Bone fractures in dogs. Veterinary medicine. Traumatic dislocation of the femoral head in dogs

Veterinary clinic "Alisavet" Moscow

Information for pet owners.

Definition. Dislocation of the hip joint (HJ) or dislocation of the femoral head is a pathological displacement femur relative to the pelvis, which is accompanied by rupture of the round ligament and overstretching of the joint capsule.
Clinical picture. Animals with damage to the hip joint, as a rule, do not step on the affected limb (floating limb lameness). Depending on the etiology of the dislocation, the position of the limb can be bent and shifted inward or outward. On palpation, pain and crepitus are determined when the joint moves.
Causes. As a rule, the diagnosis of hip joint dislocation is made after an injury (fall, accident, etc.). Occurs quite often in small breeds dogs (toy terrier, chihuahua, Yorkshire Terrier), as well as in cats. Spontaneous dislocation of the hip joint, which is not preceded by injury, is noted with hip dysplasia. This type of dislocation is typical for dogs of large or giant breeds and is rare.
Diagnosis. X-rays of the hip joint should be performed in two projections. X-ray data can not only clarify the diagnosis, but also exclude additional pathologies, which often occur after injuries. Add to list differential diagnoses may include hip subluxation, femoral head fracture, femoral head epiphysiolysis, hip dysplasia, acetabular fracture (Figure 1)

Figure 1. Radiography TBS dogs in direct projection. The red line shows the displacement of the femoral head relative to the glenoid cavity. Dislocation of the hip joint.

Treatment and prognosis. There are two ways to treat a dislocated femoral head. First, conservative treatment, which is based on closed reduction dislocation and wearing immobilizing bandages. I would like to note that the reduction of a dislocation must be carried out under anesthesia. Efficiency conservative method quite low and depends on certain factors (age of the owner, type of dislocation, weight, temperament, breed of animal, etc.)
The surgical method is considered the most effective and the frequency of recurrence of dislocation, after a properly performed operation, is reduced to almost zero. Exist different ways and surgical treatment approaches:
1. Capsulorrhaphy (suturing of the capsule). The essence of the method is to suturing the capsule so that the joint cavity is slightly smaller than after dislocation. The method is performed on large animals. The disadvantage of this method is that the technical capsule can only be sutured dorsolaterally (from above), which does not guarantee recurrence of dislocation.
2. Fixation using Kirschner wires. This method is performed closed and open method. After reducing the dislocation, the wire is inserted through the head of the femur to the side acetabulum. Then the wire is shortened so that it can be easily removed, since the implant is installed temporarily. This method is simple to perform, but repeated dislocations are not uncommon.
3. Transposition of the greater trochanter. A surgical procedure in which stabilization of a dislocation is achieved by applying tension gluteal muscle. To do this, an osteotomy of the greater trochanter is performed and it is secured distally with pins or screws.
4. Round ligament replacement. This method is the most common and highly effective. The essence of the method is to restore the torn round ligament, which is anatomically located inside the joint and prevents the dislocation of the femoral head from the acetabulum (Figure 2).
5. Extracapsular stabilization. This technique is usually performed without opening the joint cavity, by placing retaining sutures between the bones: pelvic and femur.
6. Resection of the femoral head (Arthroplasty). Although it is believed that this method does not ensure the usefulness of the hip joint, but can be performed and recommended for animals with dislocation of the femoral head. The essence of the method is resection (removal) of the head of the femur, after which a connective tissue frame is formed in the joint area. The effectiveness of this operation may be somewhat greater if the animal undergoes postoperative physiotherapy.

Dogs are quite active pets, especially in at a young age, When little puppy ready to knock you off your feet, happy to meet you (find out), and during a walk he claims to be a champion in speed and dexterity. However, there are situations that can limit such motor activity of dogs, and most of them are associated with fractures of the paws and spine.

