ABSTRACT
Surgery Report The patient was placed in the right lateral recumbent position. An approach to the distal femur and stifle joint through a lateral incision was performed. Care was taken not to elevate periosteum on the dorsal aspect of the metaphysis as these tissues can be used to assess fracture reduction. The distal femur was grasped with a Kern bone-holding forcep and the distal epiphysis grasped with pointed (Weber) boneholding forceps. With traction and extension of the stifle, the fracture was reduced. The cartilage of the proximal trochlear groove was noted to be continuous with the periosteum of the metaphysis of the distal femur; suggesting proper reduction. A small 1.6 mm (14 gauge) Kirschner wire was placed from the origin of the caudal cruciate ligament across the physis for temporary stabilization of the fracture. A 2.0 mm IM pin was first introduced normograde from the origin of the long digital extensor tendon, angling less than 30 degrees to the long axis of the femur. It is reported that this angle or less can preserve growth of the femur from its distal
to prevent wobble and lessen heat production. The pin was advanced across the physis and into the metaphysis of the distal femur, stopping if the fracture began to displace medially. A second pin of the same diameter was introduced from the medial ephiphysis at a position similar to the previously used lateral landmark. The pins were advanced until they were minimally penetrating the transcortices of the distal femoral diaphysis. The pins were bent slightly, cut as close to the bone as possible, then further ‘sunk’ into the soft bone with a mallet and counter sink. The joint capsule and lateral fascia were closed in separate layers.
