Delayed union, non-union and mal-union in 442 dogs

Marshall, W. G., Filliquist, B., Tzimtzimis, E., Fracka, A., Miquel, J., Garcia, J. and Dalla Fontana, M. (2022) Delayed union, non-union and mal-union in 442 dogs. Veterinary Surgery, 51(7), pp. 1087-1095. (doi: 10.1111/vsu.13880) (PMID:36053918)

Abstract

Objectives: (1) To estimate the prevalence of delayed union, non-union and mal-union in canine fractures; (2) to describe fracture, demographic, and treatment characteristics for these outcomes; (3) to identify risk factors for delayed or non-union. Study design: Retrospective study. Sample population: Four hundred and forty two dogs (461 fractures). Methods: A review was conducted of clinical records and radiographs from 2 teaching hospitals. “Union,” “delayed union,” “non-union” and “mal-union” were defined, and fracture, demographic, treatment, and outcome variables described. Differences in proportions or medians between “union,” “delayed union” and “non-union” were tested using χ2 and Mann-Whitney U-tests for categorical and continuous variables respectively. Potential explanatory variables for “delayed or non-union” were tested using logistic regression to identify risk factors. Results: Median radiographic follow up was 53 days (14-282). Delayed union occurred in 13.9% of fractures (64/461), non-union in 4.6% (21/461), and mal-union in 0.7% (3/461). Risk factors for delayed or non-union were age (OR 1.21, 95% CI 1.12-1.31); comminuted fracture (OR 4.24, 95% CI 2.4-7.5); treatment with bone graft (all types) (OR 3.32, 95% CI 1.3-8.5); surgical site infection (OR 3.24, 95% CI 1.17-8.97), and major implant failure (OR 12.94, 95% CI 5.06-33.1). Conclusion: Older dogs, dogs with comminuted fractures, surgical site infection, or major implant failure were at increased odds of delayed or non-union. Radius and ulna fractures in toy breed dogs were not at increased odds of delayed or non-union. Clinical significance: The identified risk factors should inform fracture planning and prognosticating. The prognosis for radial fractures in toy breeds appears better than historically believed.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Dalla Fontana, Maria and Marshall, Mr William and Garcia, Javier and Miquel, Jose and Tzimtzimis, Emmanouil and Fracka, Agnieszka
• Authors: Marshall, W. G., Filliquist, B., Tzimtzimis, E., Fracka, A., Miquel, J., Garcia, J., and Dalla Fontana, M.
• College/School: College of Medical Veterinary and Life Sciences > School of Biodiversity, One Health & Veterinary Medicine
• Journal Name: Veterinary Surgery
• Publisher: Wiley
• ISSN: 0161-3499
• ISSN (Online): 1532-950X
• Published Online: 27 August 2022
• Copyright Holders: Copyright © 2022 The Authors
• First Published: First published in Veterinary Surgery 51(7): 1087-1095
• Publisher Policy: Reproduced under a Creative Commons License