The Undercover Vet: Jack and his javelin

I used to work with a vet called Jack. He was a young guy who had just qualified but was very ambitious and a little over-confident. During the year, that I worked with Jack, he had terrible luck as you will soon find out in future blogs. I'm actually surprised that he stayed on as a vet after his first year considering his run of mishaps (although he did flirt with the idea of banking for a while).

He qualified from university as a brash, confident and stubborn lad, who was eager to do anything and everything (even if he should have left some things to more experienced hands). He left though after a year, much more conservative in his veterinary approach and far more willing to listen to the advice of others. The veterinary job is a very humbling experience - one moment you can feel great when things go well and the next day, a complete waste of space if a case goes wrong.

There was this one occasion, when an owner brought in this 45kg rottweiler to see Jack. The poor dog had been attacked by some people with bats and metal bars. On examination, Jack found the dog to be ok, although it was painful on one of his front legs. Jack decided that this dog needed x-rays of the skull, chest and painful leg. He ended up taking lots and lots of x-rays. In the end, he had his own encyclopedia of x-rays for this one case!!!

The dog was lucky that the only serious injury sustained was a broken ulna bone. The ulna is the outer bone in the front leg (arm) between the elbow and the paw. It runs adjacent to the bone called the radius and is held to it by a strong ligament. The fracture of the ulna was transverse (running horizontally across) and non-displaced (meaning the 2 fracture ends of the broken bone were sitting opposite each other).

The broken bone could have quite easily been managed conservatively by resting the dog and immobilising the leg with a bandage/splint or cast. Jack though was keen to get some bone surgery under his belt and so after discussing the options with the owner, decided the best course of action was for him to operate on the leg.

He decided to put a pin into the bone. Basically, this involves putting a metal rod into the centre of the bone to keep the fragments aligned (ironic that metal rods caused the injury and were being used to fix it!). It is normally a simple technique to perform, but to Jack's dismay, it was no ride in the park on this day.

Being a large rottweiler, the part of the bone where Jack was trying to insert the pin (from the elbow end) was very thick and extremely firm. Jack couldn't get the drill to work properly and so ended up trying to force the metal pin in manually with sheer brute force! During the insertion of the pin, Jack continued his addiction to x-raying and took several x-rays to see if the pin was going in correctly (I wondered whether Jack had some shares in selling x-ray film?!).

After pushing for what seemed an era; with little more to show than hand calluses and strained muscles, disaster struck! Jack had managed to ram only about an inch of pin into the bone (and it was still a long distance from the bone cavity where it needed to be). At this point, the pin snapped so that there was an inch of metal forced into solid bone. Jack tried to now pull out this redundant piece of pin but couldn't budge it a single millimetre. He huffed and he puffed, trying everything he could think of but eventually resigned himself to the fact that it wasn't going to move.

As the owner came in, Jack explained his troublesome day with the dog. Obviously, the gentleman was dissatisfied with the outcome and expressed his displeasure. Jack tried to offer the owner the option of letting one of the more experienced vets take over the case and remove the dog's new metal accessory for free. In the end, the owner and Jack decided to leave the broken pin in and only remove it if it began to trouble the dog at a later stage.

As for the fracture, well, it healed beautifully........how I hear you ask............by none other than a bandage and splint. As for Jack; he had cramp in his hand for a few days and was not so keen again to jump into unsupervised bone surgery.