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Abstract 60% of a dogюs body weight is supported by its fore limbs， while the hind limbs mainly play the role of power， so the probability of dogюs radius and ulna fracture is greatly increased. This paper mainly introduced the diagnosis and treatment of a case of radius and ulna fracture in dog， with an attempt to provide reference for clinical practice.
Key words Radius and ulna fracture; Diagnosis; Treatment; Postoperative care
In recent years， fracture cases account for 30%-40% of surgical diseases， of which radius and ulna fractures accounted for 8.5%-18%. Generally speaking， 60% of a dogюs weight is supported by its fore limbs， while the hind limbs mainly play the role of power， so the probability of dogюs radius and ulna fracture is greatly increased[1-2]. This paper mainly introduced the diagnosis and treatment of a case of radius and ulna fracture in dog.
Introduction of the case
Lingti， female， 18 months old， had a weigh of 13 kg. Chief complaint： When the dog was not tied with a leash， it was knocked down by a car， and then， the fore limb limps and is painful when touched.
Diagnosis
Clinical diagnosis
When the radius and ulna of the left fore limb was palpated， the dog suffered from strong pain and screamed.
Laboratory examination
DR examination
The result is shown in Fig. 1. The backbone of the radius and ulna was fractured.
Blood routine examination and biochemical test examination
The results showed that the total number of white blood cells was slightly higher， indicating that the fracture caused inflammation of the body.
Treatment
Treatment plan
A surgical protocol was signed before surgery， and surgical internal fixation was adopted.
Preoperative preparation
Instruments and disinfection
The instruments included one scalpel and two pairs of scissors used during the operation， sutures of different specifications and sterile gauze， two pairs of tweezers （toothed and toothless）， four hemostats， eight towel clamps， one needle holder and one corresponding bone plates， six corresponding screws， one screwdriver corresponding to the screws， one intramedullary needle， one medical electric drill， two rongeurs， one pliers， two periosteal dissectors， and one drill guide. All these used things were packaged and sterilized with an autoclave.
Anesthesia and fixation
The dog was injected subcutaneously with a proper amount of atropine sulfate injection （C=0.04 mg/kg）. After about 15 min， it was induced by intravenous injection of Zoletil 50 （C=10 mg/kg）. When the above steps were completed， the dog was intubated， subjected to inhalational anaesthesia with 10 ml of sevoflurane， and connected to an ECG monitor[3]. The dog was allowed to lie on the side， with the three normal limbs fixed. The fractured limb was depilated and sterilized and disinfected with common iodophor disinfectant. Then， the fractured limb was subjected to secondary disinfection and deiodination with 70% ethanol solution.
Surgical procedure
The anterior lateral operative pathway of the radius was used[4]. An anterior lateral skin incision equal to the radius was made next to the cephalic vein， and the subcutaneous tissue and fascia were cut along the same cut line （Fig. 2）. The extensorcarpi radialis muscle and the extensor digitorum communis muscle were identified， and the fascia between the two muscles was cut along the longitudinal axis above the shaft of radius. The extensor carpi radialis muscle and the extensor digitorum communis muscle were pulled forward and backward， respectively， so as to further
expose the radius and the fracture ends of the proximal and distal bones. The oblique abductor pollicis longus was located at 1/4 of the distal end of the radius （Fig. 3）. The fracture ends were reduced and then temporarily fixed with a rongeur. The bone plate was folded into a shape to accommodate the anterior surface of the radius （Fig. 4 and Fig. 5）. If the bone plate is required to exceed the metaphyseal end of the distal radius during fixation， the bone plate should be placed under the abductor pollicis longus.
During closing， the fascia between the extensor carpi radialis muscle and the extensor digitorum communis muscle should be sutured under the premise of avoiding sewing the cephalic vein. If possible， the plate should be covered with muscle. The subcutaneous tissue and skin were routinely sutured. Postoperative Xray examination was performed to observe the fixation and restoration condition （Fig. 6）.
