<div>Background: Intramedullary pinning (IMP) is the most commonly used internal skeletal fixation technique. Threaded pins (also called Schanz Screws) provide a comparatively better holding strength than non-threaded tipped intramedullary pins. The present study was planned to evaluate and compare the efficacy of positive and negative profile end threaded intramedullary pins in the management of long bone fractures in dogs.&nbsp; 
 
Methods: Eleven clients owned dog suffering from fracture of long bones were randomly divided in to two groups. Animals of group I (n=5) and group II (n=6) were treated with end threaded positive and negative profile intra medullary pin, respectively. The intramedullary pinning was done using 3 to 5.5 mm diameter pins under general anesthesia, the time taken for surgery, size of end threaded intramedullary pin used in each case was noted down. Radiographs were taken preoperatively, immediately after fixation and then at regular intervals till signs of radiographic healing were evident.&nbsp; 
 
Result: There was no significant difference between the two groups in terms of time taken for fixation/surgery and in healing time, with a gradual improvement in weight bearing postoperatively in both the groups. There was mild periosteal callus formation in all the cases when observed radiographically and the pins were removed after radiographic healing was evident in an anticlockwise manner using Jacob&rsquo;s chuck and key, under mild sedation. There was no complication like implant failure or pin tract sepsis or pin migration or pin breakage in any of the cases of two groups. However, passing the positive profile end threaded intramedullary pin in distal fragment is comparatively smoother and easier as compared to negative profile end threaded intra medullary pin.</div>

Evaluation of End-threaded Positive and Negative Profile Intramedullary Pins for Management of Long Bone Fractures in Dogs

<div>Background: Femur fractures are common in immature dogs. As compared to stainless steel, titanium implants are lighter and allow controlled micro-motion at the site of fracture that stimulates early callus formation by limiting stress shielding. Cited literature reports successful clinical use of titanium elastic nails for the stabilization of long bone fractures in young human patients; however, there is paucity of information on this technique is dogs. This study was planned with an objective to compare titanium elastic nails (TENS) and single end-threaded pin for the management of femoral fractures in young dogs. 
 
Methods: The study included 20 clinical cases (10 male and 10 female) of dogs suffering from distal femoral fracture with a mean&plusmn;SD age of 5.70&plusmn;5.60 month, body weight 11.09&plusmn;4.48 kg since 3.05&plusmn;2.35 days. The cases were divided into 2 groups; using TENS (n=10; group 1) and stainless steel end-threaded intramedullary pin (n=10; group 2).&nbsp; 
 
Result: Group 1 dogs demonstrated better fracture reduction score, early and uniform callus and better implant stability as compared to group 2, radiographically. Early weight bearing and minimum postoperative complications with better functional outcome including joint mobility was reported in group 1. In conclusions, TENS is superior fracture fixation technique for the repair of supracondylar or distal third femur fractures in young dogs with better functional outcome, minimal stiffness of stifle joint and early weight bearing, in comparison to single end threaded intramedullary pin.</div>

Comparison of Titanium Elastic Nailing and End-threaded Intramedullary Pinning for Distal Femoral Fractures in Young Dogs

Background: The use of synthetic bone substitute,b-tricalcium phosphate (&beta;-TCP) as an osteo-conductive material and platelet-rich plasma (PRP) as an osteo-inductive material is the alternate strategies for replenishing bone loss. Thus, the present study was conducted to evaluate the bone healing efficacy of &beta;-TCP and PRP combination in dogs with long bone fracture repaired with threaded intramedullary pinning. 
 
Methods: Fifteen dogs were selected, which were allotted to two groups irrespective of age, breed and sex. In six dogs of Group I intramedullary pinning was performed, while in nine dogs of Group II &beta;-TCP and PRP was applied at fracture site after stabilising with intramedullary pin. Clinical and radiographic examinations were conducted preoperatively and postoperatively on 15th, 30th and 60th day. 
 
Result: The mean weight bearing and radiographic union scores were better in group II animals as compared to group I at different time intervals. The present findings suggest that &beta;-TCP and PRP effectively enhances the bone healing in dogs with long bone fracture.

Evaluation of &beta;-tricalcium Phosphate (&beta;-TCP) and Platelet Rich Plasma (PRP) Combination for Fracture Healing in Dogs Stabilized with Intramedullary Pinning

<div>Background: The metallic ESF systems are not easily available in the field and have fixed frames leading to less versatility in size and direction. Free forms of external skeletal fixators (acrylic and epoxy-pin) have advantages as they can be customized. Both acrylic and epoxy-pin ESF systems have been evaluated biomechanically in earlier studies; in the present study both are compared clinically. 
 
