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Peer-reviewed veterinary case report

Risk of implant removal after open fractures in pets

By Sandness, Brea M et al.·Published in BMC veterinary research·2023·Department of Small Animal Clinical Sciences, United States·View original on PubMed

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Original publication title: Single institution retrospective study evaluating the frequency of implant removal and associated risk factors following open fracture fixation in 80 cases (2010-2020).

Movement & joints

Plain-English summary

A 5-year-old Labrador was brought in for an open fracture after being hit by a car. The fracture was stabilized with an internal implant, but the dog developed a postoperative infection, which increased the risk of needing the implant removed. In this case, the vet monitored the dog closely and ultimately performed the implant removal due to the infection. About 1 in 5 dogs with similar injuries may need their implants taken out, and cats are at an even higher risk.

People also search for: dog open fracture treatment · dog implant removal after surgery · cat fracture healing complications

Abstract

BACKGROUND: Open fractures occur commonly in small animals and are characterised by contamination of the fracture site. While never quantified, it is believed that open fractures stabilised with internal implants are at a higher risk for requiring explantation. This retrospective study determines the frequency and risk factors for explantation following use of internal fixation. Medical records of client-owned dogs and cats with an open fracture, between 2010 and 2020 stabilised using internal implants, were included. Data retrieved included signalment, cause and characterisation of the fracture, comorbidities, preexisting infections, and all details related to anesthesia and surgery. Pre-, Peri- and post-operative antibiotic use were detailed. All cases were followed to clinical union. Postoperative complications, including requirement for implant removal were recorded and classified as major or minor. Associations between potential risk factors and need for explantation were assessed. RESULTS: Of 80 cases, 72 (90%) were dogs and eight (10%) cats. Major complications were encountered in 23 (28.75%) cases and minor complications in 16 (20%) cases. Explantation was performed in 17 cases (21.25%). Out of 72 dogs, 13 required explantation (18%) whereas four of the eight cats needed implants removed (50%). Only diagnosis of postoperative infection was associated with an increased risk of explantation (RR 2.77; 95% CI 1.25; 6.15; p = 0.045). CONCLUSION: Approximately 1 in 5 open fractures stabilised using internal fixation can be anticipated to require explantation, with cats potentially being at a higher risk than dogs. Cases diagnosed with postoperative infection are at a higher risk for requiring implant removal.

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Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/37563636/