Bone fracture

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Dog with a broken leg and bandage

Broken bone (fracture)
A fracture is the complete or partial interruption of bone continuity, usually due to trauma or, less often, due to bone diseases. Symptoms include pain, lameness, malalignment, instability, and sometimes open wounds in open fractures. Fractures often need to be stabilized as an emergency to avoid further tissue damage.

A bone fracture, medically referred to as a fracture, is a structural interruption of the continuity of a bone. In our pets, dogs and cats, fractures can affect various bones and occur in different forms. Basically, a distinction is made between closed fractures, where the skin remains intact, and open fractures, where the bone penetrates the skin and thus there is an increased risk of infection. Furthermore, fractures are classified according to their shape: transverse, oblique, spiral, comminuted and splinter fractures describe the different fracture patterns. In growing animals, special fractures of the growth plates can also occur, which require special attention because they can affect further growth.

The bone structure in dogs and cats is basically similar to that in humans, but there are species-specific differences in resilience and healing tendency. While cats often suffer less severe fractures due to their lower body mass and higher mobility, dogs can exhibit more complex fracture patterns depending on breed and size. Bone healing occurs in several phases: first the inflammatory phase, followed by the formation of a soft callus, which is then converted to hard bone tissue, until finally the remodeling phase completes the healing process.

Causes

Bone fractures are caused by a severe trauma or getting a limb caught. Veterinary assistance is essential.

Bone fractures in pets are mainly caused by external force. Traffic accidents are the most common cause, especially in free-roaming cats and unsupervised dogs. Falls from a great height, especially in cats from windows or balconies (so-called “high-rise syndrome”), often lead to multiple fractures. In dogs, collisions with other animals or people, as well as accidents during play or romping, can also lead to bone fractures.

In addition to traumatic events, pathological factors can also promote fractures. These include bone tumors, which weaken the bone and can lead to so-called pathological fractures, in which even minor stress is sufficient to cause a fracture. Metabolic diseases such as hyperparathyroidism or kidney failure can reduce bone substance by disrupting calcium balance. In older animals, osteoporosis can weaken the bone structure, while in young, fast-growing dogs of large breeds, a calcium-phosphorus imbalance can lead to brittle bones.

Breed-specific predispositions also play a role. Small dog breeds such as Chihuahuas or Yorkshire Terriers have relatively thin bones and are prone to limb fractures. In sighthound breeds such as Greyhounds or Whippets, fatigue fractures occur more frequently due to their high running speed. Certain breeding lines may also have genetically determined bone diseases that increase the risk of fracture.

Symptoms

Broken bone (fracture) in dogs and cats

Typical Symptoms:

  • Acute severe lameness or non-weight bearing
  • Pain, swelling, instability, malalignment
  • Avoiding touch, possibly crepitation

Alarm signs:

  • Open fracture, severe bleeding
  • Malposition/”hanging” limb, severe pain
  • Accompanying signs of shock after trauma
  • Neurological deficits distally (no paw placement)

Escalation/course:

  • Increasing swelling/pain in hours → compartment syndrome possible
  • Immobilization is missing → tissue damage/blood loss increases
  • Later: infection in open fractures, necrosis

 

In the case of bone fractures on the legs, the animal can no longer use this limb. It shows great pain. The affected limb appears deformed. If the skin is cut, there may be severe bleeding.

The clinical signs of a bone fracture vary depending on the location and severity, but are usually clearly recognizable. The most noticeable symptom is a sudden lameness up to complete relief of the affected limb. In fractures of the spine, neurological deficits such as paralysis or coordination disorders can occur. Pain is expressed through vocalizations (Whining, howling, screaming), aggressiveness when touching the affected area, or general restlessness.

Externally recognizable changes include swelling, abnormal mobility of the affected body region, and malalignment of the limb. In open fractures, the skin is injured, and bone parts may be visible. Often, discoloration of the surrounding skin due to bruising is also observed. The animal typically shows altered behavior such as decreased activity, loss of appetite, or withdrawal behavior due to pain.

In fractures of the skull or pelvis, additional specific symptoms may occur. Skull fractures can lead to disturbances of consciousness, balance problems, or bleeding from the nose or ears. Pelvic fractures often manifest as a characteristic “duck gait” or difficulty urinating and defecating. In rib fractures, breathing may be impaired, which can manifest as shallow, rapid breathing or even shortness of breath.

First Aid

  1. In case of a very strong, pulsating bleeding, try to stop it.
  2. Cover the wound with a clean cloth and apply pressure to the wound.
  3. Apply a bandage (> Bleeding).
  4. Do not try to put the bone in the correct position.
  5. If bones are protruding, do not try to push them back.
  6. If necessary, after applying a temporary bandage, you can apply a splint to immobilize the injured leg.
  7. Do not manipulate too much. These and defensive movements of the animal can lead to further damage to blood vessels, nerves and surrounding muscles.
  8. If necessary, just wrap your animal in a blanket and drive to a veterinarian.
  9. If you fear further injuries to skull bones or internal organs, move your animal as little as possible.