Methods: Twenty four dogs presented with 27 fractures of long bones, were randomly divided into 4 groups, according to the bones involved, group A was divided into A-I (radius-ulna) and A-II (tibia-fibula) sub-groups and group B was divided into B-I (radius-ulna) and B-II (tibia-fibula) sub-groups. 
 
Result: The mean&plusmn;SE fracture healing time in animals was 48.85&plusmn;2.56 days with no significant difference between two groups.The early presented cases and the ones with less soft tissue trauma showed better gait scores during the follow up period. Both acrylic and epoxy-pin fixators provided stable fixation and the technique can be practiced at field conditions with minimal facilities. Epoxy-pin ESF owing to better handling characteristics of epoxy resin is easier to construct than the acrylic ESF.</div>

<div>Acrylic and Epoxy-pin External Skeletal Fixation Systems for Fracture Management in Dogs</div>

<div>Background: Elastic stable intramedullary nailing has become a widely accepted, standard surgical technique for the repair of long bone diaphyseal fractures in children and adolescents however, references for its use in veterinary practice are still rare.&nbsp; 
 
Methods: The present study was conducted on ten clinical cases, selected randomly irrespective of their age, sex and breeds; diagnosed with long bone diaphyseal fractures. Titanium elastic intramedullary nailing was performed in all the cases. Clinical, orthopaedic and radiographic examinations were performed pre-operatively, just after surgery and at 15th, 30th and 60th post-operative days.&nbsp; 
 
Result: There was an increase in the mean weight bearing score during standing and walking from 0th day to 60th post-operative day. Post-operative radiographic examinations revealed increase in the mean values of bone formation score and bone union scores. The nails were removed easily in all the cases on 60th post-operative day. Five cases had complications; delayed wound healing (n=1) and slight nail migration from insertion site (n=4) which were managed conservatively and by cutting the extra lengths of the migrated nails. The clinical outcome on the basis of functional limb usage was excellent in seven cases, good in two cases and fair in one case. Overall, titanium elastic stable intramedullary nailing had good efficacy with respect to weight bearing in dogs without any systemic adverse effect.</div>

Titanium Elastic Stable Intramedullary Nailing for the Repair of Long Bone Fractures in Dogs

<div>Background: Fracture repair is one of most common procedure carried out by veterinary clinicians. Fracture healing most of the time associated with delayed union, non-union and mal-uinon. Therefore, the objective of this study was to evaluate the clinical, haemato-biochemical and radiological outcome in patients after implantation of &beta;-tricalcium phosphate as a bone graft substitute to promote the fracture healing. 
 
Methods: Eight clinical cases brought to the clinics with femur fracture were divided into two groups viz. A and B, with four animals in each group. Femur fractures were stabilized with intramedullary pinning and &beta;-TCP biomaterial and intramedullary pinning and &beta;-TCP plus autologous bone marrow aspirate (BMA) composite in group A and B respectively. The efficacy of fixation was studied on the basis of clinical evaluation, haemato-biochemical and radiographical parameters on day 0 and on 7th, 15th, 30th, 45th and 60th post-operative day.&nbsp; 
 
Result: Excellent weight bearing was noticed in group B. The overall functional outcome in group B was better in comparison to group A animals. Haematological parameters viz. haemoglobin, packed cell volume, total leukocyte count and differential leukocyte count did not differ significantly within and between the groups. The biochemical parameters viz. serum calcium increased significantly (P&lt;0.05) on 7th and 15th post-operative day. A significant reduction in serum alkaline phosphatase level observed on successive post-operative days in both groups. Radiographs of fractures treated in both the groups showed good reduction and fracture fixation, early signs of fracture healing in group B than group A animals. The size of callus formation was more in group A than group B. No any graft related complications observed during the study period. The &beta;-tricalcium phosphate facilitated fracture healing and early ambulation of affected limb.</div>

<div>Evaluation of &beta;-Tricalcium Phosphate Biomaterial in Femur Fracture Repair in Dogs</div>

<div>Background: External skeletal fixator (ESF) has been recommended as biological method to stabilize open fracture as it does not involves the wound site, besides protecting adjacent soft tissue structures. Considering the advantages of ESF, this study was envisaged with an objective to study the outcome of open fractures of radius-ulna and tibia-fibula stabilized with linear ESF in dogs. 
 
