This video addresses non-surgical approaches for stabilizing fractures of the diaphysis of the tibia, femur, and humerus when surgical repair is not feasible.
The best treatment for these long bone fractures is surgical repair. If surgical repair is not an option then your choices are to amputate the limb or attempt conservative management.
-Splinting a fracture Ideally the fracture is a 2-piece transverse fracture and the fragments can be reduced to overlap by at least 50% before placing the limb in a splint.
However, if the fracture configuration is not ideal, and it cannot be reduced at all; it is still worth while placing the limb in a splint and then re-assessing. The splint will serve to maintain proper alignment of the joints above and below the fracture. As long as the joints are aligned, the healed bone will allow the limb to function properly, or as close to it as possible. The splint will also help maintain sufficient length to the bone.
-The tibia can readily be splinted. The splint should go above the stifle to properly stabilize the fracture. However if the fracture is quite distal on the tibia, one can get away with splinting to just below the stifle (yes this is breaking all the rules!).
-The humerus can be placed in a spica splint.
-The femur cannot and should not be splinted. The best you can do is crate rest the patient and manage their pain. The heavy muscling of the femur will help to keep the joints aligned and the fragments from moving too much.
-The closer to the joint the fracture is located, the less likely it is to heal well without surgery. So select your patients careful for conservative management.