Diagnosis

The diagnosis of a bone fracture begins with a thorough clinical examination by the veterinarian. First, a medical history is taken, in which the owner is asked about the circumstances of the accident or injury. During the general examination, vital parameters such as heart rate, respiratory rate and body temperature are checked to assess the general condition of the animal and to detect possible signs of shock.

Diagnostic imaging is crucial for the accurate assessment of the fracture. X-rays in at least two planes (lateral and ventrodorsal/anterior-posterior) are the standard procedure and allow the determination of fracture type, location and extent. In more complex fractures, especially in the area of joints, spine or skull, further diagnostic imaging procedures such as computed tomography (CT) or magnetic resonance imaging (MRI) may be required to obtain more detailed information.

In addition, laboratory tests can be performed to assess the general health status and identify possible underlying diseases. A blood count can provide information on inflammatory conditions or blood loss, while biochemical parameters such as calcium, phosphorus, and alkaline phosphatase can provide information on bone metabolism. If a pathological fracture is suspected, specific tests for tumor markers or metabolic diseases may be indicated.

Further veterinary measures

Bone fractures are usually treated surgically (Fig.).
Depending on the location of the fracture and the type of bone fracture, various methods and materials are used.
In order to achieve a resilient connection between the fragments immediately after surgical treatment, screws, plates, intramedullary nails, wires and external fixators made of metal are used. Nevertheless, immobilization for approx. 5 months is necessary for the fracture to heal.
Some of the materials inserted to stabilize the fracture must be removed again after completion of the healing process.

Supplements

The treatment of bone fractures depends on the type, location and severity of the fracture, as well as on the general condition of the animal. Basically, a distinction is made between conservative and surgical therapy approaches. Conservative treatment is considered for stable, non- or only minimally displaced fractures and includes immobilization by bandages, splints or plaster casts. This method is particularly suitable for fractures in young animals with high healing potential or for certain fractures of the forefoot or toes.

Surgical treatment is the method of choice for most fractures. Various osteosynthesis procedures are available: plate osteosynthesis provides stable fixation and is often used for fractures of long bones. Intramedullary nails are inserted intramedullary and are particularly suitable for shaft fractures. External fixators consist of pins that are passed through the bone and connected to rods outside the body – a good option for open or infected fractures. For small fragments or joint fractures, lag screws or Kirschner wires are used.

Perioperative management includes analgesic therapy, antibiotic administration for open fractures, and fluid therapy if necessary. For pain treatment, opioids, NSAIDs (nonsteroidal anti-inflammatory drugs) or local anesthetics are mainly used. The choice and combination of analgesics depends on the pain intensity and the individual patient. In open fractures, careful wound care with thorough cleaning and debridement is necessary to avoid infection.

Prognosis and aftercare

The prognosis for bone fractures depends on various factors. Basically, simple, closed fractures have a better chance of healing than complex or open fractures. The age of the animal also plays a crucial role: in young animals, bone fractures usually heal faster and with fewer complications than in older animals. The location of the fracture significantly influences the prognosis – joint fractures often have a worse prognosis than shaft fractures, as they can more often lead to arthrosis. Timely and adequate treatment is also an important prognostic factor.

Follow-up care includes regular check-ups with X-rays to monitor the healing process. In the first weeks after surgery or the application of a bandage, strict limited mobility is necessary to avoid endangering the stability of the fracture. The duration of this immobilization varies depending on the fracture type and the treatment method chosen, but is usually 4-8 weeks. This is followed by a gradual increase in activity.

Physiotherapeutic measures play an important role in rehabilitation. These can include passive range of motion exercises, controlled weight-bearing exercises, underwater treadmill training, or massages. The goal is to avoid muscle atrophy, promote blood circulation, and maintain or restore joint mobility. In addition, heat applications, ultrasound or TENS (transcutaneous electrical nerve stimulation) can be used. During aftercare at home, attention must be paid to an adapted environment – non-slip floors, no stairs and, if necessary, aids such as harnesses with carrying handles can facilitate mobility.

Summary

Bone fractures in dogs and cats are a common emergency situation in small animal practice. They are mainly caused by traumatic events such as traffic accidents or falls, but can also be favored by pathological changes in the bone structure. The clinical signs include lameness, pain, swelling, and abnormal mobility or malalignment of the affected body region. The diagnosis is made by clinical examination in conjunction with diagnostic imaging, with X-rays being the most important diagnostic tool.

The treatment options range from conservative measures such as bandages and splints to various surgical techniques of osteosynthesis. The choice of the appropriate therapy depends on the type and location of the fracture, as well as on the general condition of the patient. The postoperative phase and aftercare are crucial for the healing success and include limited mobility, pain management and, if necessary, physiotherapeutic measures.

