Executive Editor: Amy Kapatkin General Editor: Noel Moens

Authors: Bruno Peirone

Femoral shaft 32-B1

back to skeleton

Glossary

Lag Screw and neutralization plate
Main indication Skill Equipment
Diaphyseal fractures with large reconstructible fragments Some specialized surgical experience Simple surgical and imaging resources


In 32-B1, lag screw fixation combined with a neutralization plate is the standard technique for fractures with a large reducible wedge.  As an alternative to the lag screws, cerclage wires can be applied to reduce the fragment in cases where fracture obliquity allows for application of at least 2 wires.

Note: if the fragment reduction is challenging and there is a risk to detach the fragment from its muscular and soft tissue attachments during the reduction maneuver, it is advisable to switch to an indirect reduction and biological fixation technique (for more information please see "Plate and rod" or “Interlocking nail” fixation).

Plate and rod
Main indication Skill Equipment
Comminuted diaphyseal fractures with reducible or non reducible fragments Some specialized surgical experience Simple surgical and imaging resources


In the presence of non-reducible fragments or when devitalization of the fragments is likely during reduction, indirect reduction and bridging fixation such as a plate and rod stabilization technique is indicated.

Interlocking nail
Main indication Skill Equipment
Comminuted diaphyseal fractures with reducible or non reducible fragments Some specialized surgical experience Full specialized surgical and imaging resources

All B and C type fractures, especially the non-reconstructible types, are amenable for internal fixation with an interlocking nail (ILN). The ILN can be used with an open approach but is an excellent minimally invasive device, since it can be placed through small incisions without disturbing the fracture site.



The ILN provides good relative stability to the fractured bone. They are highly effective in counteracting bending forces because of their large diameter and intramedullary location. Unlike intramedullary pins, they effectively counteract axial compression and torsion because of their interlocking mechanisms.

Tie-in technique
Main indication Skill Equipment
Comminuted diaphyseal fractures with non reducible fragments in small patients Some specialized surgical experience Basic equipment only


An external skeletal fixator with an intramedullary pin tie-in configuration is an alternative to bone plating in small dogs.

*Skill
Basic surgical experience, no specialized skills Basic surgical experience, no specialized skills
Some specialized surgical experience Some specialized surgical experience
Highly experienced and skilled surgeon Highly experienced and skilled surgeon
*Equipment
Basic equipment only Basic equipment only
Simple surgical and imaging resources Simple surgical and imaging resources
Full specialized surgical and imaging resources Full specialized surgical and imaging resources

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