Shear Fracture Case Study
Shear Fracture – Technical Surgical Notes
July 30, 2004
8:30pm
A three year old spayed female English Springer Spaniel was brought in by it’s owners because of sustained injuries it acquired from being hit by an automobile.
Cardiovascular and pulmonary systems were stable, CRT normal as well as breathing. Pulse rate was 120.
Multiple small lacerations on both rear paws, and left metatarsus had a 3” laceration. Right foreleg had minor lacerations, and left foreleg had a lateral shear to distal radius, radiocarpal, and inters carpal bones.
IV catheter was placed and LRS fluid started at 150ml/hr. 10mg morphine given IV, Cefazolin and Baytril given. Started isoflurane and began cleaning and assessment of wounds.
Debrided rear leg wounds, closed with subcuticular and skin sutures and bandaged left rear leg.
12am-3am
Extensive cleaning and debridement of left foreleg to remove imbedded gravel and other large contaminants. Laser debridement to remove necrotic debris and freshen macerated tissues. Once cleaned of all contaminants, ACell was wrapped around one major tendon which was slightly re-routed to span the radiocarpal bone shears.
Another piece of ACell was secured to severed joint capsule edges to establish a new joint capsule. A bone anchor was secured in the distal radius with a figure 8 pattern using 50# leader line. 4th and 5th metacarpal bones were pinned using 1/8" Im pins. Site was closed and bandaged and foreleg secured with a spoon splint.
Post surgery: Our patient had excellent lateral to medial stability and near normal flexion and extension.
Next day discharge: Our patient went home with Rimadyl and Clindamycin, with a re-check scheduled 3 days afterwards. Minimal exercise was stressed until fully healed.
Present day: Our patient is playing Frisbee and chasing squirrels with no apparent limp, though she does tend to favor the left foreleg on very cold days, most likely a product of arthritis.