Gunshot injury and external fixator repair of the tarsus in a six-month-old Husky
A six-month-old intact male Siberian Husky presented to the Cornell Hospital for Animals following a gunshot injury to the left tarsus. The mechanism of injury was initially unknown; the dog presented bright, alert, and acutely non-weight-bearing on the left hindlimb with an open fracture of the left tarsus. Blood was present medially and laterally on the left tarsus and medially on the right lower leg, while other physical exam findings were unremarkable. On radiographic exam, highly comminuted ballistic fractures had obliterated the normal structure in the distal aspect of the left talus and calcaneus. Many variably sized and irregularly shaped particles of metal opacity were present in a transversely oriented tract through the fragmented portion of the talus, calcaneus, and surrounding soft tissue of the left tarsus. CT was used for presurgical planning and confirmed the presence of a lateral-to-medial tract of bullet fragments within the tarsus. A semicircular ring external fixator was applied to stabilize the fracture with the objective of preserving some degree of function of the hock joint. The dog initially did well, but the device was removed two months later as the result of several infected pin tracts that precluded healing in the affected area. A full cast was applied to stabilize the limb, and at the time of this publication the cast was still in place. Ancillary topics discussed in this report include wound ballistics, factors affecting healing of bone, and principles of external skeletal fixation.