Bridging plate

A bridging plate is mainly used for humeral wedge fractures and complex humeral shaft fractures, but can also be used for simple fractures. A bridging plate used alone is acceptable in young dogs, with fast bone-healing, and lightweight or midsized patients.

If a bone plate is used alone, it must withstand all the weight-bearing forces during healing since the bone will not initially be sharing the load. A large plate must, therefore, be used.

Note: A locking plate gives more stability than a plate used with nonlocking cortical screws.

A lateral approach, with the patient positioned in lateral recumbency with the affected leg up, is preferred for proximal fractures.

A medial approach, with the patient positioned in dorsal recumbency is preferred for distal fractures.

Indirect reduction is achieved by distracting and aligning the major bone segments using bone clamps or other distraction techniques.

Since the plate must withstand all weight-bearing forces alone, a large plate must be selected. A locking plate is preferred to a plate with cortical screws.

A lengthening plate (a plate without holes in the central part) can also be used.

The plate is contoured to the shape of the bone. The plate's length should allow the placement of at least three screws in each major fragment. Precise contouring is not as important when using a locking plate.

Rotational and axial alignment must be considered.

Read more about plate preparation.

The plate is secured to the bone with bone clamps or bone holding forceps.

1.5-year-old dog with 12-C3 fracture.

The fracture was fixed with a medial bridging plate.

Follow-up radiographs were taken six months after the surgery.

The aim is to reduce edema, inflammation, and pain.

Integrative medical therapies, anti-inflammatory medication, and analgesics are recommended.

Note: Because bridging plates must withstand very strong forces, rigorous leash confinement, no jumping, and possible support during walking are recommended until radiographs show signs of bone healing.

The aim is to resolve hematoma and edema, control pain, and prevent muscle contracture.

Anti-inflammatory and analgesic medications may still be needed. Rehabilitation and integrative medical therapies can be used.

A careful evaluation is recommended if the dog does not start to use the limb within a few days after surgery.

Radial nerve neurapraxia may occur in some cases. This neurapraxia usually resolves within a few days.

10-14 days after surgery, the sutures are removed.

Radiographic assessment is performed every 4–8 weeks until bone healing is confirmed.