28kg Lurcher with a closed comminuted extensive mid-diaphyseal tibial fracture. Epidural supplementary analgesia.
A medial approach, reconstruction of load sharing caudomedial surface and lag screw fixation of main craniomedial butterfly fragment, remaining soft tissues undistrubed and no attempt to fixate lateral fragment.
Four .5mm lag screws and an 11 hole 4.5mm butress plate, filling every hole to reduce stress riser effect.
It’s a ‘carpentry’style repair rather than a biological locking plate/rod fixation, in part governed by availability of locking implants at sufficient length; and orthodox 3.5mm DCP would have been insufficiently robust for the loading.
The large oblique cranial fragment presents a challenge
International Women’s Day today…here’s anaesthetic nurse Sarah….
Early onset elbow arthritis meant he was becoming limited in his movement