🔍 Key Findings
- Refracture occurred in 5.5% of limbs, with higher incidence in the plate removal group (12.5%) vs. non-removal (3.5%).
- In the non-plate removal group, refractures occurred at the most distal screw site, linked to greater screw position change during growth (OR 1.79, p=0.04).
- Screw-to-bone diameter ratio (SBDR) >0.4 was a significant risk factor for refracture in the plate retention group.
- In the plate removal group, refractures occurred at the original fracture site, associated with lower pixel value ratio (bone mineral density) and reduced radial thickness.
- Implant-induced osteoporosis (IIO) beneath the plate likely contributed to refracture risk after plate removal.
- Younger age at fracture (<6 months) was associated with higher refracture risk due to ongoing radial growth and shifting screw position.
- No significant association was found between refracture and plate type (locking vs conventional), fixation method, or ulnar union.
- Recommendations include careful SBDR sizing, motion restriction, and cautious plate removal decisions in growing dogs.
