Haemato-biochemical variations during femoral fracture repair by using intramedullary pin and intramedullary horn pegs in dogs

Introduction

Femoral fractures constitute approximately 37-45% of long bone fractures in dogs, primarily affecting young males of non-descript and large breeds due to road traffic accidents. Diaphyseal fractures demand rigid internal fixation to restore limb function, with intramedullary pinning providing axial stability and biological alternatives like buffalo horn pegs offering semi-rigid support with enhanced biocompatibility. Pre-operative haematobiochemical profiles assess surgical fitness, while post-operative monitoring detects complications and healing progress. This study analysed changes in these parameters during femoral diaphyseal fracture repair using stainless steel pins versus buffalo horn peg in twelve clinical canine cases.

Materials and Methods

Twelve dogs with diaphyseal femoral fractures, were presented to the Veterinary College Hospital, Hebbal, Bengaluru. Irrespective of age, breed and gender, the dogs were randomly assigned to Group A (intramedullary Steinmann pin) and Group B (buffalo horn peg, prepared from compact horn sections, autoclaved). Blood was collected from cephalic/saphenous veins. Hematological parameters including total erythrocyte count (TEC, 10 6 cells/cmm), total leukocyte count (TLC, 10 3 cells/cmm), packed cell volume, hemoglobin (Hb, g/dL), and differential leukocyte count (DLC, %) were analyzed using the Mindray BC-2800 Vet automated hematology analyzer. Biochemical indices such as serum calcium (mg/dL), serum phosphorus (mg/dL), serum alanine aminotransferase (IU/L), serum alkaline phosphatase (IU/L) and serum creatinine (mg/dL) were evaluated using micro lab instruments RX-50 Biochemical semi-auto analyzer using diluent reagents as per the manufacturer guidelines. The resulting hematological and biochemical data were subjected to statistical evaluation through student t test with the computer-based statistical program GraphPad Prism.

Results and Discussion

Haematological Analysis 3.1.1 Total Erythrocyte Count (TEC, millions/cmm)

In Group A, the mean ± SE total erythrocyte count (TEC) was 6.25 ± 0.25 before surgery and ranged from 6.23 ± 0.35 to 6.42 ± 0.22 on post-operative days 0, 7, 15, 30, 45 and 60 with no significant change during the post-operative period (Table 1). In Group B, the pre-operative mean ± SE, TEC was 6.30 ± 0.26 and postoperative values ranged from 6.26 ± 0.18 to 6.62 ± 0.06 across the same time points, likewise showing no significant post-operative increase. Overall, there were no statistically significant differences between intervals throughout the study (p > 0.05), and all TEC values remained within normal physiological limits. These findings were in alignment with Gahlod (2007) [2] .

In Group A, mean hemoglobin prior to surgery was 12.18 ± 0.77 g/dL and post-operatively ranged from 12.12 ± 0.41 to 12.43 ± 0.51 g/dL across days 0, 7, 15, 30, 45 and 60; in Group B, mean pre-operative hemoglobin was 12.20 ± 0.28 g/dL and post-operative values ranged from 12.16 ± 0.11 to 13.02 ± 0.11 g/dL over the same time points (Table 1). No significant changes in mean hemoglobin were observed within either group during the post-operative period, and there were no statistically significant differences between intervals throughout the study (p > 0.05). All hemoglobin measurements remained within normal physiological limits. these findings were in agreement with Hansda et al. (2012) [3] .

Total Leucocyte Count (TLC, thousands/cmm)

In Group A, mean total leukocyte count (TLC) was 13.33 ± 1.94 ×10^3/µL pre-operatively and ranged from 12.10 ± 0.71 to 13.47 ± 0.87 ×10^3/µL on post-operative days 0, 7, 15, 30, 45 and 60; in Group B, pre-operative TLC was 13.72 ± 0.37 ×10^3/µL and post-operative values ranged from 12.70 to 13.62 ± 0.30 ×10^3/µL over the same time points. No significant changes in mean TLC were detected within either group during the post-operative period, and there were no statistically significant differences between intervals across the study (p > 0.05). All TLC measurements remained within normal physiological limits (Table 1). Similar observations were documented by Tembhurne et al. (2010).

