TECHNIQUE

External Coaptation in Rabbits (Disease Investigation & Management - Treatment and Care)

Summary Information
Type of technique Health & Management / Disease Investigation & Management / Techniques:
Synonyms and Keywords --
Description Editor's Note: 
  • Information on this page is to be used together with information given in the "Treatment" section of the page Fractures in Rabbits and with information given in the page Treatment and Care.
  • This page is intended to provide the reader with information of particular importance for the treatment of lagomorphs. It does not provide details of external coaptation for fractures at different sites.
  • The reader should use the information in this text alongside their own experience in orthopaedic surgery and should consult relevant texts on small animal orthopaedic surgery as required.
Reduction and Immobilization
  • Anaesthetise the animal. (B536.124.w124)
  • Reduce the fracture such that the normal anatomical relationship between the joints above and below the fracture are maintained as closely as possible. (B536.124.w124)
    • Take care to avoid damaging soft tissues and the blood supply to the distal limb while manipulating the limb to reduce the fracture. (B602.35.w35)
  • Confirm reduction of the fracture.
    • While palpation can be used to confirm fracture reduction, radiography is advisable to check for any rotational or angular deformity. (B602.35.w35)
    • There should be at least 50% contact between the cortices in two radiographic views of the limb to give a reasonable chance of the fracture healing properly. (B536.124.w124, B602.35.w35)
  • Immobilize the limb in a normal position (i.e. so the limb will be in a normal position when the rabbit stands, and it will bear weight on it.) (B536.124.w124, B602.35.w35)
    • Note this can be "challenging" in rabbits, due to the acute angles of the joints. (B601.17.w17)
  • The joint above (proximal to) and the joint below (distal to) the fracture must immobilized. (B536.124.w124, B602.35.w35, P112.1993.w1)
    • In a large rabbit it may be possible to apply a light Robert Jones bandage with an aluminium supporting rod. Alternatively, a light modified Robert Jones bandage together with a half-cast made from one of the modern lightweight casting materials can be used. (B602.35.w35, B606.10.w10)
    • For a fracture of the humerus or femur, a spica splint is required (B536.124.w124); however, these are difficult both to apply and to maintain in rabbits. (B601.17.w17)
Appropriate Use (?) Useful for simple, closed, distal limb fractures. (B601.17.w17, B602.35.w35)
  • Useful where there is minimal displacement. (P112.1993.w1)
  • Not suitable for e.g. short oblique fractures, where compressive or shear forces are involved. (B602.35.w35)
  • May be used in highly comminuted fractures where primary repair of the fracture is impractical. (P112.1993.w1)
  • Useful if anaesthesia and surgery would be particularly risky for the patient. (P112.1993.w1)
  • Casts and dressings are relatively inexpensive and simple to apply. (P112.1993.w1)
Notes
  • Monitor weekly. (B602.35.w35)
Complications/ Limitations / Risk "The acute angles of the joints of rabbits make it challenging to apply appropriate external coaptation as it can be difficult to immobilize the limb in a functional position." (B601.17.w17)

Potential problems include:

  • Problems in immobilising the limb in a functional position. (B601.17.w17)
  • The patient chewing at the dressing. (B606.10.w10)
  • Soiling of the dressing leading to skin infections and/or pressure sores. (B602.35.w35, B606.10.w10)
  • Swelling due to too tight a splint or excessive activity of the animal. (B602.35.w35)
  • Joint stiffness. (B602.35.w35)
Equipment / Chemicals required and Suppliers
  • Cast material, splints, bandages and padding material.
    • The cast material should be light enough that it doesn't cause too much of a hindrance to the patient. (B606.10.w10)
    • Modern lightweight cast materials are preferred, e.g. Orthoplast (Johnson & Johnson, New Brunswick, New Jersey, USA) or Vet-lite (Rulite SA, Micheroux, Belgium). (B602.35.w35)
    • Conforming gauze and conforming cast padding are appropriate for padding. (P112.1993.w1)
Expertise level / Ease of Use
  • This procedure should only be carried out by an individual with appropriate clinical training and practical experience.
Cost/ Availability Costs include those of:
  • Anaesthesia.
  • Radiography before and after fracture reduction.
  • Time of the veterinary surgeon to reduce the fracture and apply the cast/bandage/splint
  • Materials required for the cast/bandage/splint.
Legal and Ethical Considerations In some countries there may be legislation restricting the use of this type of technique to licensed veterinarians. For example in the UK: "The Veterinary Surgeons Act 1966 (Section 19) provides, subject to a number of exceptions, that only registered members of the Royal College of Veterinary Surgeons may practice veterinary surgery." (See: LCofC1 - RCVS Guide to Professional Conduct 2000 - Treatment of Animals by Non-Veterinary Surgeons).
Author Debra Bourne MA VetMB PhD MRCVS (V.w5)
Referee John Chitty BVetMed CertZooMed MRCVS (V.w65)
References B536.124.w124, B601.17.w17, B602.35.w35, B606.10.w10, P112.1993.w1

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