About, how to find out that a dog has a fracture, what types of fractures there are, how to provide first aid to a dog with a fracture and how to help your pet recover faster– we will tell you about all this on the pages of our publication. Surely, this article will be useful for all dog breeders, since life is full of surprises, both pleasant and not so pleasant, and knowing what’s wrong with your four-legged friend and how to help him is very important.

Features of a fracture in dogs

So, let's remember what a fracture is.

A fracture is a pathological or traumatic disruption of the integrity of bone tissue. Fractures are open (when the bone is damaged soft fabrics and becomes visible), and closed (visually, only swelling at the fracture site and pain indicate that something is wrong with the limb).

Which fractures are more dangerous? In fact, it is wrong to assert that only open fractures pose a danger to the dog’s life, while closed ones can be ignored, citing the fact that “it will heal that way.” After all, as a result of deformation of the integrity of the bone, displacement can occur, and the bone will grow together in such a way incorrect position, which in the future may cause the dog to begin to limp and find it difficult to move. Therefore, we would not classify fractures as dangerous and not very dangerous. Any violation of the integrity of bone tissue requires the intervention of a veterinarian, since only he can assess the extent and nature of the damage and help the dog. You and I can only provide first pre-veterinary aid, although the health of our pet will depend on the correctness and timeliness of its provision.

Causes of fractures in dogs

Of course, you want to know what can lead to a situation where a dog is injured and has a fracture. This is necessary in order to, if possible, protect the pet from such potential dangerous situations. But you won’t be able to completely protect your dog from everything. Therefore, according to veterinarians, It is as a result of a collision with a car that dogs most often suffer fractures. Moreover, these can be not only fractures of the limbs, but the pelvis, spine, ribs, base of the skull can also be broken... recent cases Unfortunately, there is no hope of saving the pet, because veterinary medicine classifies such injuries as untreatable, and even if the animal is still alive, it is recommended that the owners carry out this in order to euthanize it and not prolong the terrible torment. We will not now consider all aspects of the humanity of such an act - we will only say that sometimes help lies in ending the suffering of the animal you love.

Symptoms of a fracture in dogs

Symptoms of fractures are swelling at the fracture site, pronounced pain, disruption of the integrity of soft tissues, loss of sensation, limited motor activity... If you notice that your dog has suddenly stopped being active and is experiencing higher listed symptoms- Most likely, she has a fracture. The veterinarian will be able to tell more precisely after X-raying and examining the animal, but for now you need to provide first aid to your pet.

How to help a dog with a fracture

If you suspect your dog has a fracture - no matter what, limb, pelvis, spine, most importantly, do not lose your composure in this situation, as your nervousness will be passed on to your pet. Try to calm the dog and calm yourself, and also be sure to limit the pet's ability to move - this will reduce the likelihood of broken bones being displaced and reduce the risk that a broken bone can damage the skin or internal organs.

If your dog is bleeding - this often happens with an open fracture - the wound must be treated and a bandage applied to stop the bleeding.

Treatment of fracture in dogs

Treatment of fractures should only take place in a veterinary clinic and by appropriate specialists. Therefore, it is not worth trying to set a displaced bone for your pet on your own or apply a plaster cast. With your inept actions (unless you are a veterinarian, of course), you will only aggravate the animal’s condition, and this will lead to serious complications in the future.

If a dog has a non-displaced fracture of its limbs, it will be given splints or plaster in order to securely fix the fracture site. If the fracture is open, then surgery will be necessary to remove the remaining bone tissue and connect the fragments or broken parts of the bones using various special structures.

More severe types of fractures, such as fractures of the skull or spine, require complex treatment measures or, if the case is hopeless, the veterinarian may recommend that you euthanize the animal.

Rehabilitation of a dog after a fracture

If the fracture is not complex, and the dog was given first aid in a timely and correct manner, and also, you follow all the rules for successful rehabilitation and take all measures to restore its limb after the fracture - through short term your pet will be able to return to normal life, and even go for a walk with a fixing bandage at the site of the fracture. If the fracture is more complex, recovery will take longer. However, in both cases, you must understand that veterinary care is the beginning of the recovery process. That's how recovery process will proceed - it all depends on how you care for your dog, the diet you provide it with, and also on the rehabilitation measures you take. We suggest talking about the latter in order.

