Comparison of Complications and Outcomes Associated with External Coaptation Methods Following Plate Fixation of Radial and Ulnar Fractures in 83 Toy-Breed Dogs

Introduction: Toy-breed dogs may be predisposed to radial and ulnar fractures and experience higher complication rates, including stress protection-induced osteopenia. The objective of this study was to compare outcomes and complications associated with different postoperative coaptation techniques in these patients. We hypothesized that stiffer coaptation such as splinting would be associated with higher complication rates and similar outcomes compared to use of a modified Robert-Jones bandage (MRJB) or no postoperative coaptation.

Materials and Methods: Retrospective cohort study of 83 toy-breed dogs (body weight ≤5 kg) with 87 radial and ulnar fractures undergoing plate fixation at two private specialty hospitals between May 2017 and May 2022.

Results: Postoperative coaptation methods included splinting (n = 58, 69.6%), MRJB (n = 19, 22.9%), and no external coaptation (n = 6, 7.2%). Minor complications (n = 28, 33.7%) included bandage sores (n = 12, 14.5%) and decreased carpal range of motion (n = 6, 7.2%). Major complications (n = 18, 21.7%) included radiographic osteopenia with suspected delayed or nonunion (n = 8, 9.6%), and surgery site infection (n = 5, 6.0%).

Outcomes included return to full function (n = 36, 43.4%), acceptable function (n = 17, 20.5%), and unacceptable function (n = 8,9.6%). Dogs with postoperative caudal (n = 32, 38.6%) or lateral splints (n = 7, 8.4%) had significantly higher risk of bandage sores, but MRJB was significantly protective compared to splinting. There were no significant differences in outcomes between coaptation groups.

Discussion/Conclusion: This study suggests use of MRJB or no coaptation in toy-breed dogs recovering from plate fixation of radial and ulnar fractures may decrease risk of soft-tissue injuries commonly associated with splinting, with no increased risk of other minor or major complications or difference in outcome.

Acknowledgments: The authors declare no conflicts of interest related to this report. There was no proprietary interest or funding provided for this project.

Publication History

Article published online:
11 September 2023