Complications are common with most veterinary fracture treatment methods: casting, splinting, bracing, external skeletal fixators (ESF), and surgery. In this article, Martin Kaufmann (COO, Dassiet Vet) and Dr. Sami Saku (MD, Ph.D) discuss the current treatment methods based on research and outline what a better alternative might look like.
Casts are notorious for causing complications. The often-cited research paper by Meeson et al. (2011) found that 63 % of the 60 dogs and cats who had a cast placed developed soft-tissue injuries ranging from mild to severe. Perhaps for this reason, many veterinary practitioners view surgery as a safer option than external coaptation.
“The main reason for veterinarians to choose surgery over casting is the fear of casting complications,” explains Saku. “On the human side, it’s the other way around. The most common fractures very seldom require surgery, and usually we fear its potential complications.”
Even if perceived as the safer option, invasive treatments such as surgery or ESFs do pose risks. A study on ESFs saw 60 % of dogs suffering complications during treatment2. Saku notes that the same number in humans is at most 10 percent.
Patient compliance may be a large factor behind the difference, but based on 2017 research by Meeson et al., it also seems external fixators are used differently in human and veterinary medicine.
“In human medicine, we use ESFs mainly in severe fractures that present with soft-tissue damage and severe swelling. The fixator often serves to temporarily immobilize the fracture until we can operate and fix the fracture with plates and screws”, Saku explains. In animals, ESFs are often used as the definitive treatment and are used for up to ten weeks.
Complications in veterinary casting often go unnoticed until it’s too late
Early detection is key to preventing most complications. With human patients it is often simple: they can tell you if the cast or splint is uncomfortable or painful. But dogs and cats cannot.
This means that any issues are often detected late, and complications such as cast sores, edema, eczema, or dermatitis have had time to develop. For the treating veterinarian and their staff, this means time spent on weighing other treatment options and treating the complication, more time spent operating, and more follow-up visits with the pet and owner.
Pets face longer treatment periods, pain, likely anesthesia-related risks, and – at worst – death. For pet owners, a complication means not just more worry and heartache, but also more money spent.
A treatment alternative that would allow easy modification and re-adjustment of the cast, splint or brace would make preventing and managing pain much easier. An option like this would also make it easy to follow up on how the fracture is healing and keep an eye on possible skin-related issues.
Research is crucial to uncovering better alternatives for veterinary fracture treatment
More research on how to prevent complications when treating fractures in animals is needed. It will lead to better treatment methods and medical devices, which will help pets and owners have better outcomes after a fracture.
”Basing all innovation and product development on research is crucial. This is why we collaborate closely with universities and experts in the field. It is the only way to modernize veterinary fracture treatment,” Kaufmann says.
Both Kaufmann and Dr. Saku are highly involved in the veterinary research community. Dr. Saku is currently working on research about the UPETS splint as an alternative to traditional treatment methods such as bioplastics, plaster-of-Paris, and fiberglass casts, and surgery. So far, feedback from clinics and veterinary experts has been highly positive.
 Meeson, R.L, Davidson, C., Arthurs G. I., 2011, “Soft-tissue injuries associated with cast application for distal limb orthopaedic conditions: A retrospective study of sixty dogs and cats”
 Beever, L. J., Giles, K., Meeson, R. L, 2017, “Postoperative Complications Associated with External Skeletal Fixators in Dogs”