Vet360 Vet360 Vol 4 Issue 6 | Page 13

SURGERY Advances in Antelope Fracture Repair Where are we now? Luke Poore 1 and Katja Koeppel 2 The Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Onderstepoort 2 The Department of Production Animal Studies, Faculty of Veterinary Science, University of Pretoria, Onderstepoort 1 Luke Poore Katja Koeppel Introduction Fractures of the appendicular skeleton in antelopes have been infrequently reported in the veterinary lit- erature. 1-11 The size of South African antelopes varies considerably from a 3 kg dik-dik to a 900 kg giant eland making fracture repair challenging. 12 Significant advances in both anaesthetic regimes and fracture fixation technology in the last 15 years have now made fracture repair in these antelopes a viable option. Improvements in knowledge and develop- ment of techniques for blood transfusions have also improved the success rate of such surgeries. 13 The future development of specialist intensive care units for antelopes in both the pre-operative and post-op- erative periods will also improve the success rate of fracture fixation surgeries in antelopes. Advances in Fracture Fixation Techniques with Relevance to Antelopes The aim of any surgical fracture repair is to recon- struct the original anatomical structures and restore the function of the fractured bone. Plate and screw osteosynthesis has been used in clinical settings since 1886, when Carl Hansman used a monocortical fixa- tor. 14 As implantation techniques have since been refined, clinical results have been subsequently improved. By using internal fixation with angular stability, fractures in the metaphyseal region of bone and in osteoporo- tic bone have been repaired. 15 The Synthes Locking Compression Plate (LCP) is part of a stainless steel and titanium plate and screw system that merges locking screw technology with conventional plating techniques. The LCP System has many similarities to existing plate fixation methods, but has some sig- nificant improvements. Locking screws provide the ability to create a fixed-angle construct while utilizing familiar Association for the Study of Internal Fixation (AO) plating techniques. A fixed-angle construct provides advantages in os- teoporotic bone or multifragmentary fractures where traditional screw purchase is compromised. This is particularly important in our experience of antelope long bone fractures where open comminuted frac- tures are over-represented and many fractures have areas of osteoporotic bone present. Where insufficient screw to bone fixation is available because of poor bone quality in these cases, cyclic loading of conventional plate–bone constructs can lead to secondary loss of fracture alignment and sta- bility. 16 Screws are known to be susceptible to pull- out fatigue in the metaphyseal regions of bones, os- teoporotic bone, patients having slow bone healing conditions and patients with poor compliance to re- stricted activity during the post-operative period. 17 An- telopes with long bone fractures often present with several of these issues and have poor compliance in the post-operative period. Locking screws do not rely on plate-bone compres- Issue 06 | DECEMBER 2017 | 13