Rabbit Femoral Fracture

Re: Rabbit Femoral Fracture

Mark Rowland — Mon, 27 Feb 2012 23:53:13 GMT

Thanks for the update hope it's gone ok, keep us posted :-)

Re: Rabbit Femoral Fracture

Gareth Dowdeswell — Mon, 27 Feb 2012 22:24:25 GMT

Local orthopod went for IM pin and cerclage wires. Clients often don't come back once they've referred themselves but I'll try to updat e the thread if I see the rabbit again!

Re: Rabbit Femoral Fracture

jose targa — Mon, 27 Feb 2012 15:59:41 GMT

I agree with Rieke, the most important is how are we "selling" the surgery.

You can find external fixators specially designed for very small patients. Vetinst is selling a pair of models.

Regards.

Re: Rabbit Femoral Fracture

Rieke Hettrick — Fri, 24 Feb 2012 10:24:22 GMT

I have to disagree with Martin that the majority of owners won't fund surgery, in my experience given the choice of good veterinary care and the opportunity of a favourable outcome many owners are more than happy to fund surgery.

Re: Rabbit Femoral Fracture

Martin Atkinson — Thu, 23 Feb 2012 12:33:35 GMT

[quote user="Mark Rowland"]

Or as Lance Armstrong would put it "Pain is temporary, Amputation is forever"

[/quote]

Re: Rabbit Femoral Fracture

Mark Rowland — Thu, 23 Feb 2012 11:50:24 GMT

Or as Lance Armstrong would put it "Pain is temporary, Amputation is forever"

I think in this particular case given the duration, thats not something i would disagree with.

Re: Rabbit Femoral Fracture

Martin Atkinson — Thu, 23 Feb 2012 10:03:41 GMT

I fully agree with Malcolm's opening sentence. The majority of rabbit owners don't want to pay for surgery so my experience has been that so long as the leg is pointing the right direction they will do all right with cage rest, its not as if they've got to rehabilitated to live in the wild.

Re: Rabbit Femoral Fracture

Gareth Dowdeswell — Wed, 22 Feb 2012 21:22:54 GMT

Owners referred themselves to a local orthopod today so doubt I'll find out how this one ends, but that's not necessarily a bad thing. Thanks for the advice in this thread, will be a bit better prepared for the next rabbit fracture!

Re: Rabbit Femoral Fracture

Bob Russell — Wed, 22 Feb 2012 13:31:28 GMT

My advice would be to 'continue' with conservative treatment. Any fracture at this stage is going to be more difficult. A wide range of scary looking fractures can do OK with conservative treatment.

Not ideal but often the only practical option other than blue juice!

Re: Rabbit Femoral Fracture

Mark Rowland — Wed, 22 Feb 2012 09:11:32 GMT

I think that 7 days post injury is going to make this a nightmare to get good alignment wrt scarring and muscle contracture. By all means try but you may have to consider some bone shortening and will have to take great care not to splinter those pieces. Its something you should consider referral for if you are really wanting to go down the surgical road

Goodluck...really.

Re: Rabbit Femoral Fracture

Marie Kubiak — Tue, 21 Feb 2012 21:41:41 GMT

I also use tie-in fixators with these and have reasonable success (a dozen or so that did fine and a single failure in a giant that had compromised the femoral artery at the time of fracture and failed to heal) so would recommend an attempt to fix this. Worst case scenario ot doesn't heal then amputation is an option later down the line.

Regards anaesthetic support- treat it as you would a cat or dog, IV fluids, intubation and multimodal analgesia are essential.

Marie

Re: Rabbit Femoral Fracture

Malcolm Ness — Tue, 21 Feb 2012 21:36:22 GMT

Despite the scary appearance of the rads, these fractures will sometimes do surprisingly well with conservatism - cage confinement and pain control. If the foot is pointing the right way and the limb starts to feel stable then conservatism can be considered a valid treatment. Appropriate surgery offers better, quicker pain control and the potential of a better, quicker return to function but obviously it is more costly and adds the risk of complication.

Small patient fractures are always rather more challenging than our usual patients. In my experience,plates offer the best option but frequently (in fact almost always in rabbits) the implants we have available are the wrong size - 2.0mm plates are not stiff enough and 2.4/2,7mm screws are too big for the bones.

Ex fix + IM pin is usually my choice. Small diameter IM pin placed retrograde through a minimal approach to the fracture. Ex fix comprising two pins in each fragment. The IM pin should be left protruding and bent over to be clamped/"tied-in" to the ex fix connecting bar. Ideally, positive profile threaded pins should be used and the pins should be placed into pre-drilled holes in the femur.

