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Metaphyseal femoral complete fracture with Unicondylar fragmentation

History

  1. A four months dog presented with inability to bear weight on the right limb. Surgical intervention was recommended.
  • With clinical orthopedic examination, crepitation was evident in the distal femoral extremity.
  • With radiographic examination, metaphyseal fracture with a separated fragment of the femoral condyle (Fig., 1,2).
Fig., (1) shows a mediolateral pre-operative radiographic projection. Complete metaphyseal fracture can be seen with fracture fragment displacement.
N.B. Axial tibial and femoral growth plates can be still seen
Figure (2) shows Intraoperative Line of fracture. Left picture shows uni-condylar incomplete separation. Right picture shows complete metaphyseal fracture.

Surgical treatment

  • The fracture was fixed with a transcondylar screw (reduction of the separated condyle) and Cross pinning (For metaphyseal fracture). Additional cerclage was placed bilaterally (Fig., 3-6).
Figure (3) shows the fixation of the transcondylar screw. Left picture illustrates the bone drilling, followed by screw insertion and tightening (R. pic)
Figure (4); shows the cross pinning fixation technique for the metaphyseal Fracture. The pins were inserted through the lateral surface of the femoral condyle (with 45 degree insertion point) to the opposite far cortex (femoral diaphyseal)
Figure (5); Shows the additional placement of cerclage wires bilaterally (L.picture).
Figure (6); Postoperative radiographic latero-medial projection (L) and Cranio-caudal projection (R). Complete reduction was achieved.

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