XiaoXiao J Lederer 1, Daniel D Lewis 1, Richard B Evans 2, Matthew D Johnson 1, Stanley E Kim 1
Background
Comminuted fractures of the canine radius and ulna present surgical challenges, and the optimal fixation method remains debated. Open reduction and internal fixation (ORIF) has traditionally been used, but minimally invasive plate osteosynthesis (MIPO) may offer advantages such as reduced soft tissue disruption and faster healing. This study retrospectively compared outcomes of MIPO and ORIF for stabilizing comminuted radial and ulnar fractures in dogs, focusing on time to radiographic healing, complication rates, and overall surgical success.
Methods
Medical records from two veterinary hospitals were reviewed to identify dogs with comminuted radial and ulnar fractures treated with either MIPO or ORIF. Inclusion required complete medical records and radiographic follow-up until fracture healing. Data collected included signalment, fracture classification, surgical technique, time to radiographic healing, complications, and need for revision surgery. Time to healing was determined by two blinded observers. Statistical analysis assessed differences between groups for healing time and complication rates.
Results
A total of 43 dogs met inclusion criteria: 22 treated with MIPO and 21 with ORIF. Time to radiographic healing was significantly shorter in the MIPO group (median 8.0 weeks) compared to the ORIF group (median 11.0 weeks). Minor complications were fewer in the MIPO group, while major complications and revision surgery rates did not differ significantly between groups. MIPO allowed preservation of fracture hematoma and periosteal blood supply, which may have contributed to accelerated healing.
Limitations
This was a retrospective study, limiting control over case selection and surgical variability. The non-randomized design may introduce selection bias. Differences in surgeon experience and hospital protocols could influence outcomes. The study did not assess long-term limb function or incorporate standardized clinical scoring systems.
Conclusions
Minimally invasive plate osteosynthesis was associated with a significantly shorter time to radiographic healing and fewer minor complications compared to open reduction internal fixation in dogs with comminuted radial and ulnar fractures. These findings support MIPO as a viable and potentially superior alternative to ORIF for managing such fractures, though prospective studies are needed to confirm clinical advantages.
Orthogonal radiographic images illustrating how joint reference lines (dark blue) and anatomic axes (green) were established to define the proximal and distal anatomic radial joint angles (light blue) on intact limbs. Radial length (yellow) was measured as the distance between the caudal margins of the articular surface of the radial head and of the distal radial articular surface. Theta (θ) was measured as the acute angle created at the intersection of anatomic axes.
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