De Moya et al: Closed reduction and fluoroscopic‐guided percutaneous pinning of femoral capital physeal or neck fractures: Thirteen fractures in 11 dogs
Veterinary Surgery 6, 2023

🔍 Key Findings

  • FGPP (fluoroscopic-guided percutaneous pinning) resulted in successful healing in 10/13 fractures, with good limb function.
  • Complications occurred in 5 of 11 cases, including intra-articular implants, malunion, implant failure/nonunion, and implant migration.
  • Cases with delayed surgery (>15 days) or radiographic remodeling were more likely to experience major complications.
  • Most fractures (10/13) were classified as Salter-Harris type I with mild displacement.
  • Median surgical time was 60 minutes, and no conversions to open surgery were needed.
  • Postoperative femoral neck resorption was minimal, suggesting possible benefits of the minimally invasive approach for preserving vascular supply.
  • One intra-articular pin led to progressive joint disease and required femoral head ostectomy.
  • FGPP appears best suited for acute, minimally displaced fractures in young dogs (<8 months) with planned elective explant to avoid growth disturbance.

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De Moya et al: Closed reduction and fluoroscopic‐guided percutaneous pinning of femoral capital physeal or neck fractures: Thirteen fractures in 11 dogs
Veterinary Surgery 6, 2023

🔍 Key Findings

  • FGPP (fluoroscopic-guided percutaneous pinning) resulted in successful healing in 10/13 fractures, with good limb function.
  • Complications occurred in 5 of 11 cases, including intra-articular implants, malunion, implant failure/nonunion, and implant migration.
  • Cases with delayed surgery (>15 days) or radiographic remodeling were more likely to experience major complications.
  • Most fractures (10/13) were classified as Salter-Harris type I with mild displacement.
  • Median surgical time was 60 minutes, and no conversions to open surgery were needed.
  • Postoperative femoral neck resorption was minimal, suggesting possible benefits of the minimally invasive approach for preserving vascular supply.
  • One intra-articular pin led to progressive joint disease and required femoral head ostectomy.
  • FGPP appears best suited for acute, minimally displaced fractures in young dogs (<8 months) with planned elective explant to avoid growth disturbance.

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Multiple Choice Questions on this study

In De Moya 2023 et al., on femoral pinning outcomes, what factor was most commonly associated with good healing outcomes?

A. Severe fracture displacement
B. Open surgical exposure
C. Short duration from injury to surgery
D. Use of screws over pins
E. Concurrent bilateral repair

Answer: Short duration from injury to surgery

Explanation: Delayed surgery (>15 days) was associated with poor outcomes; early surgery improved healing.
In De Moya 2023 et al., on femoral pinning outcomes, which major complication required revision or salvage surgery?

A. Transient pain
B. Delayed union
C. Implant migration
D. Neck resorption
E. Intra-articular pin placement

Answer: Intra-articular pin placement

Explanation: This complication caused progressive DJD and required femoral head ostectomy.
In De Moya 2023 et al., on femoral pinning outcomes, which finding was associated with reduced success of FGPP?

A. Use of large Kirschner wires
B. Leaving pins short
C. Moderate to severe fracture displacement
D. Proximal metaphyseal entry
E. Traction applied during reduction

Answer: Moderate to severe fracture displacement

Explanation: Fractures with mild displacement had better outcomes and higher success with closed reduction.
In De Moya 2023 et al., on femoral pinning outcomes, what was a reported benefit of FGPP over open techniques?

A. Increased accuracy of reduction
B. Reduced surgical time
C. Decreased radiation exposure
D. Reduced surgical trauma and morbidity
E. Improved visualization of joint anatomy

Answer: Reduced surgical trauma and morbidity

Explanation: FGPP is a minimally invasive technique with lower tissue trauma than open repair.
In De Moya 2023 et al., on femoral pinning outcomes, what rationale was given for elective pin removal in young dogs?

A. Prevent Kirschner wire migration
B. Limit degenerative joint disease
C. Allow femoral neck reshaping
D. Prevent premature physeal closure
E. Prevent intra-articular placement

Answer: Prevent premature physeal closure

Explanation: Pin removal was advised in dogs <8 months to reduce the risk of iatrogenic closure.
In De Moya 2023 et al., on femoral physeal/neck fracture repair, what was the most commonly reported complication of FGPP in this case series?

A. Sepsis
B. Implant migration
C. Fracture seeding
D. Muscle contracture
E. Neurologic injury

Answer: Implant migration

Explanation: Implant migration was reported in 2 of 5 complication cases, making it the most common.
In De Moya 2023 et al., on femoral physeal/neck fracture repair, what was the recommended strategy for implant removal in dogs <8 months of age to avoid growth complications?

A. Leave pins permanently
B. Only remove if signs of pain
C. Elective removal after fracture healing
D. Wait until one year of age
E. Use absorbable pins

Answer: Elective removal after fracture healing

Explanation: Elective explantation was recommended to reduce the risk of premature physeal closure in young dogs.
In De Moya 2023 et al., on femoral physeal/neck fracture repair, what was the most common Salter-Harris classification observed in the cohort?

A. Type II
B. Type III
C. Type IV
D. Type I
E. Type V

Answer: Type I

Explanation: 10 out of 13 fractures were Salter-Harris Type I capital physeal fractures.
In De Moya 2023 et al., on femoral physeal/neck fracture repair, which factor was most associated with the development of complications following FGPP?

A. Use of >3 Kirschner wires
B. Post-op NSAID administration
C. Fracture chronicity >15 days
D. Intraoperative fluoroscopy time >20 min
E. Body weight over 25 kg

Answer: Fracture chronicity >15 days

Explanation: Cases with >15 days between injury and surgery showed remodeling and had a higher complication rate.
In De Moya 2023 et al., on femoral physeal/neck fracture repair, which surgical advantage is most associated with FGPP over ORIF?

A. Allows treatment of chronic remodeling
B. Requires no imaging guidance
C. Limits surgical trauma and preserves vascular supply
D. Eliminates need for postoperative analgesia
E. Allows shorter anesthesia in all cases

Answer: Limits surgical trauma and preserves vascular supply

Explanation: FGPP is a minimally invasive technique that may reduce trauma and preserve femoral neck blood flow.

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