Peace

In order for the dog's broken bones to heal as quickly as possible, the dog must be at rest. And a fixing bandage or plaster does not completely provide her with this peace. You will need to take care to prevent your dog from running, jumping, sudden movements, as well as free movement. This can be achieved... with the help of a cage. You can purchase the latter according to the size of your pet at a pet store. The cage must be of such a size that the animal can stand in it full height and take a few steps, but no more. By keeping your pet in a cage, you will protect him from overstraining his injured limb.

Don't forget for the comfort of the patient, and also so that your dog doesn't think that being in a crate is... the new kind punishment, put warm and soft bedding in it, which will evenly distribute the pressure under the weight of the dog. If a sick pet cannot get up to go to the toilet, it makes sense to put a moisture-wicking bedding that will allow moisture and urine to drain through the bedding and not wet the animal’s skin.

Place your dog's crate in a room where you spend a lot of time; if your pet likes to watch TV (there are some!), turn it on for him.

If the cage is in a cold room, then at night it can be covered with bedding and blankets so that they retain heat inside it; it would also be appropriate to cover the pet with another bedding on top.

Walk

Despite the fact that the dog should be at rest, this does not mean that it should relieve itself on its own. If her spine is not injured, and the veterinarian has not prohibited her from moving, you can carry your pet in your arms outside to go to the toilet. If the dog is medium to large in size, you can use a sling to support your pet's body from below and, with your help, take some of the load off his injured limbs. By the way, you can make such a sling yourself from a large towel, which you pass under the dog’s belly or under the chest, depending on the location of the fracture. All you have to do is hold the ends of the towel tightly over your pet's back and support him.

Under no circumstances allow your pet to run or turn sharply during such walks.

An alternative to such walks can be a litter box in the house, but for this you will first need to teach the dog to go to the toilet in such a tray. How to do this - read about it.

About 90% of fractures, including the head and neck of the femur, occur in animals between 4 and 6 months of age. The cause of fractures in most cases is traumatic. Legg-Calvé-Perthes disease (aseptic necrosis), which mainly affects small and toy breeds of dogs, is also a common cause of femoral neck fractures. In dogs with a growing skeleton, the main blood supply to the femoral head is provided from the epiphyseal vessels associated with the joint capsule, and a small amount of blood comes from the vessels passing through the round ligament. Only after the closure of the growth zones of the femur at 8-11 months does the head of the femur receive additional blood supply from the metaphyseal vessels.

Fractures of the head and neck of the femur in dogs occur internally joint capsule and outside the joint capsule.

If, when a pathology occurs, surgical treatment is not performed within 2 days and no later than a week, then, taking into account the blood supply, complications may arise in the form of ischemia of the head and neck of the femur and, as a consequence, destruction and lysis of the bone. We are, of course, talking about fractures subject to surgical treatment, i.e. osteosynthesis.

To common clinical signs Fractures of the head and neck of the femur include lameness of the type that does not rest on the affected limb, pain on palpation of the hip joint, the occurrence of pathological mobility and pathological sounds when passive movements in the joint, which can be determined by a veterinarian during a clinical examination. To confirm the preliminary diagnosis, a mandatory X-ray examination is performed. In the vast majority of cases, radiography is necessary under general anesthesia with the animal lying on its back with the pelvic limbs extended.

Treatment of femoral neck fractures in dogs is surgical. The method of treatment depends on the type and location of the fracture. If Legg-Calvé-Perthes disease is confirmed, then resection arthroplasty of the hip joint is performed under general anesthesia. As a rule, representatives dwarf breeds dogs suffering from this pathology, with a successful operation, despite its traumatic nature, the vast majority do not experience pain and do not show lameness after completing the course postoperative rehabilitation and fully use the limb. Depending on the fracture, more large breeds and with radiographic confirmation of the absence aseptic necrosis osteosynthesis of the fracture is performed. If osteosynthesis is impossible, resection arthroplasty is performed. The timing of postoperative rehabilitation and recovery depends entirely on the nature of the injury, accompanying pathologies, the size of the animal and the willingness of the owners to accurately follow the recommendations of doctors.

