dc.description.abstract | Dogs and cats constitute the majority of domestic pets worldwide, Kenya included. These pets
are prone to sustain appendicular bone fractures, which are frequently caused by traumatic
injuries, or bone pathology. A retrospective study was carried out with the objectives of
determining the incidence and associated risk factors of appendicular bone fractures;
establishing the types and frequency of occurrence of fractures of appendicular skeleton;
determining existing protocols for the management of appendicular fractures, and the
associated complications and challenges, in small animal practices, in Nairobi County.
The incidence and associated risk factors of appendicular bone fractures and the types of
fractures and their frequency of occurrence were determined by retriving all records of cases
diagnosed with appendicular skeletal bone fractures in the practices between April 2007 and
December 2013. Data on each case which included the diagnosis, date, month and year of
occurrence, breed, gender, age, type of fracture, limb affected, bone affected and the
description of the fracture, were obtained and recorded. Protocols for management of
appendicular bone fractures, associated complications and challenges were determined by
analyzing data collected through structured questionnaires and review of patient records in
participating practices.
A total of 402 cases of fractures were retrived at the practices surveyed in this study. Out of
these, 59 were appendicular fractures, giving an incidence of 14.7%. The incidence of hind
limb fractures was higher than that for the forelimbs. Ninety percent (90%) of appendicular
fractures affected entire males and females. The age of affected dogs ranged from 4 months to
10 years. The German shepherd breed of dogs and its crosses were the most affected. Male
dogs (69%) were more affected than their female counterparts (31%).
In the forelimb, the radius-ulna had the highest incidence of fractures (22%) followed by
humeral fractures (13.6%). In the hind limb, femoral fractures had the highest incidence
(30.5%), followed by tibia-fibula fractures (18.6%). Overall, diagnosis of fractures was
achieved through physical examination of dogs and confirmation by radiography.
Unknown trauma was the principal cause of fractures; followed by motor traffic accidents,
human abuse, animal bites, falls and indoor trauma. The most common types of fractures
encountered were complete simple transverse fractures (65%), followed by oblique (15%)
and comminuted (5%) fractures. Fracture management comprised external and internal
fixation techniques. The most common internal fixation technique employed was
intramedullary fixation of long bone fractures. Other devices used included orthopedic wires,
bone plates and bone screws. Cast bandage was used largely for external coaptation.
These were no complications following appendicular fracture management in 22% of the
cases. However, complications were encountered in 44% of the cases. Delayed union, non
union and implant failure were the most encountered complications. Osteomyelitis, implant
migration, arthritis and wound infection were usually seen in cases with unstable comminuted
fractures. The challenges of managing appendicular bone fractures were non-compliance by
the owners, limitations of resources and lack of appropriate surgical instrument, equipment
and expertise. Record keeping was also noted as a major challenge in a number of practices.
The study concluded that the incidence of appendicular bone fractures in dogs in Nairobi
County is low, male dogs were affected more than female dogs and hind limb fractures were
more common than fore limb fractures. Unknown trauma and motor traffic accidents were the
two most common causes of fractures. Furthermore, the outcomes of managed appendicular
fractures were largely not satisfactory and post-management complications were not
uncommon. Whereas the necessary materials for fracture management may be readily
available, their use is constrained by high cost, limited surgical skills and lack of appropriate
surgical equipment. There is need to improve surgical skills in orthopaedics for better surgical
outcomes in fracture cases. Also there is a need to keep proper records in small animal
practices in Nairobi County. These can be achieved through targeted training. | en_US |