Orthopedic injuries, usually fractures of the long bones, are common in small exotic mammals. Distal limb fractures are often open and can be missed when hidden by thick fur, thereby requiring careful shaving and examination. Fracture repairs in small mammals can be achieved via external coaptation, internal fixation (intramedullary [IM] pinning, wiring, and plating), or external fixation. External coaptation is adequate for only a few select fractures and may not be well-tolerated by some of these patients. Patient size, relatively thin bone cortices, and inadequate stability also exclude internal fixation methods in many cases. However, external fixation is often well-tolerated by many exotic small mammals and provides excellent stability at a reasonable cost.
The primary indications for external fixation are open or comminuted fractures in which IM pinning is not feasible. The stability provided by external fixation is particularly advantageous in small mammals, in which restriction of movement is much more difficult to achieve than in dogs and cats. This article describes an external fixation system as well as several case reports of common fractures seen in small mammals. Complications are also discussed, with emphasis placed on proper confinement, covering the devices, and adequate postsurgical rechecks to reduce the incidence of complications.
COMMENTARY: Dr. Capello's article provides an excellent overview of external fixation methods for repairing fractures in exotic small mammals. Detailed descriptions and abundant images from case reports help illustrate these methods. An important point is that clinicians making these repairs must not only be proficient in the principles of surgical fixation and proper use of equipment, they must also be familiar with the surgical anatomy, physiology of movement, and differences in size and behavior of the species being treated. While this may limit the clinical usefulness of the article for many general practitioners, those interested in exotic small mammal medicine will find the information helpful for initial management of these injuries and for determining when referral to a specialist might be warranted.
External fixation for fracture repair in small exotic mammals. Capello V. EXOTIC DVM 7:21-37, 2006.