Postoperative Care
A certain amount of flunixin meglumine （1.31 ml） was intramuscularly injected after the operation; 1.31 ml of bone peptide was subcutaneously injected to promote fracture healing; 100 ml of glucose and sodium chloride injection and 65 ml of metronidazole and sodium chloride injection were intravenously injected， for subsidence of swelling; 50 ml of glucose and sodium chloride injection and 0.65 g of meropenem were intravenously injected， to reduce inflammation; intravenous infusion of 50 ml of glucose sodium chloride and two bottles of blbumin （5 ml/bottle） was performed to supply energy; and the wound was cleaned with gentamicin everyday， to reduce inflammation[5-6]. On the 4th day after the operation， swelling at the fracture position was obviously subsided， and the dog could walk slowly with all four limbs. The dog was observed for another 3 days， and there were no other obvious symptoms. The dog was returned to the hospital and examined one week later.
Treatment result
On the 15th day after the operation， the owner brought the dog to the hospital to take out sutures. It was observed that the dog could run and jump， and the affected limb restored to some extent. The DR examination found that the fracture began to heal obviously， and it could be known from the telephone interview one month later that the dog restored very well and can move freely like a normal dog.
References
[1]THOMAS DAVID. Graphical solution of small animal surgery technique[M]. Beijing： China Agricultural University Press， 2009： 321-367. （in Chinese）
[2]THERESA WELCH FOSSUM， CHERYL S. HEDLUND， DONALD A. HULSE， et al. small animal surgery[M]. Beijing： China Agricultural University Press， 2008： 909-927. （in Chinese）
[3]RITA H MILLER， DENNIS J CHEW. Handbook of small animal practice[M]. Beijing： China Agriculture Press， 2004： 22-28. （in Chinese）
[4]DONG HJ， PENG GN. Atlas of small animal orthopedic surgery[M]. Beijing： China Agriculture Press， 2011. （in Chinese）
[5]XIAO YH， ZHAN CL. Dog radius and ulna fracture cases[J]. Chinese Journal of Veterinary Medicine， 2005（41.1） ：43 （in Chinese）
[6]LIU QB， YANG M， SHEN Y， et al. External fixation treatment of a case of radius and ulna fracture in dog[J]. Shandong Journal of Animal Husbandry and Veterinary Science， 2010（31）： 26. （in Chinese）
Key words Radius and ulna fracture; Diagnosis; Treatment; Postoperative care
In recent years， fracture cases account for 30%-40% of surgical diseases， of which radius and ulna fractures accounted for 8.5%-18%. Generally speaking， 60% of a dogюs weight is supported by its fore limbs， while the hind limbs mainly play the role of power， so the probability of dogюs radius and ulna fracture is greatly increased[1-2]. This paper mainly introduced the diagnosis and treatment of a case of radius and ulna fracture in dog.
Introduction of the case
Lingti， female， 18 months old， had a weigh of 13 kg. Chief complaint： When the dog was not tied with a leash， it was knocked down by a car， and then， the fore limb limps and is painful when touched.
Diagnosis
Clinical diagnosis
When the radius and ulna of the left fore limb was palpated， the dog suffered from strong pain and screamed.
Laboratory examination
DR examination
The result is shown in Fig. 1. The backbone of the radius and ulna was fractured.
Blood routine examination and biochemical test examination
The results showed that the total number of white blood cells was slightly higher， indicating that the fracture caused inflammation of the body.
Treatment
Treatment plan
A surgical protocol was signed before surgery， and surgical internal fixation was adopted.
Preoperative preparation
Instruments and disinfection
The instruments included one scalpel and two pairs of scissors used during the operation， sutures of different specifications and sterile gauze， two pairs of tweezers （toothed and toothless）， four hemostats， eight towel clamps， one needle holder and one corresponding bone plates， six corresponding screws， one screwdriver corresponding to the screws， one intramedullary needle， one medical electric drill， two rongeurs， one pliers， two periosteal dissectors， and one drill guide. All these used things were packaged and sterilized with an autoclave.
