Abstract:The current study was undertaken to evaluate the clinical efficacy of Titanium Elastic Nails for repair of Tibial fractures in six dogs presented with fractures to the Department of Veterinary Surgery and Radiology at the College of Veterinary Science, Hyderabad. They were diagnosed by clinical signs, orthopaedic examination and survey radiography. The symptoms observed in hind limb of the dogs presented for treatment were pain on manipulation, abnormal angulation and lameness immediately after trauma, swelling, non-weight bearing, dangling of the limb and crepitation at the fracture site. Pre-operative radiographic examination in plain orthogonal views, i.e., cranio-caudal and medio-lateral radiographs revealed diaphyseal fractures in all dogs.
Pre-operative radiographs also showed the type of fractures as mid diaphyseal transverse fractures in three dogs, mid diaphyseal short oblique fractures in two dogs, and mid diaphyseal simple spiral fracture in one dog. All fractures are closed, three in right hindlimb and three in left hindlimb. These fractures were stabilized with Titanium elastic nails of 2.0mm and 2.5 mm diameter were used for all the cases which provided adequate stabilization for open reduction internal fixation and resulted in remarkable improvement with normal limb function except in two dogs, were in one dog due to hyper activity of the dog, the fracture site was opened and fracture fragments got exposed. Whereas in another dog, due to weight more than 10kg and its hyperactivity and usage of staircase one nail was broken at fracture site and without any complications in other four dogs, complete functional limb usage was seen by 60th day. All dogs showed normal weight bearing at rest, while the weight bearing of the affected limb while walking 10th post-operative day, in 3 dogs, 15th post-operative day in 2 dogs and 30th post-operative day in one dog. The mean lameness grades observed pre-operatively and on 1st day, 15th day, 30th day, 60th day and 90th day post- operatively were found to be 5.00±0.00, 3.16±0.40, 2.66±0.51, 2.16±0.75, 1.50±0.83 and 1.33±0.81 respectively. The mean age of the dogs to bear the complete weight on the affected limb were seen on 15±7.74 days.
The radiographs obtained on 30th day Post-operative day revealed proper apposition, decreased fracture gap, appearance of progressive bridging callus with adequate radio-density in all 6 dogs, and on the 60th post-operative day revealed dense callus of reduced size; fracture line disappeared and the callus became radio-dense with clear establishment of cortico-medullary canal. And on the 90th post-operative day revealed distinct cortico-medullary separation caused by remodelling, restitution of the cortico-medullary canal is completed and which is well appreciated on a radiograph by 60th and 90th post-operative days respectively. Based on present study, it is concluded that Titanium Elastic Nailing was successful in the treatment of diapyseal tibial fractures in dogs as it is lighter in weight, had superior fatigue and corrosive resistance, improved biocompatibility and lower young’s modulus.