Article prepared by doctors surgical department"MEDVET"
© 2015 SEC "MEDVET"

The pathology is accompanied by a pronounced pain reaction. The dog transfers its body weight to its healthy limbs; it can no longer step on the sprained paw. The paw may be turned inward or outward, depending on the nature of the damage. In 90% of cases, the head of the femur moves forward from the acetabulum.

Partial displacement of the head is called subluxation of the hip joint, typical for dogs with severe dysplasia hip joints. This damage is most often observed on 2 joints, while with a traumatic dislocation one joint suffers.

Diagnostics

At the appointment, the doctor conducts a thorough examination of the patient and interviews the owner about what happened.

To establish the extent and nature of damage, an x-ray examination of the joints is performed. Most often, patient sedation is required.

In addition, the doctor evaluates the function of other vital signs. important organs. In case of injury, the chest, lungs, and organs may be damaged abdominal cavity, spine. If necessary, a chest x-ray is taken to rule out rib fractures and the presence of free air in the chest. Ultrasound of the abdominal cavity can exclude internal bleeding, liver and spleen injuries.

Treatment

Non-surgical reduction of dislocation: closed dislocation is reduced using short-term anesthesia. In order to prevent re-dislocation, a special bandage or sling is used. If the support has worked adequately for several weeks, the wound heals and the femoral head remains in place. In approximately 50% of cases it is possible to do without surgery.

Surgical treatment includes access to the joint and restoration of surrounding tissue. Additional support structures are used to provide better fixation of the femoral head in the socket.

In case of severe damage articular surfaces It is recommended to remove part of the femur (resection of the femoral head) and form a “false” joint. The technique allows you to avoid repeated dislocations, and is especially indicated for dogs with severe dysplasia of the hip joints. The functional ability of the paw is completely preserved after this operation.

In the traumatological practice of a veterinarian, hip fractures in dogs are a fairly common occurrence. Most often, dogs suffer a hip fracture as a result of falls from a height, accidents or various circumstances where injury may occur. Hip fractures can also be pathological as a result of tumor growth or metabolic disorders, for example, as with nutritional hyperparathyroidism. Pathological fractures of the femoral neck as a result of Perthes disease occur in toy dog ​​breeds. Dogs Can Hip Fractures of different ages. Fractures as a result of tumor growth are more common in older dogs, fractures as a result of metabolic disorders ( nutritional hyperparathyroidism) are found in puppies as a result of protein feeding. In Perthes disease, a fracture of the femoral neck can occur at different ages.

Clinical signs of hip fracture in dogs

First of all, any fracture will be accompanied by severe pain. In this case, the dog may whine a lot, refuse to let the affected limb be touched, and sometimes even react aggressively to its owner. Support on the affected limb will be impossible; the dog will run on three legs. Hemorrhage and swelling may be found on the skin at the fracture site. Swelling may extend down to the lower leg and hock. On palpation, you can hear crepitus of the bones, and strong mobility will be felt at the site of the fracture.

With an open hip fracture, a wound will be visible. Sometimes bone fragments may be visible from the wound, and bleeding may occur. Infected fractures will show signs purulent inflammation: there may be discharge from the wound, severe swelling, increased body temperature, etc.

Displaced comminuted fracture of the femur in a dog

For hip fractures in the first two days general state will be depressed, the dog will refuse to eat, and practically not move around the house. With fresh traumatic fractures this is associated with strong pain syndrome, which requires an immediate visit to the veterinarian.

First aid for hip fractures in dogs

When providing first aid, if an animal behaves aggressively, you need to put a muzzle on the dog or bandage the dog's muzzle.

