Metacarpal Fracture

RE: Metacarpal Fracture

Malcolm Ness — Fri, 20 May 2016 11:34:01 GMT

Two sensible options here.

First, and arguably the best in a mature pet dog would be manual reduction of the fracture in the anaesthetised patient followed by support bandaging. Consider cutting the nail v short - well into the quick and even the distal part of P3 to prevent weight-bearing on the relevant toe and protect the healing fracture.

Other option is a plate - the short distal fragment is a challenge but modifying a 2mm DCP or cuttable plate into a 'hook' plate is effective but not something for the occasional orthopaedic surgeon. This bone does get fractured in young racing greyhounds but it is rather different from this particular case in a number of ways. Few greyhounds will return to full racing potential following conservative management of a MC fracture but that is not relevant here.

Pinning is inappropriate. The bone is long and straight and consequently, you can't pin without going through a joint and that is worse than having it heal in mal-union. Further, because it is so distal a fracture, you would need a pin large enough to fill the medullary canal to achieve any useful stabilisation.

Reduce and support dressing and it should do adequately well.

RE: Metacarpal Fracture

Lindsey Edwards — Thu, 19 May 2016 23:29:20 GMT

Very common in greyhounds and generally do very well reduced and splinted or cast, wouldn't leave unsupported when abaxial due to risk of splayed toe and large callous

RE: Metacarpal Fracture

grumpyoldman — Thu, 19 May 2016 17:32:53 GMT

I think the rule of thumb is if its 1 reduce and immobilise, avoid a huge callous with soft tissue/tendon drag ,2 or more better to toggle with a small pin , usually do well unless damaged neurologically when the scuffing damage starts , amputate later if its a problem .

RE: Metacarpal Fracture

David Mills — Thu, 19 May 2016 15:39:35 GMT

Leave it well alone surgically. Bandage (or not - not essential) for a couple of weeks and it'll heal fine.

RE: Metacarpal Fracture

Martin Atkinson — Thu, 19 May 2016 15:25:06 GMT

IMO If the owner wants to pay for surgery pin or plate it. If not leave it, it will heal naturally splinted by the others. Absolutely no need to amputate.

RE: Metacarpal Fracture

Anthony Dennison — Thu, 19 May 2016 13:39:14 GMT

I'll await the orthopods to come along and correct me, but I don't think amputation is necessary. With the displacement a pin would fix it in place!

Someone at your practice visit the VetCT stand at congress by any chance?