Fracture disease

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Fracture disease is commonly characterized by muscle atrophy and/or contracture, joint stiffness and osteoporosis. This chapter covers aetiology, clinical signs of fracture disease, pathophysiology, quadriceps contracture, avoiding fracture disease.

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28.1 Fracture disease affecting the forelimb of a skeletally mature dog as a result of inadequate fracture management. (a) A proximal ulnar fracture with concomitant radial head luxation (Monteggia fracture). (b) The fracture was treated with a plate applied to the ulna, without appropriate reduction and stabilization of the radial head. (c) This led to the loss of elbow function with concurrent carpal flexor contracture.
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28.2 Mediolateral radiograph of the tibia in a 10-week-old Labrador Retriever 3 weeks after cast immobilization to treat a distal diaphyseal fracture. The poor contrast between the bone and soft tissues distally is suggestive of loss of bone density and cortical thinning, consistent with a diagnosis of disuse osteopenia.
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28.3 (a) Mediolateral and (b) caudocranial follow-up radiographs of a femoral fracture inappropriately stabilized with an IM pin and cerclage wires. The distal aspect of the pin has penetrated the craniodistal femoral cortex. An area of radiolucency surrounding the distal aspect of the pin indicates pin loosening. Inadequate fracture stability will increase the risk of quadriceps contracture.
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28.4 Quadriceps contracture following inappropriate femoral fracture treatment. Stifle and tarsal hyperextension and genu recurvatum are present.
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28.5 Transarticular hinged external skeletal fixator. Hinged fixators can be used to allow passive or active joint movement. In this case, the fixator was used to protect a collateral ligament repair allowing flexion and extension of the carpus whilst preventing medial, lateral or rotational displacement.
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