In Group A, mean packed cell volume (PCV) was 37.65 ± 2.30% pre-operatively and ranged from 35.90 ± 2.20% to 37.60 ± 1.54% on post-operative days 0, 7, 15, 30, 45 and 60; in Group B, preoperative PCV was 38.70 ± 0.84% and post-operative values varied from 35.65 ± 0.26% to 40.30 ± 0.32% over the same time points. There were no statistically significant changes in mean PCV within or between groups throughout the study period (p > 0.05), and all PCV measurements remained within normal physiological limits (Table 1). Similar findings were reported by Chaurasia et al. (2019) [1] .

Group A had preoperative neutrophils 72.98 ± 2.00% (post-op 71.02-76.32%), Group B 78.67 ± 1.46% (post-op 75.16-84.16%) (Table 1). Lymphocytes averaged 20.22 ± 1.64% (A, post-op 17.90-19.22%) and 21.88 ± 0.72% (B, post-op 18.00-21.08%). Monocytes and eosinophils were comparable and stable (A, preop 4.77 ± 0.35%, 3.71 ± 0.11%; B preop 4.78 ± 0.24%, 3.01 ± 0.18%). No basophils were detected. Although Group B showed higher neutrophils, all differentials remained within normal limits and interval differences were not significant (p > 0.05) (Table 1). These findings were in accordance with Hansda et al. (2012) [3] .

In Group A, mean serum creatinine was 0.68 ± 0.05 mg/dL pre-operatively and ranged from 0.64 ± 0.02 to 0.69 ± 0.02 mg/dL on post-operative days 0, 7, 15, 30, 45 and 60; in Group B, pre-operative creatinine was 0.69 ± 0.04 mg/dL with post-operative values from 0.62 ± 0.01 to 0.67 ± 0.04 mg/dL over the same time points (Table 2). No statistically significant changes were observed between intervals during the study (p > 0.05), and all serum creatinine values remained within normal physiological limits.

In Group A, mean serum calcium was 9.95 ± 0.19 mg/dL pre-operatively and ranged from 9.89 ± 0.22 to 10.10 ± 0.18 mg/dL on post-operative days 0, 7, 15, 30, 45 and 60; in Group B, pre-operative mean was 9.78 ± 0.15 mg/dL with post-operative values varying from 9.69 ± 0.12 to 10.18 ± 0.27 mg/dL over the same time points (Table 2). Mean calcium decreased slightly until day 15 and then rose gradually, but interval differences were not statistically significant (p > 0.05). All measurements remained within normal physiological limits. Similar findings were reported by Rani et al. (2012) [7] .

In Group A, mean serum phosphorus was 5.03 ± 0.43 mg/dL pre-operatively and ranged from 5.01 ± 0.29 to 5.69 ± 0.19 mg/dL on post-operative days 0, 7, 15, 30, 45 and 60; in Group B, pre-operative mean was 5.12 ± 0.12 mg/dL with post-operative values between 5.15 ± 0.20 and 5.45 ± 0.27 mg/dL over the same time points (Table 2). A gradual increase in mean phosphorus was observed during the study, but differences between time intervals were not statistically significant (p > 0.05), and all values remained within normal physiological ranges. The findings were in concurrence with Prachasilpchai et al. (2003) [6] .

Serum Alanine Amino Transferase (IU/L)

In Group A, mean serum ALT was 24.62 ± 3.39 IU/L pre-operatively and ranged from 24.25 ± 2.08 to 25.65 ± 2.87 IU/L on post-operative days 0, 7, 15, 30, 45 and 60; in Group B, pre-operative mean ALT was 24.34 ± 4.15 IU/L with post-operative values between 24.41 ± 4.98 and 25.37 ± 3.39 IU/L over the same time points (Table 2). There were no statistically significant differences between intervals during the study (p > 0.05), and all ALT values remained within normal physiological limits. Similar findings were reported by Mahendra et al. (2007) [5] .

Serum Alkaline Phosphatase (IU/L)

In Group A, mean serum alkaline phosphatase (ALP) was 175.90 ± 11.07 IU/L pre-operatively and ranged from 176.28 ± 11.75 to 180.65 ± 6.99 IU/L on post-operative days 0, 7, 15, 30, 45 and 60; in Group B, pre-operative ALP was 174.35 ± 6.02 IU/L with post-operative values between 176.07 ± 3.50 and 180.53 ± 3.23 IU/L over the same time points (Table 2). There were no statistically significant differences between intervals during the study (p > 0.05), and all ALP values remained within normal physiological limits. The observed results were in agreement with Hegde et al. (2010) [4] .

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