Peanut - Orthosis Use for Management of L Paw (Metacarpal) Fractures

PeanutMeet Peanut, our June 2018 Pet of the Month!  Peanut is a 9 year-old Pomeranian, who fractured all 4 metacarpal bones in her left front limb back on August 2, 2017.  These fractures would be the equivalent of a human breaking the bones in the palm of their hand.  Since her metacarpal bones were too tiny for surgical stabilization, she had been managed in a cast to keep her fractured paw as still as possible.  Her cast needed to be inspected often and the interior padding needed to be changed every couple weeks.  Unfortunately, after 12 weeks, Peanut’s fractures still had not healed and the bone fragments continued to move pretty easily when the cast was off at her recheck visits.

We first met Peanut in November 2017, after it was determined that she had non-union fractures.  In order to try to help her fracture fragments heal together, we started right away with Acoustic Compression Therapy (ACT, also called “shock wave”), which uses focused sound waves to promote bone healing activity in fracture sites.  Our plan was to try to stimulate bone healing with ACT first to see if any callous formation would start at the fracture ends.  After a few treatments, we had hoped to see some progress, but unfortunately this was not the case.  Our “Plan B” was to cast Peanut for a custom carpal-paw orthotic device to help support her fractured metacarpal bones.  An orthosis can sometimes be used in fracture care and may even be easier to manage than a bandage or cast because you can take it off and replace it without sedative.  An added bonus is that there are often fewer wounds associated with an orthotic because inspection is easier to do.  Peanut’s family opted to move forward with an orthotic device at that time.

We casted Peanut on 12/15/17 and she was fitted with her new custom orthotic two weeks later. Because she had been in a cast for so long prior to getting her orthosis, Peanut took to her new “shoe” almost instantly.  We have been working on specific controlled exercises since she was fitted with her orthosis in order to strengthen her shoulder muscles and improve her balance and body awareness to help her maneuver in her device easier.  Another important part of Peanut’s rehabilitation has been working on weight loss.  Dropping just 2 pounds will make a huge difference for Peanut.  Carrying less weight will help decrease stress on her joints and let her be the active girl she really wants to be.  So far, Peanut has lost 1 pound and a total of 4.0 cm overall in girth!  We are very proud of Peanut for how well she is doing in her orthotic device and also for her weight loss thus far.  She still has a little more to go with the latter, but we know with the help of her family, nothing is out of reach for this little Pom!

Check out her progression video on our YouTube channel with this link:


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