Research article · 2025 · Full text
International Journal of Veterinary Sciences and Animal HusbandryA open reduction and intramedullary pinning for diaphyseal femoral fracture stabilization in a canine patient
Volume 10(1) · Pages 70–72 · DOI: 10.22271/veterinary.2025.v10.i1b.1994 ↗
Research areasBone fractures and treatmentsOrthopedic Surgery and RehabilitationOrthopedic Infections and Treatments
Abstract
Author-writtenA two-year-old, non-descript male dog presented to the Small Animal Orthopedics Unit at the Veterinary University Peripheral Teaching Hospital with non-weight-bearing lameness in the left hind limb. Clinical examination revealed pain, swelling, and crepitus in the left thigh, with radiographic imaging in lateral and craniocaudal views confirming an unstable diaphyseal femoral fracture. Hematological evaluation showed values within normal ranges, indicating suitability for surgical intervention via open reduction and internal fixation (ORIF). Preoperative planning, using the AO/ASIF small animal planning guide, enabled precise alignment. The surgical site on the left lateral thigh was aseptically prepared and incised, allowing realignment and stabilization of the proximal and distal fracture fragments using an intramedullary pin (IMP), trimmed to fit the site. A hand drill facilitated accurate positioning of the IMP. Wound closure was completed with a simple continuous subcutaneous suture using 1/0 polyglycolic acid (PGA) and a simple interrupted pattern for skin suturing. Postoperative radiographs confirmed satisfactory alignment and stabilization, providing an optimal environment for bone healing and functional recovery.
Summary
Source-checkedPlain-language reading of the full paper, prepared with AI and checked against the text. Each point links to the authors' own words.
Why it matters
- Femur fractures frequently occur in animals of various ages, with automobile accidents being a common cause. View evidence ↗
- Intramedullary pinning is considered an effective treatment for these fractures because it is cost-effective, accessible, and acts as an internal splint. View evidence ↗
- This pinning method helps maintain the bone's axial alignment, shares the load, and resists bending forces. View evidence ↗
The question
- The study aimed to stabilize an unstable diaphyseal femoral fracture in a two-year-old male dog presenting with non-weight-bearing lameness. View evidence ↗
What they did
- Diagnosis was confirmed through clinical examination showing pain, swelling, and crepitus, and radiographic imaging in lateral and craniocaudal views. View evidence ↗
- The procedure involved an aseptic incision on the left lateral thigh to realign and stabilize fracture fragments using a trimmed intramedullary pin. View evidence ↗
- A 3.5 mm intramedullary pin was inserted via a normograde approach through the trochanteric fossa. View evidence ↗
- Closure was performed using 1-0 polyglycolic acid for muscle and fascia lata and 2-0 polyamide for the skin. View evidence ↗
- Post-operative care included ceftriaxone (20mg/kg) for 7 days and meloxicam (0.2 mg/kg) for 5 days. View evidence ↗
What they found
- Postoperative radiographs showed satisfactory stabilization and alignment of the bone. View evidence ↗
- Periosteal callus formation began in the second week and became dense by the fifth week. View evidence ↗
- The intramedullary pin was removed once radiographic evidence confirmed complete healing of the fracture. View evidence ↗
What it means
- The authors conclude that intramedullary pinning for femur fractures is economical, provides stability, and results in minimal complications. View evidence ↗
- The authors state that the method provided proper rigid fixation and good alignment of the fractured bone. View evidence ↗
Visual summary
1 visualsIllustrations explain the paper; they do not show study data.
Normograde Pinning Concept
AI-generated conceptual illustration (canine femur). It explains the idea and does not show study data.
View source evidence ↗Figures & tables
From the original paper
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Figure 6Introduction
Femur fractures are common in both young and adult animals, often resulting from automobile accidents. Most fractures occur in the diaphysis or metaphysis of the femur, while physeal fractures are more frequent in young animals due to the vulnerability of their growth plates. Most femur fractures are closed fractures because the femur is surroundedby thick muscle layers that help prevent the bone from breaking through the skin. The intramedullary pinning methodis an effective treatment for femur fractures because it isreadily available, costeffective, and functions as an internal splint within the medullary canal of the long bone. It shares the load with the bone, maintains axial alignment of the fracture, and resists bending forces from all directions applied to the bone.
Case History and Observations
A two-year old male non descriptive dog was presented with the history of non-weight bearing lameness in the left forelimb. The animal elicited pain on palpation of midshaft femur and crepitation noticed. Radiograph revealed unstable midshaft diaphyseal fracture Surgical Operation Anaesthetic protocol: Animal was premedicated with Butorphanol @ 0.2 mg/kg, Ketamine @ 5mg/kg and Diazepam @ 0.25 mg/kg and induction was done using Propofol at the dose rate of 3mg/kg and intubated with 6mm size cuffed endotracheal tube. Maintenance was done with Isoflurane. Surgical Procedure: The animal was placed on the right lateral recumbency. Lateral aspect of left thigh region was shaved and surgical site was cleaned with chlorhexidine and disinfected with 95% ethyl alcohol and povidone iodine. Entire body was covered with surgical drape except surgical site (Figure 1).
A 10 cm incision was made from the greater trochanter to the level of the patella. The underlying subcutaneous tissue and fascia lata were dissected, and the vastus lateralis and biceps femoris muscles were separated using blunt dissection. The fracture site was identified, and the proximal and distal fragments were aligned correctly (Figure 2). A 3.5 mm intramedullary pin was then inserted through the trochanteric fossa using a Normograde approach (Figure 3). Intramedullary pin occupies 60-70% of the medullary canal. Excess pin was trimmed by pin cutter. Muscle and fascia lata were closed using polyglycolicacid 1-0 by continuous suture pattern (Figure 4) and the skin was closed using polyamide 2-0 by cross mattress (Figure 5). Dressing was done on the surgical site. Post Operative Care: Post-operative radiography was done (Figure 6). Post-operative care was done by using antibiotics (ceftriaxone @ 20mg/kg) for 7 days and analgesic (meloxicam@ 0.2 mg/kg) for 5 days. Surgical site was cleaned with antiseptic solution. Exercise was limited for 3-4 weeks in dog. Sutures were removed after 14 days.
Discussion
Uddin et al. (2017) [6] reported that the femur fracture was occurred frequently by trauma (50%), road accident (40%), and jumping from top places (10%). Beale et al. (2004) [2] stated that proximal or distal physis fractures are more common in immature dogs and Metaphyseal and diaphyseal fractures are more common in mature animals. Normograde placement is mostly preferred method for pinning because it is easier to locate the pin in a more lateral position, close to the greater trochanter and away from the femoral head. If pin diameter is less, it will cause non-union and delayed union of fractured bone. Intramedullary pin migration in diaphyseal fractures causes fragmentation in the fracture (Libardoni et al., 2016) [4] . In this case, gradual periosteal callus formation occurred in second weeks, it getting dense at the 5th week.
Intramedullary pin was removed after complete fracture healing, it was confirmed by radiography.
Conclusion
The study revealed that the use of intramedullary pinningin femur fracture is more economical and it gives more stability with minimal complications. So intramedullary pinning gave good alignment and proper rigid fixation of the fractured bone
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References
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