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Fracture Management in Dogs: When to Splint or Refer?

Fracture Management in Dogs: When to Splint or Refer?

Best Practices

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Learn when to splint and when to refer dog fractures. A practical guide for vets to make the right call in canine fracture management

By 

Sustainable Vet Group

Updated on

April 8, 2025

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Understanding Canine Fracture Management

Dogs can suffer different types of fractures, such as

  • simple
  • comminuted (broken into many pieces)
  • greenstick (partial break)
  • open fractures (bone pokes through skin)

These can happen from falls, car accidents, or rough play. Each fracture needs a different treatment plan, depending on the type and location of the break.

Making the right decision early is very important. Choosing whether to splint or refer for surgery can affect how well the bone heals and how soon the dog returns to normal activity. If the wrong choice is made, the bone might not heal correctly, or the dog may have lasting pain or trouble walking.

The main goals of fracture management are to stabilize the bone, preserve limb function, and reduce pain. A careful exam, good imaging, and quick action can give the best chance for a full recovery.

When to Splint a Fracture in Dogs

Some fractures can be treated without surgery, especially when they meet certain conditions. Here’s when splinting is a good option:

Location Matters: Distal to Elbow or Stifle

Splinting works best for fractures that occur below the elbow (front leg) or below the stifle (knee in the back leg).

These lower limb areas are easier to stabilize with an external splint. The muscles are smaller, and there’s less movement, which helps the bone stay aligned during healing. Splints are less effective for fractures higher up the leg or near joints with heavy muscle forces.

In those cases, bones are more likely to shift without surgical support. So, if the fracture is in the radius/ulna (below the elbow) or tibia/fibula (below the stifle), and the bone is stable, splinting is often the right choice.

Fracture Type: Closed, Stable, Minimally Displaced

Splinting is most effective when the fracture is closed (skin is intact), stable, and minimally displaced (bone pieces haven’t moved much). These fractures usually don’t require surgery because the bone ends are still in a good position to heal.

A splint can keep them steady while the bone forms new tissue. If the break is too unstable or the bone is badly misaligned, a splint won’t hold it properly, and surgery may be needed. Proper X-rays are important to confirm the fracture type before deciding on splinting.

Age Factor: Greenstick Fractures in Puppies

Puppies often get greenstick fractures, where the bone bends and cracks but doesn’t break all the way through. These are more common because young bones are softer and more flexible. The good news is, greenstick fractures heal quickly with the right support.

A simple splint is usually enough for stabilization. Since puppies grow fast, healing can begin in just a few weeks. But regular rechecks are important because a fast-growing bone can shift if the splint isn’t applied or monitored correctly.

Specific Bones: Metacarpal and Metatarsal Fractures

Fractures of the metacarpal (front paw) and metatarsal (back paw) bones are common, especially in active dogs.

These bones are small and located in the lower limbs, making them ideal candidates for splinting—if the break is closed and the bones are not too displaced. A splint can keep the bones in place and support weight-bearing as healing begins.

However, if multiple bones are broken or the alignment is poor, surgery might be safer to protect long-term function. Splinting works best when at least one of the central bones is intact for natural support.

When Splinting May Fail or Be Risky

Not all fractures can be safely treated with a splint. In some cases, splinting may lead to poor healing or long-term damage.

Proximal Long Bone Fractures (Femur, Humerus)

Fractures in the femur (thigh bone) or humerus (upper front leg) are hard to stabilize with a splint. These bones are surrounded by large muscles that pull the broken pieces apart. External splints can’t provide enough support, which means the bone might heal crooked or not at all.

Surgery is often the best choice here, using pins or plates to hold the bone firmly. Trying to splint these upper limb fractures often leads to pain, delayed healing, and poor limb function. Immediate referral for surgical repair is recommended.

Comminuted or Unstable Fractures

A comminuted fracture means the bone is broken into multiple pieces. These are very unstable and can’t be held in place by a splint alone. The pieces move easily, and the risk of poor healing is high. If a splint is used, the bone may heal in the wrong position or form a weak union.

In these cases, surgical fixation is needed to realign and stabilize the fragments. Using metal implants helps maintain bone structure and allows faster healing. Splinting is not advised for fractures with many bone fragments or any signs of instability.

Toy Breeds and Risk of Nonunion (Distal Radius/Ulna)

Small breeds like Chihuahuas, Pomeranians, and Yorkies are at high risk of nonunion when they fracture the distal radius and ulna (lower front leg). These bones have a poor blood supply in tiny dogs, which makes healing harder. Even a clean break may not join properly with just a splint.

In many cases, the bone fails to heal, causing long-term lameness. Surgery is usually the safer and more effective option in these breeds. Splinting might delay healing or cause further complications, so careful evaluation is essential before choosing non-surgical treatment.

Open Fractures with Soft Tissue Injury

An open fracture means the bone has broken through the skin, often causing damage to the surrounding tissue. These fractures are at high risk of infection, swelling, and poor healing. A splint alone can’t protect the wound or keep the bone clean.