Good anaesthesia and competent surgery are pre-requisites - these are small patients that will get very cold if you spend hours on the job.

Re: Rabbit Femoral Fracture

Gillian Mostyn — Tue, 21 Feb 2012 20:57:00 GMT

That muscle contracture is impressive already! Good luck....!!!!

Re: Rabbit Femoral Fracture

Gareth Dowdeswell — Tue, 21 Feb 2012 20:15:11 GMT

X-rays are uploaded!

Head vet is willing to have a go at repairing surgically. Waiting for the owner's to decide if they want this or referral, owners aren't in the country which is making everything a little more complicated. The original injury is believed to be 5 days prior to the x-rays - I'm guessing this isn't good news for the muscle contracture?

Re: Rabbit Femoral Fracture

Mark Rowland — Tue, 21 Feb 2012 18:04:02 GMT

My point here is that these fractures generally need early intervention to avoid the difficulties with muscle contracture in this species. Tie in fixators tend to work well for rabbit femur fractures in rabbits. Hope we can see the rad soon......

Re: Rabbit Femoral Fracture

Dagmar Steele — Tue, 21 Feb 2012 16:59:57 GMT

over the years I remember four or five rabbits that I've referred for surgery. They all had a pin put in and none of them failed to heal. Seems I've been lucky so far...

Re: Rabbit Femoral Fracture

Claire Fisher — Tue, 21 Feb 2012 16:54:24 GMT

I've seen a rabbit with an external fixator on a hind limb but I can't remember if it was the femur that was fractured. It was omly about 4 months old, did very well.

(Dad stood on daughter's rabbit and felt so guilty he paid to have it referred for surgery)

Re: Rabbit Femoral Fracture

Hannah Wynne Richards — Tue, 21 Feb 2012 14:14:53 GMT

Mark You know more about rabbits than I do

Wynne

Re: Rabbit Femoral Fracture

Mark Holmes — Tue, 21 Feb 2012 14:10:04 GMT

[quote user="robloxley"]

[quote user="Mark Holmes"]How do people feel about hind limb amputation in Rabbits? I've seen a few disasters and tend not to recommend them but equally a couple of successes.[/quote]

Have done a few (coxofem disarticulation) and they've done well, except need regular ear cleaning on the same side it seems.

[/quote]

Yes I have seen them go both ways. I do wonder though if HL amputation in rabbits is coming a little close to the line where acting in the animals interests and acting in the owners interests are confused.

Re: Rabbit Femoral Fracture

Mark Rowland — Tue, 21 Feb 2012 13:50:13 GMT

[quote user="Hannah Wynne Richards"]

Where's Malcolm? Personally I would be very nervous of amputation, or femoral head excision inan animalso hind-leg dependant-so would try to pin

Wynne

[/quote]

And IMHO in a rabbit more than 24hrs post injury you would probably regret it

Re: Rabbit Femoral Fracture

Rob Loxley — Tue, 21 Feb 2012 13:46:53 GMT

[quote user="Mark Holmes"]How do people feel about hind limb amputation in Rabbits? I've seen a few disasters and tend not to recommend them but equally a couple of successes.[/quote]

Have done a few (coxofem disarticulation) and they've done well, except need regular ear cleaning on the same side it seems.

Re: Rabbit Femoral Fracture

Hannah Wynne Richards — Tue, 21 Feb 2012 12:02:51 GMT

Where's Malcolm? Personally I would be very nervous of amputation, or femoral head excision inan animalso hind-leg dependant-so would try to pin

Wynne

Re: Rabbit Femoral Fracture

Mark Rowland — Tue, 21 Feb 2012 08:33:29 GMT

[quote user="Mark Holmes"]How do people feel about hind limb amputation in Rabbits? I've seen a few disasters and tend not to recommend them but equally a couple of successes.

[/quote]

I think it depends on the rabbit. From my experience, younger rabbits have done well following hindlimb amputation and it helps if they are not overweight. I find that there is a lot of case selection in these patients.

Re: Rabbit Femoral Fracture

Clive Ansell — Tue, 21 Feb 2012 07:52:49 GMT

I recently carried out a forequarter amputation in a rabbit because of a tumour, he did very well with an uneventful recovery. I have never amputated a hindlimb though.

I have also recently repaired a femur in a chinchilla; midshaft oblique fracture with an intramedullary pin. Did very well.

Re: Rabbit Femoral Fracture

Mark Holmes — Tue, 21 Feb 2012 07:16:14 GMT

How do people feel about hind limb amputation in Rabbits? I've seen a few disasters and tend not to recommend them but equally a couple of successes.