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MODERN TREATMENT OF LONG TONE FRACTURES IN DOGS
(Based on literature data)
G‘
aniyev S.Sh.
"
Student of the Tashkent Branch of Samarkand State University of Veterinary
Medicine, Animal Husbandry and Biotechnology."
Normamatov R.Q.
"Assistant at the Tashkent Branch of Samarkand State University of Veterinary
Medicine, Animal Husbandry and Biotechnology."
Abstract
. The study of bone fractures in dogs due to various causes, their
correction with various surgical methods, the study of differences in the time of bone
healing in dogs of different ages, the preparation of dogs before surgery and the care
of dogs after surgery, the analysis of literature data and scientific research based on
them were conducted. Experimental, comparative, microscopic, surgical
examination methods were widely used in this. Based on the data obtained, new
methods were used to organize modern measures for the treatment of the disease.
Keywords
:
osteosynthesis,
conservative
rickets,
osteomalacia,
intramedullary osteosynthesis, extrafocal osteosynthesis, combined osteosynthesis,
fractures of flat bones, tubular bones: epiphyseal, diaphyseal, metaphyseal
.
Relevance of the topic.
Current
The number of pets is increasing every day,
and dogs occupy one of the first places among them. At the same time, new canine
centers are emerging, private veterinary services are developing further, and
medical institutions and clinics are opening. In the coming years, as a result of the
increase in the number of dogs in households, in order to reduce dog injuries, the
development of surgical infections and purulent diseases, it is necessary to
introduce surgical operations, blood transfusion methods, tissue therapy, the use of
laser and ultrasound devices, as well as polymer materials, and modern methods of
treatment. For this reason, the treatment of diseases of the musculoskeletal system
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of pets, including dogs, is a major problem for veterinarians, due to their anatomical
features.
Classification, etiology and pathogenesis of bone fractures
. Among non-
communicable diseases in dogs, traumatic bone injuries account for up to 52.1%.
In animals, mechanical injuries, mainly aggravated by fractures of tubular bones,
are recorded in 32.7
–
44.5%. Fractures of long tubular bones in dogs account for
32.8% of mechanical injuries in dogs. Closed fractures are observed in 92% of
cases in dogs and open fractures in 8%. Fractures are most often observed in the
metaphyseal part of the bone (56%). Metadiaphyseal fractures are observed in 32%,
and epiphyseal fractures in 12%. Long tubular bone fractures in dogs were
observed most often in the femur (50.7%), less often in the tibia (22.3%), in the
humerus (12.5%), and in the wrist and elbow bones (9.8%). Fractures of the palm
and finger bones are observed in 5% of cases. By the nature of the fracture,
completely closed diaphyseal and metaphyseal fractures often prevail. Fractures in
small breed dogs have a specific localization, that is, in them, the elbow and wrist
bones most often break in the 1/3 of the distal diaphyseal segment, and this
condition accounts for 84% of leg fractures. Classification of bone fractures Bone
fractures are considered to be partial or complete disruption of the anatomical
integrity of the bone and damage to the surrounding soft tissues as a result of any
impact. Bone fractures are congenital and acquired, traumatic, pathological
(spontaneous) by the time of occurrence. Bone fractures:
–
by the nature of the
fracture, open, closed and multiple, complete and partial fractures;
–
by location
–
fractures of flat bones and tubular bones;
–
according to anatomical description
–
epiphyseal, diaphyseal, metaphyseal, the epiphysis may be separated from the
diaphysis. There are the following types of partial fractures: - cracks (fractures)
–
penetrating, superficial, single and multiple; - fracture of a part of the bone without
separation; - comminuted fracture of the bone, observed mainly at the edges of the
bones; - fractures under the periosteum; - holes. Complete fractures: in direction
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they are transverse, oblique, longitudinal, spiral, serrated. According to the degree
of damage to the bone tissue
–
they are divided into blunt, fragmented, crushed,
torn, and bullet-like. Etiology of bone fractures
–
bone fractures often occur as a
result of various mechanical influences. Secondary causes include pathological and
physiological changes in bone tissue.
