Howard is a 9 year old Patterdale Terrier. As a typical terrier, he is confident, outgoing and fearless. With the typically high pain threshold of a terrier, cars hold no fear for Howard and so when he was clipped by a car, the initial scream he let out subsided quickly and when he came into the surgery, he was even bearing weight on his left foreleg.
Despite wagging his tail, as I felt over his left foreleg, I could feel him tense up and I was suspicious that his injury was more significant than he was letting on.
Howard was admitted to the Maple Street Hospital and given pain relief.
A general anaesthetic was administered and some X rays were taken. The X rays confirmed that Howard had a fractured left forelimb.
Dog’s anatomy is similar to our own with 2 parallel bones (the radius and ulna) extending from the Elbow to the wrist or Carpus. Of the two bones, the Radius is the most important being the weight-bearing bone with the Ulna being less significant but allowing rotation of the lower part of the limb. Despite the limb feeling relatively stable, Howard had fractured both the radius and the Ulna.
After discussing with his owner, Howard was prepared for surgery and transferred to the High Sterility Operating Suite. I made a surgical incision over the fracture and carefully aligned the fractured Radius. At Donaldson’s, we keep a wide range of surgical implants in stock and so a 2.7mm plate and screws were selected as being the most appropriate implants to use. A slight bend was made in the plate to accommodate the natural curvature of the radius and the plate was attached with 4 screws above the fracture and 4 screws below. The plate I used has oval shaped holes machined into it and so, as the screws are tightened up and the screw heads sink into the holes within the plate, the bone on either side of the fracture moves to create compression at the fracture site. Compressing or squashing the two ends of the bone together helps to stimulate the natural healing process that will repair the fracture.
I had to take great care to make sure that none of the screws were too long as any screw tips that rubbed against the Ulna could cause a bony adhesion to form between the Radius and Ulna restricting future movement.
Post –op X rays confirmed that the aims of the surgery had been achieved but knowing that it might not be easy to rest Howard, we applied a thick support dressing to help to further stabilise the fracture.
Two weeks on and I am delighted to say that Howard is making good progress. Although the fracture will probably take about 3 months to heal completely, he now has the dressings off and is using the leg well. The biggest challenge remains controlling that terrier spirit and enforcing rest.