Amber, a one-year-old cockapoo, was referred to Lumbry Park Veterinary Specialists following a nasty road traffic accident. Her referring vet had managed to stabilise her and identified significant trauma to her right pelvic limb, including a complex tibial and fibular fracture with an associated open wound.

On arrival at Lumbry Park, specialist anaesthetists provided pain relief and prepared Amber to be transferred to the imaging suite for radiographs and further assessment. X-rays confirmed a comminuted mid-diaphyseal fracture of the tibia and fibula, while examination revealed a large degloving injury over the right tarsus with multiple wounds along the medial aspect of the tibia. The complexity was increased as the overlying wounds were connecting to the fractured bone, classifying the injury as a grade II open fracture.

Managing Amber’s injuries required close collaboration between many specialist disciplines including specialist orthopaedic and soft tissue surgeons, anaesthetists, imaging specialists and the nursing team. The first priority was stabilising the fracture and protecting the compromised soft tissues. A minimally invasive external skeletal fixator was placed with the aid of intraoperative fluoroscopy, extending distally as a transarticular construct to support both the fracture and the soft tissue injury.

This was followed by intensive wound management, with meticulous round-the-clock care provided by the surgical and nursing teams.
​Once the wound bed had improved sufficiently, a full-thickness free mesh skin graft was harvested from the ventrolateral thoracic wall and applied to the degloving injury. The graft healed extremely well, achieving almost complete take and restoring soft tissue coverage.

With the soft tissues stabilised, attention turned to definitive fracture repair. The tibial fracture was reduced through an open approach and stabilised using orthogonal plates. To enhance bone healing, cancellous autograft was harvested from the proximal humerus and placed at the fracture site.

Seven weeks after the final surgery, Amber had progressed superbly. She showed no apparent lameness during exercise and follow-up radiographs demonstrated strong fracture healing and she has since returned to normal activity levels.
​Anaesthesia Specialist Karla Borland, who is also Lumbry Park’s Clinical Director commented: “Complex trauma cases like Amber’s are a real team effort. From initial pain management, stabilising the fracture to reconstructing the soft tissues and supporting the patient through multiple procedures, every stage relies on different areas of specialist expertise all working together, and that is something we do incredibly well here at Lumbry Park, and it’s that collaboration that makes these recoveries possible.”

Lumbry Veterinary Specialists is one of the largest and most advanced veterinary specialist referral centres in the UK. With a 140-strong team, it offers a broad range of specialist veterinary referral services including anaesthesia and analgesia, cardiology, dermatology, diagnostic imaging, internal medicine, neurology and neurosurgery, ophthalmology, oncology, orthopaedics, physiotherapy, soft tissue surgery and has its own experienced emergency and critical care service with dedicated intensive care unit. For more information about Lumbry Park, which is part of the CVS Group, visit www.lumbrypark.co.uk.
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