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Dem's the Breaks: Pomeranians and Broken Legs 

by Lisa Stasiuk, Diogenoir

So the unthinkable has happened! One of your Pomeranians has broken its leg. Now what? Dig out the crazy glue? Highly not recommended. Indulge yourself in a fit of total hysteria? While emotionally satisfying, not very effective. After the first, second, and third wave of total self-blame (trust me, this is a vicious and repetitive cycle) well, what then?

If Fido is not bearing any weight on the injured leg within a reasonable amount of time, immobilize the limb and head off to the vet with Fido in tow. What can I say? Judgment call here! It's a little known fact (one that will shock you I am sure!) that what I consider reasonable and what others consider reasonable sometimes differs! A "reasonable amount of time" also varies depending on the situation. For instance, I would observe the Pom who has injured itself but does not appear in pain for a longer period of time than the Pom who has sustained an injury and is in immense pain.

Assessment is the name of the game at this point in time. To make a thorough assessment ask yourself the following questions:

  • Self, is this dog in immense pain?

  • Are they bearing weight on the leg?

  • Are there any noticeable deformities?

  • Is there any bruising or swelling?

  • Does the dog cry out when the injured limb is moved?"

If you answered yes to any of these question, or even if you a are unsure, splint the leg to limit the movement and get your dog to the vet as quickly as possible. Feel free to get creative with your choice of material for a splint. No one will laugh at you for showing up with a custom fitted toilet paper roll on your Pom's leg. (ok! so maybe they will laugh a little bit, but what is more important social credibility or knowing you did what you could to prevent any further damage!) For those weaker of heart (or with more social credibility to lose!) cardboard, socks, or even gauze wrapped around the leg and your toothbrush as a stabilizer will all work.

Here is where my knowledge gets limited. (I know, a shock to me too!) I have only had experience with fractures of the forelegs. For any other fractures I can only offer what has been said previously, assess, immobilize and get to your vet for x-rays.

However, if your dog has fractured a foreleg I have more pearls of wisdom from the school of hard knocks. As a side note, 83% of all fractures involving Toy's are fractures of the forelegs. Nice number huh? 83%, wow. In all honesty, I just picked that number because it sounded so solid. Seriously, although the vets I have talked to did not have any official stats, they did assure me that the vast majority of fractures involving Toy breeds are breaks
of the distal portions of the radius and ulna. Say what? In English, the radius is the larger of the two bones found in the front leg and the ulna is... you guessed it.... the smaller one. These bones are comparable to the two bones found in your forearm, which incidentally are also called by the same name.

An x-ray will confirm the presence of a break. There are three things to be aware of and to take into consideration to avoid any misconceptions of what you, Fido, and your vet are dealing with.

First is healing, or more correctly the lack of. Toy breeds are prone to fractures, most likely because of their very size compared to that of the world around them, and because of a quirk in their systems involving blood supply. The blood supple to the distal extremities in a small dog is not as good as the supply to the legs of larger breeds. We do not know why this is, but we do know that because it is so, a smaller dog will take much longer to heal from a fracture than a large breed dog.

Second, possible growth disturbances can result from a fracture of the front limbs. If it is a young Pom (usually under or around the age of six months) they are not finished growing. The fracture could affect the "growth plates" causing different leg lengths. Obviously a dog with unequal legs will not be able to gait smoothly due to the resulting limp.

Finally, the size of the bones themselves are a cause for concern. We are talking very, very tiny bones. My nine month old Pom's radius (aha pop quiz!) measured 2 & 1/2 millimeters deep (from the front to the back) and 3/4 of a centimeter wide. This is the bigger of the two bones here folks. Throw into the mix the fact that the smallest surgical pin available is 6 millimeters long and watch Lisa have a dickie-bird! (A quaint term my Mother uses).

That brings us to the actual techniques used to help ourt little ones mend in the best possible fashion. There are three acceptable ways to immobilize both ends of a fractured bone giving it a chance to mend. All are done under general anesthetic. They are: splinting, surgery to implant a steel plate, and surgery to attach an outside appliance.

Splinting a leg is the most preferred method but there are severe limitations. The splint allows the dog to heal without surgery. The major problem with the splint is that it can only be used if your vet can manipulate the bone into alignment and keep it aligned until the splint is applied. Remember the size of the bones. This method is usually what your vet will try first.

If the splinting fails and the vet is unable to get the bone aligned, they may want to try surgery. The surgery to insert the steel plate allows the vet to open up the leg and align the bone by sight instead of feel. The plate is placed on the bone over the fracture and is screwed to the bone below and above the fracture line. This forms a "bridge" over the break, compressing the fracture together allowing the opportunity for a strong heal to occur. The problem with this is sometimes the strength of the implant compromises the strength of the bone. Essentially, the plate will hold the bone together so well that the bone is not working enough to stimulate new bone formations. Not only will the fracture not heal, but the bone itself will start to break down, becoming weak and brittle. Given the size of our breed, it will be a guessing game if there will be enough skin to close over the plate after everything is said and done. Skin is only so elastic and can only be made to stretch so much
before it splits. Sometimes there just isn't enough to go around. If the fracture is close to the joint, the plate cannot be used as it must have enough intact bone to anchor to.

The outside appliance is also known as a KE appliance. This seems to be a better option. It is a device that is anchored to the bone by pins; two below the fracture and two above it. The pins are attached to a bar that runs along the length of bone on the outside of the leg. Once the bone has been aligned, the vet will take some marrow cells from a donor site, (usually the shoulder) and place them in the fracture line before compressing the bone together and anchoring the appliance with the pins. These healthy cells give a "kickstart" to healing and will help stimulate new bone growth. This is called cancellous bone grafting and is also done in humans for hip or pelvic fractures. Eventually the pins loosen, and the appliance will fall off
hopefully after the fracture has healed. In the case of Poms, the vet will likely take the appliance off after the healing is done (under general anesthesia) and apply a splint for several weeks. This is because even the smallest pins still take up approximately 40% of bone mass in a 9-month old Pom. Leaves some pretty big holes when the pins are removed, but these will fill in quite quickly.

A glossed-over, and sketchy portrayal of "what then" for sure, but one I hope  has been informative for all.

Do not expect a fracture to heal instantly or even quickly. It takes time and there are many triggers that can  complicate the healing process. Ello suffered a fracture in January
four months later, in May, there was little visible healing due to several complications we  encountered. I cannot even begin to tell you how disheartening it has been to see her go lame (first sign of something awry in the great game of healing) or to see results from a  follow-up x-ray with the fracture line still present, creating a gap in her bone that is miles wide in my heart.

Addendum: As I transcribe this article for the PCOC web page, it is four years since Ello broke her leg.. I am very happy to report that Ello is a happy, healthy Pom who not only has returned successfully to the show rings after her ordeal, but has been amazing in the whelping box as well. There is absolutely no visible sign of her old fracture, no scar and no limp. 


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