Surgical Stabilization of Comminuted Femoral Fracture Using Gentamicin Infused Hydroxyapatite Graft Combined with Locking Compression Plate-rod in Canines: A Preliminary Clinical Case Series

Abstract

Background: Comminuted femoral fractures present substantial mechanical and biological challenges because extensive fragmentation may compromise local vascularity and create bone defects. Aims: This preliminary clinical case series evaluated a gentamicin-infused hydroxyapatite graft combined with a locking compression plate–rod construct for the management of comminuted diaphyseal femoral fractures in dogs. Place and Duration of Study: The study included dogs with femoral fractures presented to the Department of Veterinary Surgery and Radiology, College of Veterinary Science, Rajendranagar, Hyderabad, over a one-year period. Methodology: Six dogs aged 5 months to 15 years (mean, 53.9 ± 66.96 months) and weighing 8–25 kg (mean, 13.83 ± 6.24 kg) with comminuted diaphyseal femoral fractures were enrolled. Injuries were predominantly caused by motor vehicle accidents (66.67%) and falls from height (33.33%). The fractures were classified using the AO/ASIF system as closed, complete mid- or distal-diaphyseal fractures. All fractures were repaired using 2.7 mm or 3.5 mm locking compression plates combined with intramedullary pins occupying approximately 40% of the medullary canal. A gentamicin-infused hydroxyapatite graft was implanted to fill bone defects associated with comminution and to provide local antibiotic delivery and an osteoconductive scaffold. Postoperative evaluation included clinical assessments of posture, gait, lameness, and functional outcome, together with serial radiographic evaluations on days 15, 30, 45, 60, and 90. Results: All dogs showed rapid functional improvement, with lameness improving from Grade V preoperatively to Grade I by day 30 and remaining at Grade I through day 90. Serial radiographs demonstrated progressive callus formation, graft integration, satisfactory alignment, and stable implant positioning throughout the follow-up period in most cases. No major complications, such as implant failure, malalignment, or infection, were observed. Conclusion: The combination of a locking compression plate–rod construct with a gentamicin-infused hydroxyapatite bone graft was associated with effective mechanical stabilisation and a favourable biological environment for the healing of comminuted femoral fractures in dogs, together with rapid functional recovery and consistent radiographic evidence of fracture union.