Methods: This study included 17 dogs suffering from open long bone fractures of radius-ulna and tibia-fibula, divided into three groups; linear ESF type I or II (group I, n=8) and type III (group II, n=3). In group III (n=6), open fractures were initially treated using conservative methods i.e management of open wound till complete healing followed by delayed internal fixation using intramedullary pin or bone plating. 
 
Result: Majority of the open fractures of radius-ulna and tibia-fibula were transverse (64.71%), involving distal third diaphysis (47.06%) in heavy weight (54.55%), 1-3 year old (64.71%), non-descript (35.29%), male (88.23%) dogs due to automobile accidents (58.82%). Neutrophilic (81.47&plusmn;4.45%) leukocytosis (24610&plusmn;2461.88 per cumm) and elevated levels of alkaline phosphatase and creatine kinase were observed. Staphylococcus spp. was the common isolated bacteria sensitive to Gentamicin, Cefotaxime, Tobramycin, Amikacin and Neomycin. High per cent fractures (83.33%) in group III had acceptable functional outcome as compared to fractures treated with linear ESF (55.55%) in groups I and II. Osteomyelitis due to pin tract infections was the major complication (8/11; 72.7%) recorded in ESF groups (Group I and II) that lead to delayed and/or nonunion. Weight bearing score improved markedly after removal of the ESF frame. In conclusions, immediate fixation of the long bone fracture using linear ESF in the presence of open contaminated / infected wounds leads to unacceptable outcome. Poor animal compliance, pin tract discharge, osteomyelitis, delayed union and nonunion are major complications associated with linear ESF. Conservative management of the open fracture wound using standard treatment for 2-3 weeks till complete wound healing followed by internal fixation with intramedullary pin or bone plate is recommended for open long bone fractures in dogs.</div>

<div>Outcome of Open Long Bone Fractures in Dogs Stabilized with Linear External Skeletal Fixator</div>

Background: Fractures in domestic carnivores are frequently seen in veterinary medicine in the world and are mostly due to impacts inflicted by car injury, trauma, or falls. Fracture type and pattern influence treatment choice.&nbsp; No data are available on long bone fracture in Algiers to provide young veterinarians in developing countries with information on these fractures and their practical treatment options. 
&nbsp; 
Methods: Cases of long bone fractures were identified from files of patients presented for surgical consultation at the Surgical Department of the Higher National Veterinary School of Algiers. Characteristics, such as age, sex, circumstances and fracture classification were analysed. The type of selected treatment was also noted, as was the follow-up, when possible. 
&nbsp; 
Result: A total number of 66 fractures was recorded. Cats were more affected than dogs representing 70.7% versus 29,3% of the animals showing limb fractures (n=58). The proportions of males and females were respectively 65.9% and 34.1% in cats and 70.6% and 29.4% in dogs. Young animals under 12 months of age represented 82,9% of cats and 64.7% of dogs. Fall from a height was the primary cause in both cats and dogs (51.2% and 58.8%). Fracture of the femur was the most common fracture (51.1% in cats and 47.4% in dogs). Femoral fractures in cats were present on the proximal bone end in over 50 percent of cases. Among these, Eighty-three percent affected the head and/or neck of the bone. Most fractures were closed. Open fractures (23.4% in cats and 5.3% in dogs) affected the lower bones.&nbsp; Animals were treated by pinning, femoral head ostectomy, casting and, amputation (on open fractures of grade II and III). Assessing clinical outcome revealed that recovery in animals having undergone intramedullary pinning or cross pinning and femoral head ostectomy was estimate good in 96,43% of cases in cats and 77.78% in dogs. 
&nbsp; 
&nbsp;

Long Bone Fractures in Cats and Dogs: Characteristics and Available Treatment in Algiers: A Retrospective Study of 66 Fractures

<div>Background: Fracture is one of the common problems encountered in dogs. Fracture healing most of the times results into complications like delayed union, mal-union and non-union. To deal with these complications bone grafting is an important technique lying with clinicians. 
 
