Fractura Expuesta Metafisaria Conminuta Proximal De La Tibia Y Diafisaria Proximal Del Peroné En Compactación Por Mordedura En Miembro Posterior Derecho.

Abstract

Diaphyseal fractures of the tibia and fibula are common in veterinary traumatology; however, when they are open, comminuted, and caused by a bite, they are considered high-complexity and low-incidence injuries. This report presents the case of Dante, a 2-year-old male Yorkshire Terrier, who was admitted to the Drs. Reyes Veterinary Clinic after being bitten by another dog. On physical examination, an open tibial fracture was evident in the right hind limb, with necrotic soft tissue, purulent discharge, and severe pain. Following radiographic evaluation, surgical treatment was pursued. The patient received in-hospital care including preoperative and postoperative management with analgesics, anti-inflammatories, and antibiotics. Initial treatment consisted of wound cleaning and soft tissue debridement. The bone fragment was temporarily stabilized with suture due to the high risk of osteomyelitis from the contaminated wound. However, this surgery failed due to progressive tissue necrosis, resulting in bone exposure. Consequently, the decision was made to implement an external fixation device originally designed for human use. Although the first surgery using the external fixator was initially successful, the patient suffered multiple refractures, requiring additional surgical interventions to reposition or replace the fixator. Unfortunately, no significant clinical improvement was achieved. Ultimately, limb amputation was performed as a salvage procedure. Throughout the treatment, wound management and regular monitoring were carried out to assess the patient’s progress. This case highlights the necessity of adapting surgical techniques in small breed patients. The use of the human-designed Hoffmann Micro external fixator served as an innovative approach for managing a complex fracture, even though the clinical outcome was not favorable.