The prognosis is good in most cases with correct diagnosis and adequate treatment, whereby the healing process should be monitored by regular check-ups. Complications such as delayed bone healing, infections, or implant failure require special attention. With modern treatment methods and comprehensive aftercare, most patients can achieve a full functional recovery.

Outlook on current research

Research in the field of fracture treatment in small animals is constantly evolving. A promising approach is the use of biological therapies to support bone healing. Platelet-rich plasma (PRP) and mesenchymal stem cells show positive effects on healing speed and quality in initial studies, especially in complicated fractures or pseudoarthrosis. These autologous procedures use the body’s own resources to promote regeneration and can be used as a supplement to conventional treatment methods.

There are also significant advances in the field of implant technology. Bioactive coatings on osteosynthesis materials can improve osseointegration and reduce the risk of infection. Resorbable implants made of polymers or magnesium alloys offer the advantage that no second operation is necessary to remove the implant and reduce the risk of stress-shielding effects. 3D printing technology also enables the production of patient-specific implants that are precisely adapted to the individual anatomy – particularly valuable for complex fractures or reconstructions.

Minimally invasive surgical techniques are also becoming increasingly important in veterinary medicine. Percutaneous plate osteosynthesis and arthroscopically assisted fracture care can reduce soft tissue trauma, thereby reducing complications and shortening rehabilitation time. The further development of imaging techniques such as intraoperative 3D imaging or augmented reality support during operations promises more precise placement of implants and thus better treatment results.

Frequently asked questions (FAQs)

  1. How do I know if my animal has suffered a bone fracture?
    Typical signs are sudden lameness, pain, swelling, abnormal mobility, or visible malalignment of the affected body region. The animal usually does not put weight on the injured limb and shows pain reactions when touched.
  2. Is a bone fracture always an emergency?
    Yes, any suspicion of a bone fracture should be considered an emergency. Even if there is no open wound, complications such as vascular or nerve injuries can occur. Timely veterinary care significantly improves the chances of healing.
  3. How do I transport my animal with suspected bone fracture to the vet?
    Move the animal as little as possible. Small animals can be transported in a stable box. For larger dogs, it is best to use a solid base such as a board. Only fix the injured limb if this is possible without resistance.
  4. How long does it take for a bone fracture to heal in a dog or cat?
    The healing time varies depending on the age of the animal, the type and location of the fracture, and the treatment method chosen. On average, it is 4-12 weeks, with young animals healing faster than older ones.
  5. What complications can occur during healing?
    Possible complications include infections (especially in open fractures), delayed bone healing or pseudarthrosis (failure to heal), implant failure, malalignment, and secondary arthrosis in fractures near joints.
  6. Does my pet need to wear a special bandage after an operation for fracture repair?
    This depends on the type of operation. For internal fixation with plates or intramedullary nails, an additional bandage is often not necessary. For external fixation or certain fractures, a supportive bandage may be required.
  7. How can I help my animal at home after fracture treatment?
    Strictly follow the limited mobility, provide a non-slip environment, avoid stairs and jumps. Pay attention to correct medication and observe the surgical wound for signs of infection.
  8. Can my animal fully recover after a bone fracture?
    With uncomplicated fractures and adequate treatment, a full recovery is usually possible. In complex fractures, especially in the joint area, limited mobility or chronic pain may remain.
  9. Are certain dog or cat breeds more susceptible to bone fractures?
    Small dog breeds with thin bones (e.g. Chihuahua, Yorkshire Terrier) and sighthound breeds with high running speed have an increased risk. In cats, no clear breed predispositions are known, but certain genetic diseases can weaken the bone structure.
  10. What preventive measures can I take to avoid bone fractures?
    Keep dogs on a leash on busy roads, secure windows and balconies for cats, ensure a balanced diet with adequate calcium supply, and avoid excessive romping on slippery floors or uneven surfaces.

Literature

  • Diehm, M. B.: Fractures of the extremities in dogs and cats – a retrospective study in the years 2010 – 2013, Tierärztliche Hochsch., Diss., 2016
  • Löwe, G. and Löwe, O. (2021). Emergencies in dogs and cats – A veterinary Guide. Kynos-Verlag. 208 pp.
  • DeCamp CE, Johnston SA, Déjardin LM, Schaefer SL. Brinker, Piermattei, and Flo’s Handbook of Small Animal Orthopedics and Fracture Repair. 5th edition. St. Louis: Elsevier; 2020.
  • Montavon PM, Voss K, Langley-Hobbs SJ. Feline Orthopedic Surgery and Musculoskeletal Disease. 2nd Edition. Philadelphia: Elsevier; 2022.
  • Pozzi A, Risselada M, Winter MD. Fracture Fixation Techniques for the Small Animal Practitioner. Veterinary Clinics of North America: Small Animal Practice. 2020;50(1):67-84.
  • Nolte DM, Fusco JV, Peterson ME. Incidence of and predisposing factors for nonunion of fractures involving the appendicular skeleton in cats: 18 cases (1998-2002). Journal of the American Veterinary Medical Association. 2019;236(11):1267-1273.