Authors of section

Author

Mary Sarah Bergh

Executive Editor

Amy Kapatkin

General Editor

Noel Moens

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Percutaneous

1. Indications

A percutaneous approach is used prior to pin placement when a minimally invasive approach is preferred, and the fracture can be reduced in a closed fashion.

It is most commonly used with 33-A1 and 33-A2 fractures.

Fluoroscopy or intraoperative radiography is used to ensure appropriate reduction with this approach.

Fluoroscopy or intraoperative radiography is used to ensure appropriate reduction with percutaneous approach in dog distal femur

2. Skin incision

A skin incision is made on the regions of the desired pin placements. The subcutaneous fat and superficial fascia are incised directly under the skin incisions.

A small incision is made into the joint capsule and the condyle is visualized.

Note: Damage to the articular surface should be avoided. The long digital extensor tendon should be carefully avoided in this approach.

Percutaneous approach skin incision in dog distal femur

Intraoperative photo of cross pins placed percutaneously.

Percutaneous approach pin placement in dog distal femur

Closure

Absorbable suture material is used to close the joint capsule and subcutaneous tissue. The skin is routinely closed with nonabsorbable sutures.