If an open fracture of the femur occurs, in no case should you try to set the bones into the thickness of the muscles, as this will cause the dog very severe pain and may cause secondary bleeding. IN in this case, you should, if possible, rinse the wound with a chlorhexidine solution and apply a protective bandage that should completely tightly cover the wound. It is also advisable to immobilize the affected limb so that it does not move. If the dog small size, it can be placed in a carrier or box for easy transportation. If the dog large size and cannot move, she can be moved on a stretcher or on a blanket.

If the fracture is closed, then you also need to fix the sore paw if possible and come to the clinic.

You cannot give any painkillers to your dog yourself, since an immediate effect of pain relief will not be achieved, and also in the process of providing veterinary care it may be difficult drug treatment as a result of drug incompatibility. In practice, there have been cases when dog owners, wanting to help their pet, unknowingly exceeded the dosage of the drug several times and subsequently suffered a fracture. veterinarian will have to treat the dog for intoxication.

At correct provision first aid can quickly alleviate the dog’s suffering, which will subsequently lead to good result treatment.

At a veterinary clinic appointment for a dog with a hip fracture

At the veterinary appointment, the veterinarian will provide first aid to the dog, this primarily includes pain relief, administration of antibiotics and anti-edematous medications. In the event that the dog’s owner cannot care for it, such an animal can be placed in the clinic’s inpatient unit for all necessary manipulations.

If the fracture is infected, then in addition to treating the wound, it is possible to administer an intravenous infusion (dropper) to relieve intoxication of the body. If, in addition to the hip fracture, the dog has other life-threatening injuries, then it may be necessary additional research, for example, ultrasound. After providing first aid, the veterinarian will begin to diagnose the fracture; for this, an x-ray examination will be performed. After the x-ray, it will be possible to plan treatment tactics for the fracture, technique surgical intervention etc.

Almost all hip fractures are treated only through surgery (osteosynthesis) using plates, wires and other methods of fastening. Before surgery, biochemical and clinical tests blood and an echo (ultrasound) of the heart was done to provide for all the risks of the surgical operation.

About anesthesia for a fracture

All surgical operations for hip fractures, they can only be done under general anesthesia. For general anesthesia A fairly large variety of drugs are used that are administered to the animal both intravenously and in the form of gas (inhalation/gas anesthesia). In our clinic, for this problem, epidural anesthesia is actively used, which reduces the anesthetic risk. Epidural anesthesia provides good pain relief, thereby administering drugs general anesthesia will be minimal and, accordingly, the effect of general anesthesia on the body will also be minimized, which is better for the dog.

Treatment methods for hip fracture in dogs

Treatment for a hip fracture depends on the type of fracture, the process that caused the fracture, and other factors.

If a dog has a femoral neck fracture due to Perthes disease, treatment will be to remove the head of the femur (femoral head resection).

If your dog has a hip fracture as a result of oncological problems, then amputation of the limb and subsequent treatment by a veterinary oncologist is possible.

As for all traumatic hip fractures, they will be treated with osteosynthesis. The method of attachment depends primarily on the type of fracture. Non-comminuted diaphyseal femoral fractures in dogs are assembled using intramedullary osteosynthesis (pins) and using bone osteosynthesis (plates).

Fracture after reduction with a pin

Comminuted femoral diaphyseal fractures are assembled using plates. When choosing a plate for a planned operation, many factors are taken into account, including the weight of the dog, anatomical features hip, bone density, type of fracture, length of the injured area of ​​the bone, etc.

For femoral fractures in the epiphysis area, intercondylar femoral fracture and femoral neck fracture, osteosynthesis is carried out using Kirschner wires, screws and also special plates.

For infected hip fractures, various external fixation devices are used.

Recovery after surgery

After surgery, the dog is prescribed antibiotics, suture treatment and, if necessary, painkillers. Support on the affected limb is restored within a week, the dog can move freely, but it is better to avoid active walks and games. Suture removal is scheduled after 10-12 days. You should come back for a control x-ray with your dog in 3-4 weeks.

Hip fractures with the right approach to treatment and, depending on their complexity, completely grow together within 2-4 months.