Authors of section

Author

Cassio Ferrigno

Executive Editor

Amy Kapatkin

General Editor

Noel Moens

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Bridging plate

1. Principles

The intact fibula maintains the limb alignment. The plate function is to protect the fibula from loading forces and to stabilize the tibial fracture.

Note: All simple fractures may be reduced and stabilized with a compression plate. Anatomical reconstruction is not required because of the intact fibula and a bridging technique may be preferred.

bridging plate

2. Preparation and approach

For this procedure, one of the following two patient positions are used:

One of the following two approaches are used:

3. Surgical technique

Reduction

The fibula is helping the reduction and bone alignment. Care should be taken during surgery not to damage the fibula when manipulating the tibial fracture fragments.

bridging plate

Plate placement

The plate is contoured and placed on the medial side of the tibia, in bridging function.

Read more about plate preparation.

additional material 01

Plate application

The plate is applied by inserting at least three bicortical screws in each major segment. The plate should bridge at least 75% of the length of the tibia.

42 A1

Locking plate

The use of a locking plate may be advantageous because there is less plate contouring needed.

bridging plate

4. Case example

4 month old mix breed dog with a 42-A1 fracture from falling from a height.

definition

The fracture was repaired with a 2.4mm locking compression plate, three locking screws and one cortical screw using a MIPO technique.

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Postoperative radiographs at 30 days showing healing of the fracture.

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Postoperative radiographs at 38 days (implant removal).

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5. Aftercare

Phase 1: 1-3 day after surgery

The aim is to reduce the edema, inflammation and pain. A Robert Jones or modified Robert Jones bandage can be used to decrease the edema and protect the surgical wound. Integrative medical therapies, anti-inflammatory medications and analgesics are recommended. In most cases, 10-20 minutes of ice therapy is recommended every 8 hours.

Phase 2: 4-10 days after surgery

The aim is to resolve the hematoma, edema and control pain, and prevent muscle contracture. Anti-inflammatory and analgesic medications may still be needed. Rehabilitation and integrative medical therapies can be used.

If the dog is not starting to use the limb within a few days after surgery, a careful evaluation is recommended.

10-14 days after surgery the sutures are removed.

Phase 3: 10 day-bone healing

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

Implant removal

More information about implant removal can be found here.