In fact, covering an open wound with a splint can trap bacteria and lead to serious infections. These cases need surgical cleaning, antibiotic treatment, and often internal fixation to support healing.

Leaving an open fracture untreated or trying to manage it with a splint is dangerous and should always be referred for emergency surgical care.

When to Refer for Surgical Intervention

Some fractures go beyond what splinting or basic care can handle. In these cases, timely referral improves outcomes.

Joint Involvement or Multiple Bone Fractures

When a fracture extends into a joint, or when multiple bones are broken, the risk of long-term issues increases. Joints need perfect alignment to avoid arthritis or loss of movement. Multiple fractures are harder to stabilize with external methods.

Surgery ensures the bones are correctly positioned and fixed in place. Referral is important in these cases to restore function, reduce pain, and prevent complications like joint stiffness or permanent lameness.

Fractures with Infection or Delayed Healing

If a fracture becomes infected or is not healing after several weeks, surgical help is often required. Infected bone (osteomyelitis) needs cleaning, drainage, and strong antibiotics. A splint alone won’t fix it. Delayed healing, or nonunion, may also need bone grafting or surgical stabilization.

Early referral helps prevent further damage and gives the best chance of recovery. Waiting too long can lead to permanent problems, so monitoring progress is key.

Imaging or Fixation Beyond GP Capabilities

Some fractures require advanced imaging like CT scans or special fixation tools such as locking plates or external fixators. These resources may not be available in general practice. When equipment is limited, referral ensures the dog gets the proper diagnostics and treatment plan.

Without clear images or the right tools, the fracture may not heal correctly. In complex cases, referral is not just helpful—it’s necessary for safe and effective care.

Surgeon-Level Expertise Needed

Fractures involving neurologic damage, growth plates, or reconstructive challenges often demand a skilled orthopedic surgeon. These cases require precise technique, careful planning, and experience in bone healing.

Attempting surgery without the right expertise can lead to failed repairs or long-term disability. Referring these cases early allows for better outcomes, fewer complications, and faster healing. Knowing when a case is beyond your scope is a sign of good judgment and strong patient care.

Clinical Decision Tips for General Practitioners

Before deciding between a splint or referral for surgery, it’s important to follow a clear checklist.

  • First, assess the fracture location. Splinting works best for injuries below the elbow or knee.
  • Next, check if the fracture is closed, stable, and minimally displaced.
  • Consider the dog’s age and breed. Puppies with greenstick fractures may heal well with splints, while toy breeds may not.
  • Also, evaluate the clinic’s resources. Do you have the right imaging, splinting materials, and experience to monitor healing?

Once you apply a splint, schedule frequent rechecks, especially in the first 7–10 days. Watch for swelling, pressure sores, shifting of the fracture, or signs of delayed healing. If the bone alignment worsens or healing stalls, don’t hesitate to change the plan and refer.

Good communication with a specialist is essential. Share imaging, fracture details, and your current treatment plan. Early referral improves outcomes, especially for complex or high-risk cases. Acting quickly and knowing your limits helps the dog recover better and shows clients you are prioritizing their pet's care.

Final Thoughts

Knowing when to splint and when to refer is key in fracture management. Splints work well for simple, closed, stable fractures in the lower limbs, especially in young dogs or certain paw bones. But fractures involving joints, multiple bones, or unstable patterns often need surgery to heal correctly. Toy breeds and open wounds also require extra caution.

Timely referral can make the difference between full recovery and long-term problems. Waiting too long with the wrong treatment can lead to pain, poor healing, or permanent damage.

Working together with orthopedic specialists improves outcomes and builds trust with pet owners. As general practitioners, recognizing your limits and seeking help when needed is not a weakness—it’s part of giving the best care. Collaborative care leads to better healing, happier patients, and stronger professional relationships.

FAQs

Can you splint a femur fracture in dogs?

No, femur fractures should not be splinted. The femur is surrounded by strong muscles that make it hard to keep the bone aligned. Splints won’t provide enough support, and healing may fail. Surgery with internal fixation is the best treatment for femur fractures in dogs.

How long should a dog wear a splint for a leg fracture?

Most dogs need to wear a splint for 4 to 6 weeks, depending on the fracture type and age. Puppies may heal faster. Regular rechecks and follow-up X-rays are important to check progress and avoid problems like pressure sores, swelling, or delayed healing.

What are the signs a fracture needs referral?

Signs include joint involvement, multiple bone fractures, open wounds, unstable or comminuted breaks, or no healing progress after a few weeks. Also, if proper imaging or surgical tools aren’t available, referral ensures better care and improves the dog’s chance of full recovery.

What’s the risk of nonunion with splinting in toy breeds?

Toy breeds have a high risk of nonunion, especially in distal radius/ulna fractures. Their small bones have less blood supply, which slows healing. Even simple fractures may not heal with splints alone. Surgery is often recommended early to avoid long-term lameness or permanent damage.

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