Initial clinical experience with the IMEX (TM) circular external skeletal fixation system - Part I: Use in fractures and arthrodeses

The IMEX(TM) Circular External Skeletal Fixation (CESF) System was used to stabilize fractures (12 radius and ulna and five tibia and fibula) in 15 do gs and two cats and arthrodeses (two pancarpal, one talocrural and one pant arsal) in four dogs. The ages of the animals with fractures ranged from six months to nine years (mean +/- SD: 2.7 +/- 2.5 years; median: 2.0 years) a nd the body weights of dogs with fractures ranged from 5.4 kg to 43.6 kg (m ean +/- SD: 21.3 +/- 12.6 kg; median: 22.7 kg). The ages of the dogs having arthrodeses ranged from eight months to two years (mean +/- SD: 18 +/- 10 months; median: 18 months) and body weights of dogs with arthrodeses ranged from 19.0 kg to 29.1 kg (mean +/- SD: 22.7 +/- 4.7 kg; median: 21.4 kg). T en fractures were open and four had been previously managed with another fo rm of stabilization,Ten fractures were comminuted and all of the fractures involved the diaphysis; two extended to the distal metaphysis. An extensive open reduction tvas used on three, a limited open reduction on seven and a closed reduction on seven fractures. Arthrodeses were performed via a limi ted open approach, for debridement of the articular cartilage and implantat ion of a cancellous bone graft. Most animals placed substantial weight on t he affected limb within a few days following the operations. Wire and pin t rack inflammation was the most common complication during the convalescent period and was often associated with a decrease in weight-bearing. Sixteen fractures achieved radiographic union (mean +/- SD: 46 +/- 13 days; median: 43 days) long-term function (direct examination: mean +/- SD: 76 +/- 38 da ys, median: 43 days; telephone communication: mean +/- SD: 366 +/- 247 days ; median: 381 days) was assessed as excellent in 10 animals and good in sev en. All of the arthrodeses achieved radiographic union (mean +/- SD: 74 +/- 31 days; median: 71 days). Long term function (direct examination: mean +/ - SD: 185 +/- 182 days, median: 102 days; telephone communication: mean +/- SD: 485 +/- 22 days; median: 590 days) was assessed as good in two dogs an d fair in two dogs. Our results establish the utility of the IMEX(TM) CESF System for stabilizing fractures and performing arthrodeses in dogs and cat s.