Pug vs Truck
Tonka is an 11 year old, blind, deaf male neutered Pug who decided to go on a little jaunt across the street by himself. Unfortunately for Tonka, he was greeted by a passing truck and suffered what initially appeared to be a closed, long oblique, mid diaphyseal fracture of the left tibia based on emergency radiographs. A splint was placed and the dog referred for surgery. Straightforward repair with a locking plate and interfragmentary compression of the fracture was considered the primary repair option.
Pre-operative repeat radiographs were obtained for planning purposes which revealed propagation of several fissures from the mid diaphysis cranially, proximally and caudally into the metaphysis, making this a comminuted fracture and plate repair alone insufficient. In the end, orthogonal plate-rod anatomic repair of the fracture was performed using 2 2.0 LCP plates and a 4mm IMPeek rod. Where possible, lag screw fixation was performed through the plate to reduce the fissured areas of bone.
Post operative radiographs show good implant placement, realignment of the limb and reduction of the fracture.
As our clinical expericence improves with each case, we find new tips and tricks to speed up surgery. In this case, we appreciated that smaller screws, like 2.0mm have a small cutting flute, so they have a hard time cutting their own thread through the IMPeek rod without stripping the head or binding up. Tapping the hole with a 2.0mm tap was a far more efficient means of getting screws through the rod and locked into the plate.
The dog was discharged the following day and will return for follow up in a few weeks.