The Case
This patient is a 9-year-old Old English Bulldog who was initially presented at a local veterinary clinic after a horse kick accident. Radiographs confirmed a scapula fracture, prompting the referral of the case to Wasbek Small Animal Clinic in Germany for comprehensive diagnostics and potential surgical treatment by Dr. Johannes Frahm.
Diagnosis
Dr. Dominik Wilke from the Wasbek Veterinary Clinic, shared insights into the diagnostic process, stating, “To precisely determine the location and type of fracture, we opted for a computed tomography examination. The CT revealed a complex multifragment fracture of the scapula, involving both the supraglenoid tubercle and the articular surface.”
Surgical Solution
Given the involvement of the joint, Dr. Frahm and Dr. Wilke opted for surgery. Their first step was the realignment of the fractured scapula, securing it with our wide, 6 hole titanium Rapid Luxation plate and 2.4mm cortical screws (3x8mm, 2x10mm, and 1x6mm). The surgical approach was cranial to the spine of the scapula, involving dissection down to the supraspinous fossa located near the spine of the scapula.
Subsequently, the surgical incision was extended distally to expose the supraglenoid tubercle. Using the C-arm, a guide pin was inserted, followed by the insertion of a compression screw (a 36mm Rita Leibinger Medical 4.0 LeiCOM Medi Compression Screw) over the pin, which was then removed.
A postop CT scan revealed a successful compression of the fracture gap, with the compression screw positioned outside the joint space. The surgery lasted approximately 2.5 hours, with an increased level of difficulty due to the rarity of this fracture and the challenging access to the supraglenoid tubercle caused by the patient's well-developed musculature.
Well done, Dr. Frahm and Dr. Wilke!
SPECIAL THANKS to Dr. Johannes Frahm, Dr. Dominik Wilke, and the whole team of Wasbek Veterinary Clinic for letting us share this very interesting case. Images courtesy of and copyrighted to:
24647 Wasbek, Germany
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