tibia bone fractures in dogs and cats
Fractures of the tibia are relatively common in dogs and cats, with tibial diaphyseal fractures being the most commonly encountered injury of this bone.
What is a fractured tibia bone in a dog or cat?
Any breed of dog can suffer from fractures through falls or the impact hit from a car. Puppies have an increased incident of fractures, around 50% more than older dogs, due to lack of fear and experience. Age and bone brittleness affects the older dog, with decreased capacity of the bone to absorb any pressure. When a dog does suffer from a fracture of any kind, the tell-tale sorry look, the awkward gait, and the obvious distress are easy to see. Take your animal to the veterinarian immediately so he can be checked for other internal injuries as well.
More than a staggering 50% of fractures that occur in house cats and dogs happen when pets are less than one year of age, reflecting an increased prevalence of traumatic incidents in younger animals. The various patterns of tribal diaphyseal fractures can in many instances be associated with the age of the animal involved. Tibia bone fractures in dogs or cats occur when the bone is highly stressed and breaks because it is unable to take the impact. Non-comminuted and greenstick, or incomplete, fractures are more commonly seen in juveniles; while comminuted fractures are seen primarily in adults. The disparity in frequency of comminuted fractures in adults versus juveniles may relate to the increased brittleness of adult bone and the decrease in capacity of such bone to absorb the energy inflicted. Regardless of age, the most frequent fracture type is the spiral, oblique fracture.
Common symptoms displayed by cats and dogs that have a broken tibia
- Snapping when anyone attempts to examine the area, especially the tender parts around the fracture
- The dog or cat is unable to support it’s weight on the affected leg or demonstrates an inability to walk
- There may be swelling around the site of the injury area
- Visible agitation and cringing because of the pain
- Unable to get comfortable because of the pain
- Shaking and trembling uncontrollably
- Your cat or dog may have a sad-eye expression and be whimpering
- Lack of interest in food or water
- Rapid breathing or panting
Types of Tibia bone fractures in dogs and cats
- An incomplete fracture – The bone tends to bend with only a partial break at the base of the injury where the most pressure occurs; this often happens in flexible younger dogs
- A complete fracture – The bone is broken right through and there are two or more fragments created
- Open fracture – The bone breaks and pressure causes it to break through the skin and protrude
- Closed fracture – Although the bones are broken right through, they don’t break through the skin surface
There are many ways a bone can break, and the treatment for each varies.
How does a dog or cat break it’s tibia bone?
Although falls account for a lot of fractures in dogs, it is the traumatic vehicle accident that causes the largest number of injuries. While the fracture itself is upsetting enough, there are other things to be aware of:
- There may be more than one broken bone meaning the animal may be unable to walk
- The shock of an impact from a car can cause internal damages so it is essential to get them checked over to detect any life threatening injuries
- Mature dogs are susceptible to injuries because of their decreasing bone density
How does a veterinarian diagnosis a broken tibia bone fracture in a dog or cat?
When your dog is brought into a clinic, the veterinarian will immediately check the seriousness of the injury. Some dogs may become quite stressed and aggravated making it hard to find the extent of the damage.
If this is the case, the decision to sedate your dog will be the easiest and kindest way to handle the situation. Once your dog is sedated and relaxed, the veterinary team can begin to examine the area without risk of being bitten.
X-Rays, ultrasonography and blood tests may need to be done first to enable the detection of any possible internal injuries. Depending on the extent of the injury the veterinarian will often check for injury to the chest and thoracic area and the abdominal areas.
The test results will show the type of fracture it is, and then the right treatment can be decided upon. Often the most effective treatment is an operation to help realign the bones and enable them to heal. Options for treating fracture vary from inserting screws and bone plates to hold the break together, pins inside the bone, implants, or external frame with pins going through the skin.
To you, as the distressed owner, this may all sound traumatic, but your dog is a tough little survivor and very adaptable. The veterinary caregiver will advise what medications can be used to safely ease the pain, while the owner’s job is to watch over the patient at home and make sure they are not bouncing around too soon.
Treatment and surgery options for dogs and cats with a fractured tibia bone
There are various ways to treat a fracture, but which method to use will depend on the fracture itself, and the age of the animal. The main object is to fix the bone fragments so that they cannot move, which reduces the pain, preventing any further damage to the muscles and tissues around the area enabling healing. Fixation may be external or internal.
A cast is the simplest method and is ideal for an injury that is not open or infected and suits a younger growing dog. If the fibula, the other bone running alongside the tibia, is not broken, a cast can be used successfully.
More intensive breaks require bone plates and pins. With this method, a plate is put onto the bone and pinned in place immobilising the fracture. It provides solid support but is more intrusive disrupting the surrounding tissues.
