Most fractures are caused by automobile accidents and falls from a height. The bones most commonly broken are the femur, pelvis, skull, jaw, and spine. Fractures are classified as open or closed. In an open fracture (also called a compound fracture), a wound exposes the bone. Often the bone is seen stick- ing through the skin. These fractures are contaminated by dirt and bacteria and thus are accompanied by a high rate of bone infection. Signs of bone fracture include pain, swelling, inability to bear weight, and deformity with shortening of the affected leg.
Treatment: Injuries that cause fractures can also cause shock, blood loss, and trauma to internal organs. Controlling shock takes precedence over treating any fractures (see Shock). A dog in pain is often uncooperative and may bite in self-defense. Take precautions to avoid being bitten. If necessary, muzzle the dog (see Handling and Restraint). Open wounds over bones should be covered with a sterile dressing, using several gauze pads, if available. If you cannot get gauze pads, cover the wound with a clean cloth or towel and wrap loosely. If there is continued bleeding, carefully apply pressure to the site. Splinting fractures relieves pain and prevents shock and further tissue dam- age while the dog is being transported to the veterinary hospital. The decision to splint is based on a number of factors, including the severity and location of the injury, the time it will take to get professional help, the presence of other injuries, and the availability of materials. Note that improper splinting can cause more harm than good. Do not attempt to splint the leg if the dog resists. Always splint the limb in the position in which you find it. Do not attempt to straighten a crooked leg. An effective splint is one that crosses the joints above and below the fracture. When the fracture is below the knee or elbow, fold a magazine, a newspaper, or a piece of thick cardboard around the leg. A cardboard roll, such as for paper towels or toilet paper, may work if you slit it open. Extend the splint from the toes to a point well above the knee or elbow. Hold the splint in place by wrapping it with a roll of gauze, a necktie, or tape. Do not wrap tightly. Fractures above the elbow and knee are difficult to splint. The best way to prevent further damage is to keep the dog as still as possible. Dogs in shock should be transported lying down, either on a flat surface or in a hammock stretcher, to facilitate breathing and prevent a drop in blood pressure. Head injuries and spinal cord injuries require special handling and transport. Fractures where the ends of bones are at angles or far apart must be reduced under general anesthesia by a veterinarian, to bring the ends together and realign the bone. This is accomplished by pulling on the leg to overcome the muscular forces causing the displacement. Once reduced, the position of the bones must be maintained. In most dogs, with fractures above the knee or elbow the position is held with pins and metal plates, while fractures below the knee or elbow are immobilized with splints and casts. Fractures involving joints usually require open surgery and repair with pins, screws, and wire. Displaced jaw fractures cause malposition of the teeth. The jaw should be adjusted and the teeth wired together to maintain the correct position until healing is complete. Depressed skull fractures may require surgery to elevate the depressed fragments.