Methods: The present study was conducted on 14 clinical cases of dogs with femur fracture. After preliminary examination the dogs were randomly divided into two groups. In group A (n=8) fractures were managed by intramedullary pinning and in group B (n=6), fractures were managed by IM pinning and demineralised bone matrix (DBM) xenograft implantation at the fracture site. The efficacy of the treatment was assessed on the basis of clinical, hemato-biochemical and radiographic observation on day 0 and on 7th, 15th, 30th, 45th and 60th post-operative days.&nbsp; 
 
Result: The pain, lameness and weight bearing scores on the affected limb showed non-significant (P&gt;0.05) variations between the two groups on different post-operative intervals. The hematological parameters also varied non-significantly (P&gt;0.05) between the two groups. A significant (P&lt;0.05) increase in the serum alkaline phosphatase values was observed upto 30th post-operative day in group B animals as compared to group A animals and thereafter it gradually decreases and return to normal level on 60th post-operative day in both the groups. Radiographic scores were better in group B dogs. Early radiographic signs of fracture healing were observed in group B dogs than group A dogs. No any graft related complications were observed during the study.</div>

<div>&nbsp;</div>

Clinical Evaluation Osteogenic Properties of Demineralised Bone Matrix (DBM) Xenograft in Femur Fracture in Dogs

<div>Background: Fracture of long bones is a common orthopaedic condition noticed in dogs and its primary goal is to completely restore the function of the injured limb as early as possible. Osteo-conductivity of hydroxyapatite can be improved further by decreasing the particle size to nanometre range and incorporation of inorganic materials in hydroxyapatite can enhance osteoblast cell material interactions. Strontium, Zinc, Silver and Fluorine are known to play an important role in the bone formation and also affect bone material characteristics such as crystallinity, degradation behaviour and mechanical properties. When doped with plasma spray nanohydroxyapatite, these multi-ions cause no harm to the physical environment during the degradation process of hydroxyapatite as these are nontoxic and play significant role in bone metabolism, growth and nourishment. Bone markers have tremendous potential as a rapid and sensitive method for assessing the response of the skeleton to medical or surgical interventions providing valuable information regarding bone turn over in animals. Hence, the current study was undertaken to evaluate the potential of multi-ion doped nano-hydroxyapatite coated intramedullary titanium implants in long bone fracture repair in dogs compared to the conventional intramedullary titanium implants through radiographical studies and evaluation of bone markers.&nbsp; 
 
Methods: Radiographical evaluation, Sandwich ELISA kits developed by Bioassay technology laboratory. 
 
Result: Plasma spray nano-hydroxyapatite coated titanium intramedullary implants have shown excellent osteo-conductivity when doped with multi-ions of Strontium, Zinc, Silver and Fluorine facilitating rapid osteoblastic activity and rapid bone turnover at the fracture site and complete fracture healing by 3rd week post-operatively as evidenced by radiographic scores and a peak BALP (Canine Bone Alkaline Phosphatase) values and early limb usage. Bone reabsorption and bone tissue remodelling due to osteoclastic action at the fracture site was quicker when the multi-ion doped nano-hydroxyapatite coated titanium intramedullary implants were used which is evidenced by the radiographic scores and highest CTX (Canine C-telopeptide of Type 1 Collagen) values indicating completion of fracture healing and near completion of bone tissue remodelling by 9th post-operative week in long bone fracture repair in dogs.</div>

​Efficacy of Multi-ion Doped Plasma Spray Nano-hydroxyapatite Coated Titanium Implants in Long Bone Fracture Repair in Dogs- Radiographical and Bone Markers Evaluation

Evaluation of End-threaded Positive and Negative Profile Intramedullary Pins for Management of Long Bone Fractures in Dogs

Comparison of Titanium Elastic Nailing and End-threaded Intramedullary Pinning for Distal Femoral Fractures in Young Dogs

Evaluation of β-tricalcium Phosphate (β-TCP) and Platelet Rich Plasma (PRP) Combination for Fracture Healing in Dogs Stabilized with Intramedullary Pinning

Acrylic and Epoxy-pin External Skeletal Fixation Systems for Fracture Management in Dogs

Titanium Elastic Stable Intramedullary Nailing for the Repair of Long Bone Fractures in Dogs

Evaluation of β-Tricalcium Phosphate Biomaterial in Femur Fracture Repair in Dogs

Outcome of Open Long Bone Fractures in Dogs Stabilized with Linear External Skeletal Fixator

Long Bone Fractures in Cats and Dogs: Characteristics and Available Treatment in Algiers: A Retrospective Study of 66 Fractures

Clinical Evaluation Osteogenic Properties of Demineralised Bone Matrix (DBM) Xenograft in Femur Fracture in Dogs

Efficacy of Multi-ion Doped Plasma Spray Nano-hydroxyapatite Coated Titanium Implants in Long Bone Fracture Repair in Dogs- Radiographical and Bone Markers Evaluation