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UC Davis Orthopedic Surgeons Repair Growth Plate Fracture in Puppy

October 4, 2016

Tilly was treated for a broken femur after falling off a utility vehicle on her family's ranch.

Tilly was treated for a broken femur after falling off a utility vehicle on her family's ranch.

"Case of the Month" - October 2016

Tilly, an 8-month-old female Australian cattle dog, loves to help her owners care for their Arabian horse ranch. She enjoys being around the horses, and especially likes her daily dips in the pond and riding with her family members on their utility vehicle. Recently while accompanying them on a feed, she attempted to jump off the vehicle and got her right leg stuck in the loop of the hand rail and fell to the ground. She immediately yelped loudly and started favoring her leg. Knowing she was hurt, the family rushed her to the UC Davis veterinary hospital.

Students, residents, and faculty veterinarians with the Orthopedic Surgery Service gave Tilly a physical examination and noticed she was markedly lame in her right hind leg, but had normal neurologic reflexes in that leg, as well as normal sensation. She was painful on manipulation of her hip.

X-rays of Tilly's hip revealed a Type I Salter Harris fracture of her right femoral neck, which is a lateral break across the entire growth plate near the head of the femur. Femoral fractures in this area can happen in juvenile dogs with minor trauma and can often be overlooked on traditional radiographs. These fractures have to be repaired within five days of the injury, otherwise severe bone remodeling can preclude an appropriate repair. The surgical repair—which is often performed with the aid of advanced intraoperative imaging—requires special care to local blood circulation to avoid later femoral head and neck necrosis. In dogs with chronic fractures, instead of primary repair, a total hip replacement or a femoral head and neck excision is performed.

Dr. Po-Yen Chou and others on the surgical team discussed several options, ultimately choosing to surgically approach the hip joint in order to reduce the fracture. The surgery was without complication, reducing the fracture and realigning the bone with pins. Post-operative radiographs showed an appropriate fixation, and surgeons expected Tilly’s break to heal without complication.

Tilly was hospitalized for one night after her surgery. She was placed on pain medications and received supportive care from the hospital technicians in order to keep her comfortable and to monitor her closely for any signs of post-operative or post-anesthetic complications.

Tilly was discharged with strict instructions to keep her activity restricted for six to eight weeks. She was not allowed to run or jump – a tough order for an active puppy. Tilly was confined to a crate at night and a small indoor area when supervised during the day.

“Trying to keep an energetic 8-month-old puppy occupied while on crate rest is as hard as it sounds,” said Laura, one of Tilly’s family members. “The crate confinement was definitely tough, but we knew we needed to follow Dr. Chou’s directions carefully to ensure the best possible outcome for Tilly.”

After four weeks of this restriction, Tilly’s leg showed tremendous improvement. She was able to increase her activity to several walks per day lasting five minutes each. 

At her five-week recheck examination, Tilly showed no lameness on her right hind leg. She had normal neurologic reflexes in the leg, as well as normal sensation. She no longer exhibited pain on manipulation of her hip, and her orthopedic surgeons were pleased with her recovery. Follow-up x-rays confirmed their notions, showing a complete healing of the fracture. Tilly was given the green light to slowly increase activities over the next four weeks leading toward a full return to normal activity.

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About the Veterinary Medical Teaching Hospital
The William R. Pritchard Veterinary Medical Teaching Hospital at the University of California, Davis—a unit of the #1 world ranked School of Veterinary Medicine—provides state-of-the-art clinical care while serving as the primary clinical teaching experience for DVM students and post graduate veterinarian residents. The VMTH treats more than 50,000 animals a year, ranging from cats and dogs to horses, cows and exotic species. To learn more about the VMTH, please go to www.vetmed.ucdavis.edu/vmth. Timely news updates can be received on its Facebook (www.facebook.com/ucdavisvetmed) and Twitter (www.twitter.com/ucdavisvetmed) pages.

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rjwarren@ucdavis.edu
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