fracture types and
animal sizes
 Plating requires some expertise and
expensive equipment
 Plating requires an aggressive
surgical approach in most instances
 Plates may interfere with blood
supply more than any of the other
 Advantages of one over another

 Open approaches can delay fracture

healing and predispose to infection
 Plates/screws
 Interlocking nails

 Closed approaches can be used with

 IM pins
 External fixator
 Interlocking nails require a limited
approach