Fracture Repair

Most fractures in dogs and cats require surgical stabilization. Without internal or external fixation, broken bones cannot be kept in correct position during the weeks of healing, leading to malunion (healing in a bad angle), non-union (failure to heal), limb shortening, and chronic pain. Surgical stabilization allows early, comfortable weight-bearing that actually promotes faster bone healing through controlled loading. Exceptions include very stable, non-displaced fractures in young animals where splinting or casting alone may suffice — the surgeon determines the appropriate approach after reviewing imaging.

Fracture repair is performed under general anesthesia. The technique chosen depends on the fracture pattern and location:

• Bone plates and screws — most versatile; the plate is contoured to fit the bone and holds fragments in anatomic alignment; ideal for many long-bone fractures
• Intramedullary (IM) pins — a pin inserted down the marrow canal resists bending forces; often combined with cerclage wires or interlocking screws for rotational stability
• Cerclage wires — loops of wire around the bone that hold oblique or spiral fragments together; used adjunctively with pins or plates
• External skeletal fixation (ESF) — pins through the skin into bone segments, connected by an external frame; particularly useful for open (compound) fractures or when soft tissue damage contraindicates implants near the skin

After repair, post-operative X-rays confirm alignment before the patient wakes. The goal is alignment that allows the bone to heal without stress shielding and supports early controlled weight-bearing.

Emergency stabilization of a fractured limb — splinting and pain management — begins as soon as the patient arrives. Full-body radiographs screen for concurrent injuries (chest trauma, other fractures) before anesthesia. Bloodwork assesses internal organ status, which is especially important in trauma patients. If surgery cannot proceed immediately due to severe swelling or the patient's systemic condition, the fracture is temporarily stabilized and the patient is pain-managed until it is safe to proceed. Owners should withhold food once surgical timing is confirmed by the team.

Bone healing takes time — the implants hold the fracture stable while new bone forms, a process that takes several weeks to months depending on the fracture type and the patient's age. Recovery milestones:

• Weeks 1–2: strict rest; limb use is limited but often begins within days; pain medication; incision care; bandage or splint changes if an external device is used
• Weeks 3–8: controlled leash activity; no running, jumping, or rough play; follow-up X-rays at approximately 4–6 weeks to assess healing progress
• Weeks 8–12+: final X-rays confirm bridging bone callus; gradual return to full activity based on imaging results

Young animals (especially kittens and puppies) heal remarkably fast — sometimes in as few as 4–6 weeks. Adult and senior animals typically take 8–12 weeks or longer. The repair holds the bone stable throughout this period.

Fracture repair carries risks that vary with the complexity of the injury. Possible complications include infection (particularly with open fractures), implant loosening or failure before healing is complete, delayed union, and malunion if postoperative instructions are not followed. Implants may occasionally require removal if they cause irritation after healing. The large majority of dogs and cats with appropriately managed fractures heal well and return to full or near-full function. Pathologic fractures (those caused by underlying bone disease or cancer) carry a different prognosis and require additional evaluation to determine the best course of action.