Open Comminuted Tibial Fracture Repair in a Spitz
Centre Veterinaire Daubigny · Right Hindlimb · Trauma Surgery
Case Summary
A 1-year-old female Spitz presented with an open comminuted fracture of the right tibia and fibula following a fall from a moving bicycle carrier. Fracture reduction and stabilisation were performed using an LC-DCP 2.0 mm plate with 9 screws.
Prior to closure, the wound was lavaged with saline followed by Simini Protect Lavage. The patient recovered without complication. At 2 weeks the wound was fully healed with mild lameness. Radiographs at 2 months confirmed complete bone healing with no signs of infection. At 6 months, the patient remains well with no infection.
Clinical Presentation
History and Physical Findings
The patient presented following a fall from the carrier basket of the owner's bicycle while in motion. The owner reported visible bone protrusion from the right hindlimb. On examination, the patient was in otherwise good general condition with no abnormalities identified beyond the limb injury. Bloodwork was unremarkable.
Radiographic evaluation confirmed an open comminuted fracture of the right tibia and fibula with significant displacement. Open fractures carry an inherently elevated infection risk due to direct environmental contamination at the fracture site. Surgical stabilisation was indicated urgently.
Surgical Protocol
Fracture Reduction and Fixation
The patient underwent surgery for open reduction and internal fixation of the tibial fracture. An LC-DCP 2.0 mm plate was applied with 9 cortical screws. Prior to closure, significant lavage with saline was performed followed by Simini Protect Lavage. Closure was routine. Post-operative radiographs confirmed adequate fracture reduction and satisfactory implant placement.
| Step | Description |
|---|---|
| 01 | General anaesthesia induced. Right hindlimb prepared and draped. |
| 02 | Open fracture site debrided. Comminuted fragments identified and reduced. |
| 03 | LC-DCP 2.0 mm plate positioned and secured with 9 cortical screws. |
| 04 | Significant lavage with sterile saline performed prior to closure. |
| 05 | SiminiSimini Protect Lavage applied at closure stage. Dwell time allowed, then saline rinse. |
| 06 | Routine layered closure performed. |
| 07 | Post-operative radiographs confirmed adequate fracture reduction and implant placement. |
Open fractures present a heightened infection risk due to direct contamination of the fracture site. In this case, Simini Protect Lavage was applied following saline lavage as a final step before closure. Simini reduces bacteria, biofilms, and resistant bacteria at the surgical site. Its use in an open fracture case demonstrates the lavage in one of the highest-risk infection scenarios in small animal orthopaedic surgery. The patient achieved complete bone healing at 2 months with no signs of infection at any point during follow-up.
Post-operatively, the patient was discharged the day after surgery with 2 weeks of meloxicam, 1 week of buprenorphine, and 4 weeks of cephalexin.
Outcomes and Follow-Up
Recovery at 2 Weeks, 2 Months, and 6 Months
The patient made an uneventful recovery. The patient began weight-bearing on the operated limb within a few days of surgery. Follow-up at each stage confirmed progressive healing without complication.
Wound Fully Healed
Walking on operated leg with mild lameness. Wound completely healed. No signs of infection.
Complete Bone Healing
Radiographs confirmed complete fracture healing. No signs of infection at the implant site or surrounding tissue.
Full Recovery
Patient doing well with no signs of infection. No implant complications reported. Normal function restored.
This case represents single-surgeon clinical experience. For controlled intraoperative activity data including CFU comparisons against saline and other antiseptics, see the clinical evidence summary and the Intraoperative Lavage White Paper.
Follow-Up Timeline
Post-Operative Course
Day of Surgery
Open comminuted tibial fracture reduced and stabilised with LC-DCP 2.0 mm plate and 9 screws. Saline lavage followed by Simini Protect Lavage applied at closure stage. Post-op radiographs satisfactory. Discharged day 1.
Early Weight-Bearing
Patient began walking on the operated leg within a few days of surgery. Recovery described as uneventful.
2-Week Recheck
Walking with mild lameness on operated leg. Wound completely healed. No infection signs. Meloxicam course completed.
2-Month Radiographic Recheck
Radiographs confirmed complete bone healing. No signs of infection at the fracture site or implant interface.
6-Month Follow-Up
Patient doing well. No infection reported at any stage of follow-up. Full recovery confirmed.