July 9, 1998 CHAMPAIGN, Ill. -- Veterinary surgeons have found that doing less does more good when it comes to healing bones with multiple fractures. By attaching a stainless steel plate and pins to hold the affected bone in place -- instead of reassembling the fragments -- recovery occurs more rapidly.
The use of the plates and pins is not new. The procedure, known as bone-plate fixation, has been used for years (since 1840 in humans and 1943 in dogs), but it usually follows an often lengthy operation to separate damaged soft tissue and reposition bone fragments.
In a study involving shattered femurs in dogs, University of Illinois scientists eliminated the long surgery to see just how well the bone-plate fixation would do on its own. In an article accepted for publication in the Journal of the American Veterinary Medical Association, they will detail their study and report that it's not nice to mess with Mother Nature.
"We feel that any time that you have to strip the fragments from their soft tissue and put them back together, it impairs healing," said Ann L. Johnson, a veterinarian and orthopedic surgeon at the U. of I. College of Veterinary Medicine. "The body is powerful enough with its biological response for healing. If we just hold a shattered bone where it belongs and don't mess with it, the bone will heal quicker. It's really impressive what nature will do if you don't get in its way."
Fifteen dogs suffering four to eight fractures of a femur had surgery to attach the plates and pins. Their surgical, recovery and healing times were observed and compared with that of 20 dogs with similar serious injuries that had been treated previously with fragment reconstruction and the plating.
X-rays taken during the dogs' recovery period showed that those treated with just the plates and pins had achieved significant bone healing within 10 weeks after surgery, compared with 12 1/2 weeks for those treated with both procedures. Fragments that were not needed in the natural healing shrunk over time and were reabsorbed into the new bone that formed.
The simpler procedure also shortened the mean initial surgery time required from 192 minutes for fragment reconstruction to 116 minutes for applying just the bridge plate to hold the fragments in place. It also reduced the level of trauma to soft tissue on the affected bone, allowing for a faster formation of new bone between the fragments, and it shortened the time needed for anesthetizing the already traumatized dogs, the researchers noted.
The research was conducted by Johnson; Charles W. Smith, chief of small animal surgery; and David J. Schaeffer, a professor of veterinary biosciences, who co-wrote the journal report.
Johnson also described the mechanics and biology of how the fractures heal using the simpler method in an article in the April issue of the Compendium, a peer-reviewed continuing education journal for veterinarians. The article was co-written with U. of I. veterinarians Jo Ann Eurell and John M. Losonsky and Colorado State University veterinarian Erick L. Egger.
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