Baby

Baby is a nine month old female Bedlington Terrier.  She was presented as an emergency on March 8, 2001, after having been in a dogfight with a MUCH bigger dog.  There were puncture wounds around her right shoulder joint and palpable “moving pieces of bone” under the skin.  Radiographs showed a fracture of the greater tubercle of her right humerus (Figure 1).  This was a fracture of the bony prominence where the supraspinatus muscle attaches, which helps extend the shoulder joint.

Figure 1. Pre-operative radiography show fractures caused by dog bite.

Surgery was performed on March 9, 2001.  The wounds were debrided and torn muscle was sutured.  The greater tubercle was fractured into three pieces. The fractured bones were reconnected with two pins and a figure-eight tension band wire (Figures 2 & 3).  A tension band wire acts to counteract the pull of the very strong supraspinatus muscle and actually convert the muscle pull into a compressive force on the fracture site, thus aiding in promoting fracture stability and healing. 

Figures 2 and 3. Anterior-posterior (left) and lateral (right) radiographs, showing the reconstruction of the greater tubercle.

Baby's leg was put into a sling to keep weight off of it for two weeks (Figure 4) and the wound was closed over a Penrose (soft “rubber”) drain so that any fluid accumulation in the wound would be “drained” away. 

Figure 4. Sling on right foreleg.

Baby's injury is considered an “open” fracture (the old term was “compound” fracture).  It presents additional challenges because of the tremendous additional contamination with bacteria, hair, and other foreign debris.  Greater effort must be taken to painstakingly clean the wound and debride away foreign material and devitalized tissue because of the increased risk of infection.  The use of a Penrose drain is critical to prevent build-up of fluid that could act as a growth medium for the contaminating bacteria.  So far, Baby is doing very well.