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Postoperative Care Following Fractures

Bone requires rigid stabilization for proper healing to occur. Methods for stabilization are classified into surgical and non-surgical techniques. Non-surgical stabilization techniques involve placing external splints and bandages to hold the bone in alignment. Only certain fractures will heal well with external stabilization. Other fractures require surgically-placed metal implants to hold the bone in alignment allowing passive motion of the joints while healing occurs.

Activity and Physical Rehabilitation

STRICT CAGE REST is extremely important for your pet to heal after surgery. Implants are generally made out of stainless steel or titanium. They are quite strong; however, they can bend and break if they are stressed. All fractures need at least 4 to 6 weeks to heal. During this time there will be a lot of stress placed on the implants, and it is very important to protect the surgical repair at all cost. Implant failure is often catastrophic and can result in the need for an additional surgery or even amputation. The only activity allowed after surgery should be closely supervised short trips outside (ONLY ON A LEASH) to urinate and defecate. Uncontrolled activity such as running, jumping or stairs should not be allowed.
Physical rehabilitation is very important to restore joint function. Southeast Veterinary Specialists is extremely lucky to have a certified animal rehabilitation practitioner on staff. Robert Porter (Robby) is here to guide you through the process of physical rehabilitation after the surgeons have mechanically reconstructed your pet's bone. If a human member of your family received this type of surgery, the doctor would likely prescribe physical rehabilitation. Physical rehabilitation is also important for your pet. Physical rehabilitation appointments with Robby are strongly recommended after most fracture repairs. We understand that both time and finances may be limited; however, it is our opinion that aggressive rehabilitation can greatly improve your pet's function after surgery. If you cannot make the rehabilitation sessions with Robby, you will have to take on the role of physical therapist. Since the leg must remain completely unstressed, your pet will rely on you and Robby to help him/her move the joints through a complete range of motion several times daily. Each joint of the fractured leg should be gently flexed and extended to the fullest extent possible ten to fifteen times at least twice daily (3 to 4 times daily would be ideal). These exercises can be started about 10 days after surgery and continued for at least one month.

Medication

Medications may be recommended postoperatively. Generally, with longer surgical procedures, antibiotics will be given at surgery and continued after your pet goes home from the hospital. The length of treatment and choice of antibiotic will depend on the surgical procedure. If infection is suspected at surgery a culture will be performed. The antibiotic dispensed may need to be changed depending on the culture results. Pain medication is given after surgery and continued as long as it is needed. The stronger pain medications (generally opiates) are given by injection, requiring your pet to stay in the hospital until these are no longer needed. In most cases, a non-steroidal anti-inflammatory drug such as carprofen (Rimadyl®) or deracoxib (Deramaxx®) will be recommended. This class of drugs is often helpful in relieving postoperative inflammation, pain, and swelling. This will help your pet be more comfortable and return to normal function sooner. Do not give your pet any other medication without consulting your veterinarian. Many other non-steroidal anti-inflammatory drugs available for people are often toxic in dogs.

Sutures and Bandages

A bandage is often placed after surgery to help decrease pain and swelling. Bandages are generally removed within 48 hours after surgery. If the bandage is still on your pet after he/she returns home, it is important that it stay clean and dry. If your pet needs to go outside, it is helpful to place a plastic bag (Ziploc bags work well) over the foot to protect the bandage. If the bandage becomes soiled or you notice swelling of the toes, contact our office immediately.

Recheck Examinations and Radiographs

Your pet will need a recheck examination and x-rays at 4 weeks and 8 weeks after the operation. This will tell us how the bone is healing and help determine how much exercise (if any) your pet can have at that point. If you have any concerns between scheduled visits, please call your veterinarian.
Fracture repair and healing can be complicated; however, with diligent care and appropriate surgical therapy, function can be recovered. The aftercare is just as important, if not more so, than the surgical treatment and cannot be overemphasized.