Something that has always made me wonder ever since I started back in anatomy was how small the muscles of the lower legs are compared to the size of the body – yet these are responsible for keeping the body up as well as movement.
With motion a lot of it is based on the principle of them acting like springs and storing energy to release it again later. However to me they do look for small for such a purpose…
This fracture was in the tibia and fibula bones of the back leg. The type of fracture that this was, is known as a Salter Harris type II fracture, it involves the top of the bone however misses the growth plate. The
Today however I learnt that looks here are deceiving, assisting on a fracture repair where the surgery had been delayed – injury happened on Saturday and surgery was not until Wednesday – so there were already complications from the formation of fibrinous tissue and some bone remodelling. During the surgery we realised that we could not reduce and position the broken bones back together because of the muscle tension and so we detached the muscle that sits on the front of calf – the tibialis cranialis.
For such a small muscle, once it was detached the change in tension in the leg was remarkable. It allowed us to reposition the fractured part of the bone with good alignment. Once this was done it was possible to place screws into the bone to hold this in position.
Fixing the muscle back to its attachment was a lot quicker than I had expected, however to give it time to heal and regain basic strength we decided that the leg should be bandaged for a time after the surgery. The patient should recover uneventfully.
Being a vet student brings great diversity in my daily patients which is one of the reasons I love it so much, today I assisted in surgery on a pigeon. Now this is one of those things that is not always taught in vet school – there simply is not enough time with everything else that we must learn.
A lot of my knowledge on the less common animals come from a lot of self study (if you are interested in pigeons check out the BSAVA Pigeon Manual here) when really I should probably be learning about the common things on dogs and cats… However sometimes like today the extra study pays off.
Now birds are different to other animals because they need to extremely light to be able to fly. One of the main weight savings is made by the bones being pneumatised – this means that they are hollow and join the lungs in the respiratory system in helping the bird breathe. This also helps the birds respiratory system be more efficient than in other animals – it is one of the reasons they can fly at such heights where other animals would suffer from a lack of oxygen.
Another important difference for when we consider surgery is that bird bones are a lot more mineralised than in other animals. This means that they are more likely to splinter than to “break” – an important thing to remember.
Before we started the surgery we did radiography, one of the goals is to return function and this allows us to check that the important ligaments of the wing are intact. It also allows us to see the damage and plan the surgery – in this case because the fracture was near the end of the bone where there was muscle attachment we needed to fix this into the proper position before we could then insert a intramedullary pin into the bone to fix it.
I am extremely lucky here that I have some very talented vets to learn from, and I was allowed to assist in this procedure. For me it was the most delicate orthopaedic surgery that I have assisted on so far, and in this case I was amazed at just how we could work with bones barely wider than a matchstick. However the surgery went very well, we fixed the end of the bone into the correct position and then inserted a long pin through the middle cavity of the bone to fix the two pieces together. Now something important to remember is that this long pin would act like a hinge for the two pieces of bone to rotate around so we inserted a second pin into the bone and the other end so we could fix them together to prevent rotation.
Hopefully this pigeon will make a full recovery, and be the first of many different species that I will be able to help when I finally qualify!
With the start of week 4, time already seems to be flying away from me. Monday’s are really light for me this semester with just 1 lecture first thing in the morning. This means that I have the option to spend the rest of my time either in surgery or studying extra things that are not normally gone into in detail. Or of course I can spend my time going over stuff again as they repetition is key.
After my lecture today I ended up heading towards clinic, and arrived as they announced an afternoon surgery for a fracture repair by the department director. Enough for me to get interested so I stuck around.
Now somehow I ended up doing anaesthesia, here we don’t really have any monitoring equipment so everything must be monitored manually. With normal animals you can generally see if the chest is moving for breathing, however when it comes to birds because the chest is covered by the wings this is more difficult. Personally I tend to try and keep a finger on the chest to feel for the movement (even this can be tricky when its a surgery which requires movement of the leg which cause more movement).
So this owl had suffered some kind of trauma which resulted in fractures in both of the legs. One of these was pretty easy to fix with the “break” being in a part of the long bone of the femur. This was repaired with a intramedullary pin. The second fracture was a lot more interesting. At the end of the femur there is something called the femoral head which sticks out sideways and connects to the hip joint. The fracture here was between the femoral head and the main part of the femur so on a very small yet important piece of bone. This was wired back together, because the bone here is so soft the wire could be placed simply by using needles to pass it through.
The owl was then recovered from the anaesthetic, and taking down to one of the bird boxes where it will have a chance to heal before being released.
If you notice I am holding the owl through a towel, whilst this prevents struggle it is even more important that human contact is limited so that the owl does not become imprinted (and then tame). There will be very limited human contact now until release.