A pet parent’s guide to fracture repair

Unfortunately, broken bones are all too common among pets. They can occur without warning and at any stage of life, making them a painful and stressful injury for animals and the families who love them.

While splints and casts may occasionally be used to treat certain fractures, surgery is typically recommended to ensure that any fragments of bone are properly aligned, secured in place, and unable to move. This way, fractures can have the opportunity to heal correctly, preventing long-term pain and physical limitations, and allowing pets to continue living the highest quality of life possible.

Surgery of any kind can be understandably daunting for pet families. To gain a deeper understanding of fractures and their surgical treatment, we spoke with Jennifer Peterson-Levitt, DVM, MS, DACVS, a board-certified veterinary surgeon at the MSPCA-Angell West in Waltham. Dr. Peterson-Levitt offered a look into the process of evaluating and repairing fractures, as well as the recovery involved in getting patients healed and back on their paws.

 

A cat recovering from fracture repair surgery.

 

What are the most common fracture cases that you see?

Dr. Peterson-Levitt: The most common fractures that we see are usually located in the legs — so either the forelimbs or hindlimbs — as a result of some kind of trauma. Trauma can be the result of something obvious, like getting hit by a car or a dog bite, or it could also be the result of unwitnessed trauma when pets are unsupervised. For example, when puppies are running, jumping, or playing, they can land funny and have a fracture at their growth plates.

What are the signs of a potential fracture?

Dr. Peterson-Levitt: The main sign is an acute onset of lameness. Basically, that’s when a pet was walking completely fine, and then they’re suddenly not walking well. Obviously, this is even more apparent after they’ve had some kind of traumatic event, such as being hit by a car, falling down the stairs, or being in a dog fight. However, it can also be the result of something pretty low impact. For instance, if an older cat jumps off a shelf, or if an older dog jumps off a couch, and they’re then suddenly not weight-bearing, it could be a fracture caused by a bone tumor that’s made the bone so weak that the relatively low-impact jump caused it to break. So really, anytime a pet is walking completely normally, but then it’s suddenly very painful for them, it could be a sign of a fracture.

What should a pet’s family do if they suspect their pet has a fracture?

Dr. Peterson-Levitt: They should come to the Emergency Room because fractures really hurt. At the ER, we can evaluate a pet’s condition and make sure that they’re stable. We can then get x-rays either to confirm or rule out a fracture, and also administer pain medication to make them comfortable. Once a fracture is confirmed, their pet can then be transferred for surgery either that same day or the next day to have the fracture repaired.

How are fractures diagnosed?

Dr. Peterson-Levitt: Sometimes, we can determine if there is a fracture just by feeling it during a physical examination or by noticing obvious stability issues. Other times, the fractures may be less obvious and an x-ray may be needed to diagnosis it.

What kind of supportive care is given throughout the diagnostic process to make pets comfortable?

Dr. Peterson-Levitt: The two main things that we give pets to improve their comfort are pain medications and stabilization of the fracture with a splint or cast.

 

X-rays of a cat’s fractured leg before surgery (left), right after surgery (center), and post-recovery (right).

 

How are fractures treated?

Dr. Peterson-Levitt: Surgery is usually recommended to help stabilize the bone. Bone typically takes about eight weeks to heal — faster in puppies and slower in older pets — and the bone needs to be still during that time in order to heal. We will normally recommend surgery to place a bone plate, screws, or some sort of implant to help hold that bone still. Sometimes in young animals, or sometimes in certain fractures that are not very displaced, we can do a cast or a splint, and they can heal that way. All casts and splints are intended to help pets heal, but they can cause pressure sores or wounds, if mismanaged. Therefore, the pros and cons of surgical stabilization versus external stabilization options (like a cast or splint) should be carefully considered.

What happens during surgery?

Dr. Peterson-Levitt: In surgery, we realign the fractured bone and stabilize it using an implant. It could be with a bone plate, it could be with screws, it could be with an external fixator — which is metal equipment that you see on the outside — or it could be with an interlocking nail, which is a big, strong implant that goes down the center of the bone. It is important to ensure that the bone is properly realigned to allow the pet’s joints to continue to function normally and increase their chances of returning to normal function after surgery.

How can certain surgical technologies, like the Ziehm Solo FD C-arm used at Angell West, enable minimally invasive fracture repairs?

Dr. Peterson-Levitt: Not all fractures, but some fractures are candidates for minimally invasive fracture repair. For some fractures, you have to make a big incision and really move things around to stabilize them. But for other fractures, you can make smaller incisions and use intra-operative imaging, like the C-arm, to help guide what you’re doing without making a big incision. Anytime that you can do a minimally invasive fracture repair, it’s nicer than an open procedure because there’s less surgical trauma, and pets will generally heal faster with less post-operative pain.

 

The team at Angell West using a C-arm to perform a minimally invasive fracture repair surgery.

 

What makes a fracture a good candidate for a minimally invasive procedure?

Dr. Peterson-Levitt: There are numerous factors that we consider when deciding if a fracture is a good candidate for a minimally invasive repair, including the patient’s age, the affected bone, and the fracture configuration. In general, the best candidates for a minimally invasive fracture repair are young patients with minimally displaced fractures that occurred within the last three days.

What is the recovery process like for pets and their families following a surgical fracture repair?

Dr. Peterson-Levitt: Post-operative recovery generally involves a pet taking it easy while the bone is healing. Surgery is generally done to put the bone back in the appropriate position and hold it still, and then the bone has to heal. When a pet wakes up from surgery, the bone is still technically broken and is just being held in alignment, and it then takes about eight weeks on average to heal. Recovery usually involves no running, jumping, or rough-housing. Pets can go for short walks and can go to the bathroom, but otherwise, they need to take it easy at home for however long it takes for that bone to heal. For puppies, that could be three or four weeks, while for an elderly pet, it could be 10 weeks.

Following surgery, families will need to help ensure that their pets don’t lick or chew the skin incision while it’s healing. This usually takes about two weeks, and it can be helpful to use a cone/e-collar or recovery sleeve to help protect the incision. Once the skin incision is healed, physical therapy can be utilized to help maximize their chances of success after surgery.

What are the signs of a potential complication following surgery, and what should a pet family do?

Dr. Peterson-Levitt: Although most pets are still sore for the first few days following surgery, their comfort and function should slowly and steadily improve throughout their recovery period. Any setback in their healing progression (i.e., sudden increase in limping or holding up the affected leg, worsening swelling, discharge from the incision) would warrant a recheck exam, and the family should contact their veterinarian.