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Mon - Dec 11
2017


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Fractures Caused by Poor Husbandry
Fracture of the Calcaneus Bone (Heel Bone)

In the past 30 odd years I have been presented many times with hand reared macropods of various species with fractures of the Calcaneus.  Fig 1 and Fig 2 show schematics of a dog calcaneus but the macropod would look similar except the metatarsals are different.

The history is always the same. The Joey got out of his pouch and hopped down the hallway and suddenly went lame.

In the early years we tried splinting these and keeping them in the pouch and although they did heal the outcome, as far as mobility goes, was poor. Sometimes the deviation was so far medial and cranial that the hock joint was perpendicular.

For the past 15 years I have been treating these with orthopaedic surgery.

FROM "HANDBOOK OF SMALL ANIMAL ORTHOPEDICS
& FRACTURE TREATMENT" BINKER, PIEMATTEI & FLO.

Fig 1

Fractures of the Calcaneus
(A) Fracture of the tuber calcanei. (B, C)Two Kirschner wires, 0.045" or 0.062" in diameter, placed side by side, as far medially and laterally as possible. Note that the tendon of the superficial digital flexor has been retracted medially. The exact position of the transverse hole for the wire is not critical and is usually at midshaft or slightly distal as shown here.
FROM "HANDBOOK OF SMALL ANIMAL ORTHOPEDICS
& FRACTURE TREATMENT" BINKER, PIEMATTEI & FLO.

Fig 2

Fractures of the Calcaneus


(A) Fracture of the shaft of the calcaneus. (B,C) A single Steinmann pin, 5/64" to 1/8" in diameter, has been countersunk in the tuber. This pin position allows the wire to be placed through a drill hole in the tuber, which minimises irritation of the tendon of the superficial digital flexor. A single pin is used when the fracture reduces well and is stable relative to rotation in the reduced position. (D) If the fracture line is smooth or slightly comminuted, two smaller countersunk pins or Kirschner wires in the sagittal plane are used because they provide more rotational stability.

The fractured bones are realigned and held in place with a pin and a tension band wire.  The tension band wire is necessary to counter the pull of the Achilles tendon. The pins and wires are usually removed after 5-6 weeks.


Grey kangaroo with Fracture of Calcaneus (Hock extended)

Grey kangaroo with Fracture of Calcaneus.
(Hock extended)

In Extension the gap opens up between fragments.


Grey kangaroo with Fracture of Calcaneus (Hock flexed)

Grey kangaroo with Fracture of Calcaneus
(Hock flexed)

The arrow points to the actual fracture site.
In flexion the fragment is pulled up by the tendons and the actual fracture face is now pointing downwards almost 90 degrees to its true position.



Agile Walaby



Agile Walaby 2.5kg female







The proximal fragment has been replaced in the correct position and a short Steinmann pin has been placed through both fragments and right into the tarsal bone.   A hole was drilled distal to the fragment and a 22gauge stainless steel wire was threaded through then passed around the pin in a figure 8 and tied.   It is this wire that will oppose the pull of the tendons and prevent the pin bending.   The excess pin is cut off just above the the wire where it exits from the end of the Oss calcis.

The pin and wire are removed after 5-6 weeks at a second operation.   Success rate is > 80% for a return to full viability.  Always give calcium supplements.   It is not unusual to get more than one case from the same carer so always look to the husbandry of that carer.





PAGE 6 - Fracture of the Calcaneus Bone continued - Conclusion


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Fractures in Macropods - Jim Pollock B.V.Sc


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