Limb Injuries

FRACTURES

Fractures are broken bones. Normally the break is complete but in the young animal the bone may only be cracked or bent. This is called a greenstick fracture and is extremely painful, often more painful than a complete break. The most common cause of fractures is direct force, and in our domestic animals this is usually due to being hit by an automobile (car, truck, train and in Melbourne the rare tram). Other causes are falls, being dropped (or thrown), being stepped on or kicked and getting the leg caught while the body is still in motion. All fractures need veterinary attention.

SYMPTOMS AND SIGNS

• The animal will not be able to use the leg at all and if able will hold the leg up. Sometimes the foot will be rested on the ground when the animal is standing at rest.



• Pain at or near the fracture site and some animals will not allow the limb to be handled at all.



• The limb may appear deformed, twisted or shortened.



• Swelling around the break. Sometimes it is possible to see bruising if the hair is parted.



• A coarse grating may occur if the bone fragments move against the other. However don't actively seek this sign.



• Shock. This is due to pain and/or blood loss. Severe blood loss can result from femoral or pelvic fractures.

Fractures may be closed, where the skin is unbroken, or open, where a wound leads to the fracture or the bone may be exposed. Open fractures are generally more serious as infection may result and more care is required for successful healing.

MANAGEMENT

• Control bleeding.



• Keep the animal as quiet as possible. Cats and small dogs can be placed in a box or a basket.



• Try to support the leg when moving the animal by resting the leg on a towel or in your hand.



• If you are unable to take your pet directly to a veterinarian then you may need to bandage or splint the leg.
  • Cover all wounds. If the bone is not exposed apply a dry bandage. If the bone is above the skin and will dry out then apply a wet bandage. Be very careful about cleanliness.
  • Apply a bandage or a splint if your pet will allow you otherwise keep your pet as quiet as possible until you are able to transport him/her. Allow you pet to make itself comfortable rather than force it into a position you think will be comfortable.

HOW TO APPLY A BANDAGE OR A SPLINT FOR A LOWER LIMB

Supporting the fracture helps to prevent pain and swelling. In closed fractures it may prevent the bone penetrating the skin. Bandaging an open fracture helps prevent contamination and prevents the bone from drying out. Only fractures below the elbow and below the stifle (knee) can be easily bandaged. There are two general rules. Lots of padding. And bandage above and below the joints of the affected bone. For instance is the radius (forearm) is broken bandage above the elbow and below the wrist.

The most successful bandage for supporting fractures is the modified Robert Jones. This bandage is fairly easily applied and if applied well can be better than a cast.

• Be gentle. If your pet won't tolerate your handling stop now. However if the bone is exposed some type of bandage must be applied if there is a to be a delay in reaching your vet. Be careful not to be bitten and apply a muzzle if necessary.



• Cover all wounds.



• If the bone is exposed cover the bone with gauze swabs or bandage, torn sheet or a sanitary napkin soaked in sterile saline or home-prepared salty water. Some cling wrap can be used over the wet layer to keep the fluid in this layer.




Salty water is made by adding 1 teaspoon of table salt to 1 pint or 2 cups of water. Boiled water is recommended. Saline used for cleaning contact lens or the Intravenous fluid Sodium Chloride are basically the same thing as salty water but are usually sterile and are excellent for wound cleaning.

Apply another layer of cotton wool.

If you do not have the equipment for the above bandage you can apply a splint. Rolled newspaper or magazines make good splints. If you use sticks or other hard material either apply a layer of bandage material to the limb first or wrap a towel or cloth over the splint. Attach the splint with torn strips of cloth or gauze. Tape or tie in place.

Front leg - the splint can be applied to the front, back or sides of the leg.

Back leg - the splint should be applied to the outside of the leg.

HOW TO APPLY A SLING ON THE FRONT LEG

Generally it is best not to try and stabilize fractures to the humerus and scapula (the bones above the elbow) but keep your pet quiet and let it find a comfortable position on its own. However if your pet is in severe pain or the leg is so floppy it is getting in the way it is possible to apply a "Velpeau" sling.

Wrap wide adhesive elastic tape over the gauze layer in a similar manner.