Fracture Repair – External Fixation (KE)
With external fixation, a fixation bar is attached to the exterior of the skin, with bars going through the skin into the bone. It may sound quite gruesome to the owner, but this method requires less disturbance to the injury, it immobilizes the fracture, and allows the tissue and bone to heal quickly. Numerous methods of external and/or internal fixation have been advocated for the treatment of tibial diaphyseal fractures. The method of fixation ultimately employed is dependent upon the age of the animal and the severity of the fracture. Simple fractures may be effectively treated with closed reduction and external fixation, an intramedullary pin, a combination of cerclage and an intramedullary pin, bone plate, or Kirshner-Ehmer splints. Complex fractures are better treated with bone plates or Kirshner-Ehmer splints. Closed reduction and external fixation is used quite successfully on immature animals. Increased severity of fractures in immature animals leads to the use of intramedullary pins, wires, and external fixators. Bone plate application is used almost exclusively on fractures on adults. The frequent use of bone plates in the mature animal is related to the greater number of highly comminuted and severe fractures observed in the adult.
External skeletal fixation devices may be applied to the tibia in a number of different configurations, depending upon the age and the size of the animal and type of fracture present. The techniques involved in the proper applications of external skeletal fixators will be the subject of a future journal article. The device may be used with intramedullary pins and interfragmentary screw fixation. External fixators are particularly useful in open fractures since the device affords rigid immobilization without invading the traumatized area. It also allows aggressive, frequent treatment of associated soft tissue wounds while maintaining rigid fracture fixation. Complications associated with external fixators include pin tract infections and pin loosening or breakage.
Fracture Repair – Intramedullary Pinning
The intramedullary pinning method means pins are inserted into the medullary cavity of the bone and secured at the dense bone ends. It secures the fracture and provides a strong rigid support when coupled with cerclage wire. This method has no exposed hardware which would hinder the animal’s movements.
Intramedullary pinning of tibial shaft fractures is a successful method of treating spiral and oblique fractures. Intramedullary pins provide excellent axial stability but minimal rotational stability, and when used alone to treat fractures, it should be applied to rotationally stable fractures only. An intramedullary pin in conjunctions with multiple full cerclage and/or hemicerclage wire may be used to provide additional rotational stability. A tibial intramedullary pin is best introduced just medial and caudal to the tibial tuberosity on the medial side of the patella ligament with the stifle flexed. While retrograde introduction of a pin from the fracture site into the proximal tibia can also be performed, if the pin is improperly placed, significant interference with stifle joint function can occur. Intramedullary pins should be removed as soon as the healing process is complete, and immature animals must be watched closely for the timing of pin removal.
Fracture Repair – Closed Reduction and Coaptation
As previously mentioned, simple and/or non-displaced fractures may be successfully treated by closed reduction and coaptation, especially in immature animals. The main advantage is that blood supply to the fracture site is not disrupted by an open surgical procedure. In cases in which it is difficult to maintain a satisfactory reduction, placing through and through pins above and below the fracture site and then incorporating the pins in a cast is an especially useful technique which is simple to perform and has the additional advantages of preservation of soft tissues and blood supply to the fracture site. Complications associated with closed reduction and coaptation, including inadequate immobilization and/or incomplete reduction of fracture fragments, as well as muscle atrophy and prolonged joint immobilization have led to increased utilization of open reduction and internal fixation techniques for more complex tibial diaphyseal fractures.
Fracture Repair – Bone Plates and Plate Fixation
The repair of tibial diaphyseal fractures with bone plates is advantageous in a number of clinical situations. Plate fixation of tibial fractures is generally reserved for those fractures not associated with severely contaminated or infected soft tissue wounds. Bone plates may be placed as compression, neutralization or buttress plates, depending on the fracture configuration. In simple transverse or short oblique fractures, bone plates applied as compression plates establish early axial and rotational stability and encourage early return to activity. In spiral, oblique and severely comminuted fractures, interfragmentary compression is best achieved with individual lag screws through the plate. Following fracture reconstruction, the bone plate is applied as a neutralization plate to increase the stability of the fracture site. If complete fracture reconstruction is not attained, the fracture defects should be filled with an autogenous cancellous bone graft; and the bone plate is applied as a buttress plate. In multiple fracture patients, plate fixation of tibial shaft fractures is often more appropriate than other forms of internal fixation, as plates and screws afford the most rigid fracture stabilization and encourage early ambulation.
Post-Op recovery and rehab after a dog or cat has a broken tibia bone surgically repaired
- Ensure that your dog doesn’t lick the wounded area as this can lead to infection or delay healing; if he does persist, put an Elizabethan collar around neck
- If bandages get wet or slip, make sure you have it changed or checked to prevent damage and infection from setting in
- Short walks for toiletry requirements are permitted, but if your dog is going outside onto damp grass, put a plastic bag over any bandages to keep them dry
- Confine your dog in a comfortable environment to prevent movement and encourage rest
- Healing time is typically four weeks for puppies, and expect eight weeks for older dogs to recover before they can begin to get back to normal activities
Tibia bone fractures are quite common in dogs and cats due to their exuberant personalities, but they can recover and return to a normal healthy life if the animal gets veterinary assistance immediately, and follow up visits are made with your veterinarian to make sure that everything is healing well and accordingly.