Specific Fractures

Head   Trauma to the head is not unusual, especially soft tissue trauma – gravel rash from the road, but fractures do occur and can be serious. Fractures also occur from running into the walls and fences of pens.

Fractures of the mandible may only be noticed when there is severe displacement or later when there is the swelling of a healing callus. If there is little displacement they will often heal with no treatment.

Maxillary fractures occur more frequently in captivity when the Joey is spooked and runs frantically into a fence. They will smash themselves into a fence repeatedly in an attempt to escape in a panic attack. The result of such events is often a broken neck and death. Minor fractures of the maxilla will often heal without treatment.

Vertebra Fractures of the cervical vertebra are usually self inflicted and usually cause rapid death. If death does not follow the animal will usually be paralysed and require euthanasia. Fractures of the Thoracic and lumbar vertebra usually are caused by MVA and are usually euthanased.

Luxation of L4/L5 Vertebra Agile Wallaby

Tail Many tail fractures are missed on initial examination and may not be noticed until there is deviation or a callus developing. If there is obvious fracture and deviation then splinting is required to hold the fracture immobilised for callus formation and healing (3-4 weeks in a juvenile). Sometimes the tail will be so badly traumatised some of it may need amputating. We have had macropods successfully released with only half a tail. The tail is important for balance and anything with much less than half a tail will have problems. Splints can be made out of lolly pop sticks, padded alliminium, plastic syringe cases hexalite or other casting materials. If not moulded for the shape of the tapering tail it must be well padded and held in place with Elastoplast. Be careful not to stretch the Elastoplast tight, just lay it on to stick and prevent the splint from sliding own the tail. Healing is generally excellent. Some minor fractures may be supported with Elastoplast alone.

Rib Fractures
It is uncommon to fracture ribs and often the diagnosis is made when the healing callus forms and is noticeable. If there is a “flail chest” then this will need to be strapped for 3-4 weeks.

Fore Limbs
These are not commonly fractured. Fractures of the hand require little treatment if not complicated. Fractures of the radius and ulna can easily be treated with small light casts or half-casts extending to include the elbow and wrist. These are left on for 3-4 weeks.

Fractures of the upper arm or humerus are treated as for humans with a collar and cuff for a sling plus lightly strapping the limb to the body.

Hind Limb
Pelvis
Many pelvic fractures that do not involve the acetabulum and have mild displacement will heal well with cage rest only. They are usually up and about in a few days and doing well in 4-6 weeks.

Dislocations are generally only seen in the pelvis and as a rule can only be replaced by a veterinarian, with the animal under a deep general anaesthetic.

Femur
Fractures of the thigh bone or femur can not be handled with a splint or cast and basically can only be handled with an orthopaedic implant such as a plate and screws or intramedullary pins and wires. These bones always displace and over-ride and only surgery is successful for treatment.

Pelvis and Femur Fractures

Tibia and Fibula or shin bones are probably the most common bones to find fractured. All macropods have very long Tibias and Fibula. It has been my experience that the majority of fractures occur in the lower half of these bones and these can often be treated with casts and half-casts extending from toes to knee. I prefer Cutter Cast or Hexalite half-casts strapped on with Elastoplast . I like to use Soffaban under-cast padding.

In the upper third of the tibia fractures are often best treated by plating. Pins and wire can be used but is more difficult. One often has to rely on casts and half-casts in which case confinement to the pouch is essential. Healing may result in a large callus that may take months to remodel.

AGILE WALLABY Fracture of proximal Tibia Fracture of Tibial Crest Fracture of Proximal Fibular	AGILE WALLABY Fracture of proximal Tibia Fracture of Tibial Crest Fracture of Proximal Fibular
Post op radiograph	4 Weeks Post Op

Calcaneus Fracture the heel bone has a special aetiology and I will deal with it as a separate issue. While it can be presented in MVA cases it is rare.

Feet and Toes
Fractures of metatarsals and digits are often caused by carers standing on a Joey's feet. Joey's have a tendency to creep up unobserved and stand a very close to their carers and sometimes get stood on. These fractures heal well with casting.

Lower limb fractures in very young joeys with minimal displacement can be treated with a Robert Jones bandage alone. This is just a thick layer of cotton wool and bandage over stirrups of Elastoplast to prevent it slipping off. The whole is then wrapped with Elastoplast.. Robert Jones bandages are often used on a lower limb fracture to give light weight support after a rigid cast or half-cast has been removed.

Cardinal Rule : All animals with a cast or splint or Robert Jones bandage must be seen at least once weekly by the vet. This will usually enable us to detect problems before major complications occur. Generally speaking, except for joeys in an artificial pouch, larger macropods do not cope that well with casts unless the after care handling are acceptable to the macropod, facilities for restraint are non-traumatic and confinement is easily maintained.

Schematic drawing of the right hind leg of a macropod (Fauna of Australia 1B Mammals)