Closed fractures are accompanied by pain, impaired function of the legs,
deformity (change in shape), extra-articular movement of the bones, and bone
crepitus. In partial fractures, pain and impaired function are less pronounced. In
open fractures, bleeding, pain, soft tissue damage, and other symptoms are
observed. Bone fracture healing - the integrity of the broken bone is restored with
the formation of a bone graft. Clinical, radiological, hematological, biological,
histological, radiation, and other examination methods show significant changes in
the div after injuries. As a result, local and general changes occur, and the
biochemical metabolism of the blood is disturbed. In general, in fractures of tubular
bones, within 8-10 days, strong changes occur in the div as a whole and at the
fracture site. Clinical, biochemical, and histological changes are observed. After a
fracture and osteosynthesis, the animal's appetite decreases, its general temperature
increases, its pulse and breathing increase, and an inflammatory process develops
at the fracture site.
Treatment of tubular bone fractures in dogs by osteosynthesis
. Many
methods of treating bone fractures in dogs have been proposed worldwide,
including traditional (plaster langets) and operative (intramedullary and
supraosseous osteosynthesis, mono- and bilocal devices). However, despite this,
these treatment methods also have their own serious drawbacks. The use of
complex osteosynthesis does not provide reliable fixation of the short distal
segment of the bone. In addition, when osteosynthesis is performed in puppies,
peg-shaped pins damage the growth zones of the bone, and as a result, various
deformations and joint dysfunction develop. Closed intramedullary osteosynthesis
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provides less traumatic fixation of fractures and early loading of the affected limb
with div mass. In numerous closed fractures, the femur is first fixed, then the
tibia, pelvis or spine, and the stability of the forelimbs is ensured. In multiple
fractures of the hind limbs, for example, in the case of femoral fractures and in a
stable condition of the animal, an external fixator is placed on one limb, and the
other limb is closed intramedullary osteosynthesis is performed without drilling. In
cases of poor condition of the animals, an external fixator is placed first, and then
osteosynthesis is performed. In the case of transverse diaphyseal fractures of the
femur, intramedullary osteosynthesis with a fixator with anti-migratory (non-slip)
properties ensures reliable fusion of the bone fragments and rehabilitation of the
damaged limb.
One of the methods of surgical treatment of fractures of long tubular bones
is the Ilizarov interosseous osteosynthesis, widely recognized in world veterinary
medicine. It creates a mechanical-biological complex for good osteogenesis (low
trauma, accurate repositioning of bone fragments, rigid, stable and controlled
fixation, maximum preservation of osteogenic tissue and vessels in the lesion site).
Based on the above information, effective methods of treating dogs with tubular
bone fractures have been developed in order to prevent the development of
complications in the treatment of fractures and reduce recovery times. The
"retrograde" method of intramedullary osteosynthesis of broken femurs and
humerus in dogs with a steel pin (according to Bogdanova) into the bone canal and
the treatment of the forearm and shin bones with a steel plate are widely used in
practice. Because, according to the literature, treating bone fractures with these
methods ensures accurate repositioning of the broken bone and, as a result,
accelerates the process of bone healing.
Intramedullary osteosynthesis technique is performed in the following order:
Fixation and anesthesia: the sick animal is fixed in a supine position, with the
broken leg elevated. General and local anesthesia are used to perform this
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operation. For general anesthesia, 2.5% aminazine is injected into the dog's vein at
a rate of 1 ml/10 kg of div weight and an additional 2% ketamine at a rate of 0.1
mg/kg. 0.5% novocaine solution is injected along the incision line in an amount of
10
–
20 ml, separately into each layer. 14 Preparation of the surgical field: after the
animal is firmly fixed on the operating table, the area of the broken bone is cleaned
of hair. Then, according to the Grossix method, the surgical field is treated with
5% iodine solution twice, before and after anesthesia. Instruments: In addition to
the surgical instruments that are always used during this operation, special
instruments are used: a rasp, a drilling machine and drills of different diameters,
pins of different diameters and lengths made of stainless steel wire of different
thicknesses, and standard pins . a ) The process of installing a pin b) X-ray image
Figure 1. Installing a pin in a broken shoulder and femur in dogs Surgical
technique: an incision in the skin is made parallel to the broken bone and its length
is on average 10
–
15 cm, depending on the size of the animal. After cutting the skin
and subcutaneous tissue, the superficial and deep fascia are cut and the path to the
muscle layer is opened. Before cutting the muscle layer, blood flowing from the
blood vessels is stopped. Two methods can be used to cut the muscle layer - cutting
and layering. 15 In the first method, a direct cut is made to access the broken bone,
but blood vessels may be damaged, which requires measures to stop it. When using
the layered method, nerves and blood vessels are less damaged. However, it is more
difficult to remove the broken bone and to drain the fluid that formed after the
operation.