Anesthesia and fixation
The dog was injected subcutaneously with a proper amount of atropine sulfate injection （C=0.04 mg/kg）. After about 15 min， it was induced by intravenous injection of Zoletil 50 （C=10 mg/kg）. When the above steps were completed， the dog was intubated， subjected to inhalational anaesthesia with 10 ml of sevoflurane， and connected to an ECG monitor[3]. The dog was allowed to lie on the side， with the three normal limbs fixed. The fractured limb was depilated and sterilized and disinfected with common iodophor disinfectant. Then， the fractured limb was subjected to secondary disinfection and deiodination with 70% ethanol solution.
Surgical procedure
The anterior lateral operative pathway of the radius was used[4]. An anterior lateral skin incision equal to the radius was made next to the cephalic vein， and the subcutaneous tissue and fascia were cut along the same cut line （Fig. 2）. The extensorcarpi radialis muscle and the extensor digitorum communis muscle were identified， and the fascia between the two muscles was cut along the longitudinal axis above the shaft of radius. The extensor carpi radialis muscle and the extensor digitorum communis muscle were pulled forward and backward， respectively， so as to further
expose the radius and the fracture ends of the proximal and distal bones. The oblique abductor pollicis longus was located at 1/4 of the distal end of the radius （Fig. 3）. The fracture ends were reduced and then temporarily fixed with a rongeur. The bone plate was folded into a shape to accommodate the anterior surface of the radius （Fig. 4 and Fig. 5）. If the bone plate is required to exceed the metaphyseal end of the distal radius during fixation， the bone plate should be placed under the abductor pollicis longus.
During closing， the fascia between the extensor carpi radialis muscle and the extensor digitorum communis muscle should be sutured under the premise of avoiding sewing the cephalic vein. If possible， the plate should be covered with muscle. The subcutaneous tissue and skin were routinely sutured. Postoperative Xray examination was performed to observe the fixation and restoration condition （Fig. 6）.
Postoperative Care
A certain amount of flunixin meglumine （1.31 ml） was intramuscularly injected after the operation; 1.31 ml of bone peptide was subcutaneously injected to promote fracture healing; 100 ml of glucose and sodium chloride injection and 65 ml of metronidazole and sodium chloride injection were intravenously injected， for subsidence of swelling; 50 ml of glucose and sodium chloride injection and 0.65 g of meropenem were intravenously injected， to reduce inflammation; intravenous infusion of 50 ml of glucose sodium chloride and two bottles of blbumin （5 ml/bottle） was performed to supply energy; and the wound was cleaned with gentamicin everyday， to reduce inflammation[5-6]. On the 4th day after the operation， swelling at the fracture position was obviously subsided， and the dog could walk slowly with all four limbs. The dog was observed for another 3 days， and there were no other obvious symptoms. The dog was returned to the hospital and examined one week later.
Treatment result
On the 15th day after the operation， the owner brought the dog to the hospital to take out sutures. It was observed that the dog could run and jump， and the affected limb restored to some extent. The DR examination found that the fracture began to heal obviously， and it could be known from the telephone interview one month later that the dog restored very well and can move freely like a normal dog.
References
[1]THOMAS DAVID. Graphical solution of small animal surgery technique[M]. Beijing： China Agricultural University Press， 2009： 321-367. （in Chinese）
[2]THERESA WELCH FOSSUM， CHERYL S. HEDLUND， DONALD A. HULSE， et al. small animal surgery[M]. Beijing： China Agricultural University Press， 2008： 909-927. （in Chinese）
[3]RITA H MILLER， DENNIS J CHEW. Handbook of small animal practice[M]. Beijing： China Agriculture Press， 2004： 22-28. （in Chinese）
[4]DONG HJ， PENG GN. Atlas of small animal orthopedic surgery[M]. Beijing： China Agriculture Press， 2011. （in Chinese）
[5]XIAO YH， ZHAN CL. Dog radius and ulna fracture cases[J]. Chinese Journal of Veterinary Medicine， 2005（41.1） ：43 （in Chinese）
[6]LIU QB， YANG M， SHEN Y， et al. External fixation treatment of a case of radius and ulna fracture in dog[J]. Shandong Journal of Animal Husbandry and Veterinary Science， 2010（31）： 26. （in Chinese）