Kamil S. İnal
Background
Locking plate and external skeletal fixation systems are widely used for fracture stabilization in small animals. Supracutaneous locking plates (SLPs), initially developed in human orthopedics, combine aspects of external fixation and locking plate systems. This technique is less bulky than conventional external skeletal fixation and may provide good stability while preserving fracture hematoma and soft tissue vascularization. Limited veterinary data exist on SLP use in dogs and cats, prompting this prospective study.
Methods
The study included 30 patients (15 cats, 15 dogs) with 33 nonarticular radial–ulnar or tibial fractures treated between 2018 and 2021. Fractures were stabilized with SLPs using at least two bicortical locking screws per fragment. Closed reduction or minimally invasive osteosynthesis was performed. Clinical, radiographic, and computed tomography (CT) evaluations were conducted over 13 weeks. Fracture healing was assessed by lameness scoring, radiographic scoring, callus/cortex ratio, Hounsfield unit (HU) density, and three-dimensional bone volume (BV) measurements. Complications were recorded.
Results
Of the 33 fractures, 8 were radial–ulnar and 25 were tibial. Median healing time was 50.5 days (range: 27–88). Limb use was restored within days in most animals. Radiographic scores improved steadily, with 22/33 fractures achieving union by day 30. Callus area, HU density, and BV increased significantly until implant removal. Most complications were minor, including screw tract discharge and edema (15/33 cases), while major complications (implant failure, nonunion, delayed union) occurred in 3/33 cases. Cats and dogs tolerated bilateral or multiple SLP applications without issues.
Limitations
The study excluded animals over 32 kg and had limited numbers of bilateral/multiple fractures. Fracture types and distributions were not standardized. Surgical application requires expertise, particularly in cats where screw placement in the radius was technically difficult.
Conclusions
SLPs provided effective stabilization and acceptable outcomes for radial–ulnar and tibial fractures in cats and dogs. The technique preserved biological fracture healing, offered smoother surfaces compared to external fixators, and reduced bulkiness, making it a practical alternative. While minor complications were common, major implant-related issues were rare. SLPs appear to be a viable minimally invasive method for managing nonarticular long bone fractures in small animals.
Clinical, radiographic, and three-dimensional bone views in Case 15 (A–M). Radiographic views of Case 15 on preoperative (A and F) and
postoperative days 0 (B and G), 30 (C), 54 (D, H, and I). Clinical views of Case 15 on postoperative days 30 (J) and 54 (E andM). Three-dimensional
views of the bone on postoperative day 0 (K) and postoperative day 54 (L).
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