The operation mainly uses the incision method. After all the tissues are cut
down to the bone, the tissues attached to it are separated using a rasp. When the
periosteum is preserved, it is cut using a scalpel and separated from the bone with
a rasp. After that, the proximal part of the fractured bone is taken out, and if it is
difficult to remove it, hooks can be used. Based on the previously taken X-ray
image, a pin is selected whose dimensions correspond to the bone canal. In this
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case, it is necessary to ensure that the diameter of the pin passes freely through the
narrowest part of the bone marrow canal. Otherwise, the probability of a thick pin
breaking the bone is very high. A pin with a sharp tip is hammered into the bone
canal from the proximal third of the fractured bone using a hammer. After the pin
exits the lower end of the upper fractured bone, it is adjusted to the canal of the
lower fractured bone. That is, in this case, the anatomical integrity of the bone is
restored and the pin is hammered into the lower part from top to bottom up to the
distal epiphysis. The upper part of the pin is cut off, leaving 0.5 cm, and after the
formation of a package in the bone (this corresponds to approximately 20
–
25 days
in dogs), the pin is pulled out through the remaining part and removed. After
osteosynthesis of the broken bone, first a continuous suture is placed on the muscle
layer and then continuous knotted sutures are placed on the skin. After the wound
heals, the sutures on the skin are removed after 7
–
10 days.
The plate osteosynthesis technique is performed in the following order:
Fixation, anesthesia, and preparation of the surgical site are performed in the same
order as described above, and the surgical instruments used are the same, only
standard plates and screws are used instead of pins.
Surgical technique: the incision is made parallel to the fractured bone, the
length depends on the size of the animal, and is on average 10
–
15 cm. After the
skin and subcutaneous tissue are cut, the superficial and deep fascia are cut. After
that, the path to the muscle layer is opened. Before cutting the muscle layer, the
blood flowing from the blood vessels is stopped mechanically. After all the tissues
are cut down to the bone, if the periosteum is preserved, it is cut with a scalpel and
separated from the bone with a rasp. After that, the proximal and distal parts of the
fractured bone are combined, and a plate that matches the bone is placed. The
fractured part of the bone should coincide with the center of the plate. The ends of
the fractured bones are brought together. Using a parma machine, the bones are
pierced through the holes in the plate and screws are inserted into them, first the
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proximal part of the bone, then the distal part. After osteosynthesis of the fractured
bone, continuous sutures are first placed on the muscle layer and then continuous
knotted sutures are placed on the skin. After the wound heals, the sutures on the
skin are removed after 7
–
10 days. Once the bone graft is formed, another surgical
procedure is performed and the plate placed on the bone is removed.
Conclusion
. Today, long tubular bone fractures are very common among
dogs , and the reasons for this can be various mechanical injuries, accidents,
improper training of dogs, or many other reasons. As a result, dogs may not be able
to fully perform their duties or may remain disabled for the rest of their lives. When
dogs are injured with bone fractures, it is necessary to use quick and effective
treatment methods. Osteosynthesis is a clear example of this . This treatment
method ensures that the bones of dogs return to their original position in the shortest
possible time ( on average 35-40 days). We have widely used these methods in our
scientific work.
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