Multi-institutional Retrospective Analysis of Fracture Treatment Methods in Nondomestic Ruminants
As appendicular limb fractures in nondomestic ruminants are difficult to manage successfully, this study was commenced to investigate fracture repair methods and hopefully develop a set of recommendations for fracture fixation. The study methodology employed a retrospective examination of medical records involving appendicular limb fractures in any nondomestic ruminant species that is, or has been, housed at a participating facility. Five facilities (two academic institutions, three zoological parks) were chosen for inclusion in the study. Cases (n=49) consisted of at least 20 different species with a total of 62 fracture events. The majority of fracture events (n=36) had unrecorded/unknown etiologies, but transport, intra-specific trauma, and manual restraint were frequent causes in the remainder. Eighteen animals were immediately euthanatized due to poor prognosis. The remaining cases (n=31) were treated with amputations, stall rest, casts (normal and transfixation), external skeletal fixation [type I and type II (normal and with IM pins)], IM pins only, and bone plates (normal and IM pin combinations). Hyperextension injuries, limb infections, and skin necrosis were seen in animals with either casts or bone plates applied. Subjectively, bone plates and casts had higher associations with fatalities, loss of a limb, and general postoperative complication rates than external skeletal fixation. In addition, bone plates and casts appeared to require multiple anesthesia events for managing complications compared to the external skeletal fixation repairs. Given the variation in species conformation, fracture classification, and case management, it is not possible to make definitive conclusions as to the optimal repair methodology without additional data.