HOW TO APPLY A SLING ON THE BACK LEG

The need to apply a sling to the hind leg for a femoral fracture is very rare in the first aid situation. However for completeness -

• Wrap wide adhesive elastic tape over the gauze layer in a similar manner. Stick the bandage to some of the animal's fur otherwise it will slip.

DISLOCATIONS

Dislocations are less common than fractures in our pets. They occur due to direct force such as being hit by a automobile or when the leg is caught while the body is still in motion. It may not be possible to decide if the limb is fractured or dislocated so if in doubt treat as a fracture. Do not attempt to reduce the dislocation.

SYMPTOMS AND SIGNS

• Inability to use the leg.



• Pain.



• Elbow - the lower leg will be rotated outwards and the elbow joint will be distorted.



• Hip - the leg will appear shorter and the foot may appear turned inwards. In slim animals it may be possible to tell that the pelvic area is no longer symmetrical.



• Hock - the joint will appear distorted.



• Other joints are uncommonly dislocated and may appear distorted.

Do not try to immobilize dislocations above the elbow or knee. For dislocations below this treat as for a fracture.

BRUISES, SPRAINS AND STRAINS

SYMPTOMS AND SIGNS

• Weight bearing to non-weight bearing lameness.



• Pain.



• Swelling.



• Bruising and tenderness to touch.

MANAGEMENT

• If in doubt treat as a fracture.



• Keep your pet quiet and restrict exercise to only going out to the toilet and no more. Do not allow your animal to jump or use stairs.



• Seek veterinary advice.



• Cold compresses (ice wrapped in cloth) can be applied at the site of the swelling once a diagnosis has been made. Only apply for 20 minutes at a time.

ANTERIOR CRUCIATE RUPTURE

This is an extremely common injury. Some weeks this practice repairs more cruciates than fractures. It is due to the one of the ligaments within the stifle (knee) tearing. It occurs when a dog (it is uncommon in cats) slips usually when it is turning. Rottweilers are prone to this injury as they are a heavy dog with a straight hind leg conformation. Working dogs may rupture their cruciate if they catch their leg jumping a fence and flip over it. It is also a common injury in (human) footballers.

SYMPTOMS AND SIGNS

• Initially there may be pain and swelling in the affected stifle. The dog may carry the leg at all times until this initial swelling starts to resolve.



• Later the dog may rest the foot of the affected leg on the ground without pressure on the main pad. When walking limited weight will be put on the affected leg and it may be held up at faster gaits.



• The lameness may improve over the first week then plateau or start to get worse again.



• In some cases a clicking sound is heard while the dog is walking.

MANAGEMENT

• Confine your dog and take it out on a leash to use its bowel and bladder.



• Avoid stairs and do not allow your pet to jump.
  The opposite leg is now taking all the weight normally shared between the hind limbs and rupturing this cruciate as well is unfortunately quite likely.



• See your veterinarian.

BROKEN OR BLEEDING NAIL

BROKEN NAIL

If the nail is not bleeding and is causing the dog or cat pain because it is in the way then it needs to be removed. Only remove it yourself it is loose and you feel comfortable doing so.

You may need to have someone help you hold your pet or muzzle your dog. Grasp the broken nail with a pair of pliers and tug. If it does not come away easily then seek veterinary help.

BLEEDING NAIL

This can happen if your dog or cat tears the nail or if you have trimmed the nail too short.

• Restrain your pet and elevate the affected limb above the body if possible by rolling your pet onto its back.



• Apply a clean cloth against the nail. Cotton wool can be used in this circumstance as the fine fibres aid clotting.



• An alternative is to drag the affected nail over a bar of soap to clog the nail and then apply the cloth to the nail.



• Apply pressure for at least 5 minutes. Nails tend to bleed for long periods of time. Do not remove the pad until bleeding stops.



• Apply a bandage if the nail tends to start bleeding as soon as the pad is removed or your pet is licking the paw excessively.



• If bleeding does not stop in 15 minutes transport to your veterinarian. Continued bleeding may indicate a bleeding disorder and your pet may be in serious trouble.