A Retrospective Study of Risk Factors Associated with Refracture after Repair of Radial-Ulnar Fractures in Small-Breed Dogs.

Objective:  The aim of this study was to identify risk factors for refracture after radial union in small-breed dogs.

Study design:  In our retrospective study, medical records of radial-ulnar fracture cases in small dogs treated with plates and screws were reviewed. General information and postoperative course (days until confirmed radial fracture healing, with or without ulnar union, time to final follow-up, with or without plate removal and refracture) were recorded. The fracture line location, screw positions, radial thickness and width, and pixel values throughout the postoperative periods were obtained from the radiographs. The affected limbs were classified into non-plate removal (P) and plate removal (R) groups.

Results:  Refracture occurred in 5 of the 141 limbs at the most distal screw in the P group and 5 of the 40 limbs at the same site as the initial fracture in the R group. Multivariate analysis indicated that refracture was linked to the amount of relative change with growth in the position of the most distal screw in the P group, with pixel value and radial thickness ratios at the same site as the initial fracture in the R group.

Conclusion:  Reducing the screw diameter relative to the radial width to the appropriate extent may be considered in cases where the screw positioned at the most distal end of the radius is expected to be relatively proximal as the distal radius grows; not removing the plate may be considered in cases with a decreased radial thickness or bone mineral density beneath the plate during plate removal.