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Fracture management in small animal practice 1. Triage and stabilisation

FRACTURE management has gradually evolved over the past 50 years, progressing from traditional traction and external coaptation techniques to methods involving the use of internal fixation to aid an early return to limb use. The way in which implants are used has also changed, from a desire to painstakingly anatomically reconstruct every fracture to a realisation that preservation of the fracture environment can be extremely beneficial, resulting in the advent of techniques facilitating `biological fracture fixation'. One of the main stimuli behind the evolution of fracture repair has been an appreciation of the interaction between a bone and its soft tissue envelope, and consideration of the animal as a whole rather than the fracture viewed in isolation. This article discusses the triage and stabilisation procedures for the initial management of all fractures, with the aim of encouraging the clinician to consider the fracture as part of the entire animal rather than as a single entity. An article in the next issue will examine the steps involved in the logical assessment of a fracture and will describe how to plan a suitable repair.

Chris Shales graduated from Cambridge in 2000 and, having spent two years in practice, returned there as a surgical resident in 2002. He subsequently spent a year as a clinical surgeon at the Queen's Veterinary School Hospital before taking up a post at Bristol University in small animal orthopaedics where he currently works. He holds the European College of Veterinary Surgeons diploma in small animal surgery and the RCVS certificate in small animal surgery.