Veterinary Solutions

Photo #1

"Tuff" a three and a half year old male Labrador mix presented to Northside Veterinary Hospital on July 22, 2002 with a comminuted fracture of the right hind tibia after being hit by a car the previous evening.

Photo #2

The fracture was stabilized using a one quarter inch tip threaded Steinman Pin with three pieces of circlage wire to control a large butterfly fragment. After fixation, the voids between the major bone fragments were filled with small pieces of crumpled ACell Vet™ material and a single layer of the ACell Vet™ was placed over top of the fracture area.

Photo #3

The incision was closed using #2-0 Vicryl subcutaneously and #2-0 Ethilon for final skin closure.

Photo #4

A final post-op radiograph was taken to verify pin placement and fragment stabilization after bandaging.

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On August 12, 2002, approximately three weeks later, Tuff returned for recheck. Radiograph reveals some calcification, however still appears as a non-union.

Photo #5

At next recheck on August 28, 2002, Tuff using the leg at approximately 80% of normal function. Lateral radiograph shows no callus formation and looks like an early non-union. Explained to owner that it appeared the leg would need to be fixed using a bone plate. Upon opening and exploration, the tibia appeared very smooth and stable with no crepitus. Following consultation with ACell Vet™ technical personnel regarding healing properties of ACell Vet™ with subsequent calcification, a second sheet was used to re-wrap the area and then closed using #2-0 Prolene without plating, leaving the original hardware intact.

Photo #6

At recheck August 30, 2002, still appears unchanged on radiograph, however, Tuff is now using the leg normally. Follow-up on October 30, 2002; cortical bone appears to be forming with smooth margins and no apparent callus formation.

Photo #7

At follow-up on November 13, 2002, the radiograph shows good cortical healing with a well defined medullary canal. The tibia is very stable and the pin is removed.