A retrospective study of postoperative complications after fracture repair in dogs and cats, with focus on fractures in the radius and ulna

Sammanfattning: Orthopaedic surgeries, including fracture surgeries, are performed on a routine basis at large hospitals in Sweden. Complications after surgeries are inevitable but can probably be reduced by the understanding of potential complications that can arise and risk factors behind them. This study aims to understand the complications after fracture surgeries. The author also sought to provide descriptive data over different types of surgically treated fractures. To the author’s knowledge, there are no such study done in Sweden up to date, and similar studies from other countries are out of date. Fractures in the radius/ulna in small and toy breed dogs are not only common, but also poses great challenges in fracture repair and high complication risks during the postoperative recover period due to various biomechanical factors. The author will therefore focus on fractures in the radius/ulna in small and toy breed dogs in this study in terms of surgery and complications. Data from a four-year period (2012–2015) was collected from medical records at University Animal Hospital in Uppsala, Sweden. A total of 161 surgically treated fracture cases were studied, of which 122 (76%) were dogs and 39 (24%) cats. Non-surgery treatments and fractures in the mandibula and ribs are excluded. One-year postoperative follow-up was done, patients with missing information was contacted through telephone or e-mail interview. Median age for all surgically treated fractures and as well as surgically treated fractures in the radius/ulna was less than one year of age for dogs and < 2 year of age for cats. There are significantly more dogs with body weight less than 6kg with fractures in the radius/ulna compared to other fractures. The five most common surgically treated fracture types in dogs were fracture in the radius/ulna (38%), tibia/fibula (24%), femur (12%), metacarpus/metatarsus and phalanges (9%) and humerus (7%). The five most common surgically treated fracture types in cats were fracture in femur (39%), tibia/fibula (15%), radius/ulna (15%), metacarpus/metatarsus and phalanges (13%) and humerus (8%). The overall complication rate for all fracture for dogs and cats were 63.8 and 50.0% respectively. The overall complications rate for fractures in the radius/ulna was 52.2% in dogs and 16.7% in cats. Implant related, splint/bandage related, gastrointestinal, surgical site infections and delayed union were common complications after surgical repair of all fractures and fractures in the radius/ulna. The most commonly used surgical technique for fracture repair in the radius/ulna was with plate and screws (72.3%). The vast majority of all radius/ulna fractures received perioperative antimicrobials. Deaths within one year after surgery were around 5% for all surgically repaired fractures dogs and cats combined. When attempting to compare overall complications rate, deaths and reoperations/amputations between groups with all fractures excluding radius/ulna and fractures in the radius/ulna, no significant difference were found due to small sample size.