Femur Diaphyseal Fracture Repair — ROCKEY

Signalment and History
ROCKEY, an INDIE male (~28 kg), was presented after an automobile accident with inability to bear weight on a hind limb. On presentation (16 Jul 2025) he was getting up on three limbs and limping on the left hind limb; passed bloody urine once. Radiographs demonstrated a closed, complete oblique femoral fracture of the left femur.

Preoperative Assessment & Diagnostics
Pre-op workup included radiographs (requisition 436003 / 438739), CBC, LFT and KFT and FAST scans where indicated. Initial labs showed leukocytosis and some LFT elevation (AST/ALT trending high in perioperative samples). AFAST/TFAST were performed to rule out concurrent abdominal/ thoracic injuries. The patient was admitted for monitoring and surgical fixation.

"MRI + CT + 3D planning for safer surgery."

Surgical Procedure
On 17 Jul 2025, femoral fracture stabilization was performed using an intramedullary (IM) pin combined with lateral plate fixation and cerclage wiring. The incision was on the lateral femur; fracture ends were distracted and reduced to anatomical alignment, then stabilized with IM pin and lateral plate augmented with cerclage wire. Routine three-layered closure was performed (absorbable deep sutures, non-absorbable skin sutures). Estimated blood loss minimal; no intraoperative complications reported. Intraoperative analgesia and antibiotics were given (CT, tramadol).

Postoperative Management
Immediate postop care included IV/SC fluids and injectable medications (CT 450 mg, clindamycin 220 mg, Rantac, Tribvet, Melonex, tramadol, Perinorm, Lasix as indicated). Rockey was admitted to IPD for monitoring with nursing care and fluid therapy. Bandaging applied; wound checks and suture care performed. Owners instructed on E-collar use (10 days), strict activity restriction, wound care with Betadine and Staphban ointment twice daily, and suture removal at ~10 days.

Oral medications on discharge included:

• Chymerol Forte — 1 tab twice daily for 10 days

• Cephavet 300 mg — twice daily for 10 days

• Bioclan 300 mg — 0.5 tab twice daily for 10 days

• Firotail 57 mg — 1 tab twice daily for 5 days

• Pantop 40 mg — 1 tab twice daily for 10 days

• Boniheal syrup — 8 ml twice daily for 30 days

• Merical Brisket — twice daily for 30 days

• Calcitrol sachet — once weekly for 3 weeks

Postoperative Course & Follow-up
During hospitalization Rockey was clinically active, intermittently weight-bearing on the operated limb. Dressing changes revealed mild inflammatory discharge at the suture site which reduced after bandaging and treatment. A follow-up on 27 Jul 2025 showed sutures in good condition, pet walking on operated limb, and radiographs confirming implant in position. Medication and follow-up plans were provided; suture removal advised on 01 Aug 2025.

Discussion
Diaphyseal femoral fractures from high-energy trauma often require robust internal fixation. Combining an IM pin with lateral plating and cerclage wiring provides axial, bending and rotational stability—useful in oblique/spiral fractures. Perioperative stabilization, infection prophylaxis, and strict activity control are crucial to healing and reducing complications.

Conclusion
This case documents femoral diaphyseal fracture repair in a medium-breed patient using IM pinning with lateral plate and cerclage wiring. With appropriate surgical technique and postoperative care, the patient progressed to ambulation with implants confirmed in position on follow-up radiographs.