puppy fracture and growth plate damage

Question
My three month old puppy sustained a hairline fracture in the radius and ulna.  We immediately rushed her to the vet and she was put in a splint/cast for three weeks.  After the splint was removed it appeared the bottom ulna growth plate had closed from damage and the radius was bowing to compensate for the short ulna.  My vet suggests waiting two more weeks for a new set of x-rays to make sure the radius is still growing on all sides before deciding on a surgical procedure.  If the radius is growing, they will probably want to wait 4-5 months until growth is nearly complete before operating and straightening the radius with a cut and plate insertion while cutting the ulna to relieve the elbow joint and straighten her leg.  If the radius is not growing they would do surgery immediately and attach an external brace with pins traveling through the skin into the bone which would remain on for a few weeks.  If I don't to surgery she will have terrible arthritis in a year or two.  I realize this is going to be very difficult for me and my pup, but would you prefer one surgery over the other?  I can only imagine the external attachment will be a very high risk of infection procedure.  If we wait 4-5 months for the other procedure might the radius be too bowed to be repairable?  In the later procedure what will happen to the ulna after they release it and put the plate in the radius?  Will it ever rejoin or will it remain unattached indefinitely and are there any consequences of that?  What do you think the recovery times of these procedures would be?

Answer

Kirshner apparatus While it's really a shame this minor break has now caused so many problems due to growth plate involvement, I can say with experience that putting in a Kirchner apparatus now is going to be just fine and serve her much better than later down the road.

I would wait until the xray and see what it looks like. A hairline fracture means the bone never separated, so if the break was in the middle of the leg- I don't see how the growth plate was ever involved unless her leg was splinted incorrectly. (that happens more than you know)

If they are pushing for plating on a three month old dog I would ask for a second opinion. As you know from my profile I am not a vet, but the wonderful man I worked for for over 17 years used "outside" pins on legs for decades and had great results. If they are wrapped properly and cared for correctly by the owners there is rarely infection. I never saw one in 25 years.

It makes me laugh that so many vets are into the whole plating thing (think $$$$) when Kirchner apparatus and pins work just fine. Some of them are actually amazed when bones heal using them. They consider them too 'primitive' for use.

I would not wait 4 months. The growth plate is most likely okay anyway. Her elbow and upper leg area would have to have been pretty smashed to mess with the plate.

I hope that is the case, that the plate is fine. Please let me know how it goes after the second set of xrays.

Here is an image of a leg with pins in place.