The Possible Risk Factors for Bone Fractures in Animals and Management of Pre and Post -Operative Pain

The occurrence of fractures is more when the forces acting on the bone exceed its ultimate strength. The type of fracture depends on the magnitude, rate, and direction of the force applied and also on the shape, size, and structure of the bone involved. The predisposing factors may be bone neoplasia, generalized bone disease, bone defects, and a history of previous fractures, the possible forces resulting in fractures may be torsion (leading to spinal fractures), compression on bending forces leading to oblique fracture with/without comminution, shearing forces leading to transverse fractures. These bone fractures may be oblique/transverse/comminuted / Spinal/segmental. Fractures in small animal patients represent a challenging combination of orthopedic and soft-time injuries. When compared to closed fractures the proportion of risk factors for open fractures is more. Open fractures are typically the result of high-energy trauma. Sexually intact dogs & cats are at high risk for fractures than sterilized animals as they tend to roam which may increase the likelihood of a traumatic event. Younger age was a significant risk factor for the occurrence of open fractures because of the more active nature of the puppies and kittens. This is because the physical properties of a more mature skeleton influence fracture configuration and thus the likelihood of an open fracture. Body weight was found to be a risk factor for open fractures in dogs after adjusting for age, breed, and neuter status. The force or energy necessary to fracture a bone in large dogs is more likely to be sufficient enough in larger dogs relative to the force or energy necessary to fracture a bone in smaller dogs. Comminuted was the only fracture configuration found to be a significant risk factor for an open fracture as it results due to higher energy and higher velocity trauma that causes soft tissue damage and more fracture fragments. Pain is a multi-dimension experience and its response is unique to each individual and involves two components as sensory component i.e., nociceptors, which is the neural processing of new noxious stimuli, and the effective component i.e., pain perception, which is the unpleasant sensory and emotional experience associated with either actual or potential tissue damage. Pain management is central to veterinary practice, alleviating pain, improving patient outcomes, and enhancing both, the quality of life and the veterinarian–client–patient relationship. Nociceptive pain, pathological pain, and maladaptive pain are the various dimensions of pain perceived by the animal. For managing pain, non-steroidal analgesics can be used alone, but they are also synergistic with other analgesic drugs (opioids) or modalities (local, regional, and epidural analgesia). The NSAI Analgesics are inhibitors of cyclo-oxygenase (prostaglandin synthases) which catalyzes the incorporation of molecular oxygen into arachidonic acid. Fentanyl patches, butorphanol, and buprenorphine are opioid analgesics used for perioperative pain management. For spinal, pelvic & high comminuted hind limb fractures, epidural administration of 0.5% bupivacaine at induction can provide profound hind limb analgesia post-operatively for up to 24 hours CRI (Continuous Rate Infusion) analgesia plays a key role in pre-operative, intra-operative, and post-operative situations, preemptive analgesia achieved in various ways has reduced the post-operative analgesia demand.