Aim: The aim of this case series was to review clinical outcomes and complications associated with the use of inverted circular-linear hybrid external skeletal fixator constructs with the ring positioned proximally in order to stabilise fractures with short proximal fracture segments.
Materials and methods: The medical records of dogs and cats with proximal juxta-articular fractures managed using an inverted hybrid construct at three institutions between December 2008 and October 2023 were reviewed. Data regarding animals' signalment, fracture description, construct configuration, subjective assessment of reduction and alignment, time to fixator removal and functional outcome were recorded at the time of the last clinical evaluation or via a follow-up phone conversation with the owner. Restoration of alignment of the healed bone was objectively assessed after fixator removal by comparison of joint orientation angles between the fractured and contralateral bone.
Results: Twenty dogs and two cats underwent fracture stabilisation with an inverted hybrid construct, including 18 tibial fractures (82%), three humeral fractures (14%) and one femoral fracture (4%). Postoperative reduction and alignment was subjectively considered anatomic in six fractures, near-anatomic in five fractures and acceptable in 11 fractures. Median time to fixator removal was 4.5 weeks (range: 2-20 weeks). Pin or wire tract inflammation developed in nine dogs and was the primary complication occurring during the postoperative convalescent period. Owners of 16 animals were contacted by telephone 7-88 months (median: 37 months) following surgery. Fourteen of those animals had no lameness, whereas two owners reported that their dog had an occasional, subtle weight-bearing lameness. All owners were highly satisfied with the outcome of their pet's surgery.
Discussion: This descriptive case series illustrates the utility of novel inverted hybrid constructs for stabilising proximal juxta-articular appendicular long bone fractures in small animals.
