Claim of the Month: Femoral Fracture

Claim of the Month: Femoral Fracture

Pet: Luca*, 2 ½ year-old neutered male Bernese Mountain Dog

Luca’s Story

As a giant-breed dog, Luca was already well-acquainted with his orthopedic surgeon.  Luca was diagnosed with cruciate ligament disease on his right side, and had undergone a TPLO surgery to repair the knee at just under two years of age.  He was barely out of recovery from his knee surgery when he suffered an accident.  He was waiting in his family’s parked truck when he spotted another dog in the distance.  In his excitement, Luca leapt out the open window of the truck.  His left hind leg caught on the side of the vehicle as he fell. Luca was immediately lame after the fall: he refused to put any weight on the left hind leg.

Fearing another cruciate ligament rupture, Luca’s humans immediately rushed him to his family veterinarian. He was sedated and given pain control for his examination.  Radiographs revealed a different problem:  Luca had suffered a long oblique fracture of his femur, the bone extending from his left hip to his knee, with a few bone fragments.

About the Condition: Fractures

Fractures of the long bones happen most often because of a trauma.  Falls, blunt force impacts, or entrapment/entanglement of a limb are some of the accidents that can lead to a broken bone.  Underlying pathologies, such as bone tumors, inherited illnesses, or nutritional and metabolic abnormalities can also cause bone fractures.

Limping or favouring of the injured leg, along with pain, swelling and bruising, are the most common clinical signs of a fracture.

Sedation or anesthesia of the patient is usually necessary to thoroughly examine a fractured limb, and to perform radiographs.  X-rays confirm the presence of the fracture, but they also help veterinarians understand the shape and location of the fracture, so that the best treatment plan can be chosen. A fracture can be:

• Transverse – straight across the bone
• Oblique – at an angle, diagonally through the bone
• Spiral – twisting around the bone
• Simple – with the bone breaking into two separate pieces
• Comminuted – with the bone breaking into more than two pieces, or fragments
• Compound – with one or more pieces of bone puncturing the skin
• Stable/nondisplaced – with the fractured pieces in good alignment
• Displaced – with the fractured pieces in poor alignment

The shape and location will determine whether a cast, or pins, plates, and wires will be needed to stabilize the limb.

In addition to evaluating the fracture, veterinary teams need to ensure that other traumatic injuries haven’t occurred in the accident, such as head trauma, internal bleeding, or contusions.  If no accident was witnessed, and a tumor or metabolic abnormality is suspected, additional tests may be required.

Treatment

The goal of fracture treatment is to bring the broken fragments bone back into close alignment with each other and keep them still while the bone heals.  Any movement among the fragments will slow down or interrupt the healing. 

A cast or surgical implants (like pins or plates) can be used to hold the healing pieces in place.  In addition, the activity and weight-bearing of the animal will have to be carefully restricted.  Finally, pain, swelling, and infection need to be well controlled.

Larger, or more active animals are more likely to need surgery and surgical implants to stabilize a fracture.

Luca’s fracture required 5 loops of surgical wire, a bone pin, and a plate with screws to stabilize.  Because he is a big dog, and his opposite knee was already fragile, his owners had to help him move around using a sling.

His first four weeks after surgery involved very strict rest – he was not allowed any running, jumping, playing, use of stairs, or climbing onto furniture.  He could not have any walks during this time.  Over the following four weeks, slow short walks were introduced to help build strength in his affected leg.  Many dogs benefit from physiotherapy during this time to help stretch and strengthen the affected leg. 

Radiographs were performed periodically throughout the recovery period to ensure that the bones remained in good alignment and were healing well.  After 8 weeks, Luca was allowed to start slowly building back up to his pre-injury activity levels.

Surgical implants like pins and plates are not typically removed unless they become loose or infected.  Animals with surgical implants must be handled with care, as infections elsewhere in the body (such as dental disease or urinary tract infections) can lead to bacterial growth on the implant.

Claim Outcome

Luca has required $10,307.41 in specialty veterinary care for his fractured femur so far this year. His Pets Plus Us Accident and Illness Max policy has reimbursed his family $9,276.97** of those fees. We are happy to report that he is recovering well!

Learn more about our Accident and Illness plan.