Franklin Vets Blog

Whoppa’s unusual fracture

August 2, 2020

“Whoppa” was a 6-month-old German wirehaired pointer who came into our Waiuku clinic with a front leg lameness, after having been attacked by another dog. Whoppa had been bitten in several places, one of them being over the left shoulder.

Now, bites are not a common cause of fractures but can occur, especially when big teeth in big mouths bite small bones in small patients. But in this case, Whoppa was quite a big dog himself.

But given the degree of pain around the shoulder, x-rays were taken of the leg, showing a slightly unusual injury.
Fractures in young dogs are tricky to see sometimes as the bones still have open growth plates. These are the area in a long bone where the bone grows, and can look very like fractures themselves.

Whoppa's diagnostic x-rayWhoppa's diagnostic x-ray marked up
Here I have marked the normal growth plate with a red line, and the fracture in a yellow line in the same image as above.

At this point, Whoppa was transferred over to the Pukekohe clinic for orthopaedic assessment and repair.

Now, to complicate it further, this is called an avulsion fracture, where the fractured piece of bone is being pulled away from the main shaft of the bone by a muscle. In this case, it’s a muscle called the supraspinatus, which attaches to the humerus and the scapula as shown below:

Supraspinitis muscle

So, to counteract the pull of the muscle tendon, which is going to try and pull the fragment of bone away from the shaft and prevent it healing, we had to place either a screw through the fragment and into the shaft or a pin and tension band device. The fragment was too small to accommodate a screw without splitting, so we went for a tension band instead, like this:

tension band for avulsion fracture

Several wounds were tidied up at the same time.
Whoppa had restricted activity for several weeks after surgery, and x-rays at 10 weeks showed complete bone healing.

complete bone healing with implants

The implants will stay in permanently unless they start to cause problems, and Whoppa should now live a normal active life.

A very nice result for something a little unusual. I love these cases as they make you think a bit outside the square, and to see the patient back bouncing around again pain- free is a really satisfying feeling for me.

Paul Eason BVM&S MANZCVS (Surgery; Emergency and Critical Care Medicine.