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COMBINATION USE OF PLATE AND PINS

First broadcast on www.provet.co.uk in a Focus Week on Orthopaedics


This information is provided by Provet for educational purposes only.

You should seek the advice of your veterinarian if your pet is ill as only he or she can correctly advise on the diagnosis and recommend the treatment that is most appropriate for your pet.

Studies suggest that a combination of the use of intramedullary pins with a bone plate might optimise the success rate for comminuted fractures

In comminuted fractures the fragments of bone are unable to share in the weight bearing load and the whole of the load is borne by whatever  implant has been used by the surgeon. Intramedullary pins by themselves are inappropriate for the treatment of such fractures because of the inherent instability of the apposed bone fragments, and because they are ineffective at reducing rotation and shearing forces.  Bone plates by themselves can be effective, but they bear all the load and frequently bend.

Studies have shown that adding an intramedullary pin that is about 50% of the diameter of the medullary canal to a  plate repair can increase the fatigue-life of the plate by 10 times. The pin is positioned first. The aim is to have at least 2 screws proximally and distally that engage both cortices of the bone. In the midshaft region it may only be possible to screw through one cortex.

Based upon these results, pinning and plating might become a routine method for the treatment comminuted fractures in veterinary surgery in the future.

 

Updated October 2013