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Pre-operative care primarily consists of pain scoring, analgesia, bandage stabilization, radiographs, and surgical preparation. Orthopedic injuries and surgeries are associated with moderate to severe pain and inflammation, thus appropriate multimodal analgesia before, during and after surgery is essential. Multimodal analgesia allows for beneficial synergistic analgesic effects, as well as requiring lower individual analgesia doses, potentially reducing undesirable side effects. Patients pain should be frequently reassessed using a reliable system such as the Glasgow Composite Pain Score. Pre-operative fractures should be managed with a mu-opioid agonist analgesic such as methadone or fentanyl, alongside a non-steroidal anti-inflammatory drug such as meloxicam. If patients are still painful, they may benefit from a constant rate infusion such as fentanyl-lidocaine-ketamine. Partial opioid agonists such as buprenorphine competitively inhibit the action of pure agonists, thus are typically unsuitable. Pre-operatively, external coaptation stabilization of the fracture will significantly reduce associated pain, protect any wounds from additional contamination and minimize overall wound swelling and inflammation. Whilst the traditional Robert-Jones bandage provides better stabilization, the modified Robert-Jones bandage enables daily examination and application of therapies such as wound care until surgical procedures are possible, making it the superior choice for short-term stabilization. Radiographs must be taken prior to surgery to confirm the presence, location, and type of fracture. Surgical preparation is similar to most limb surgeries. Hair should be clipped 10cm proximal and distal of the expected surgical incision, with the paw covered in a sterile bandage. Animals should be placed in dorsal recumbency with the affected limb in hanging limb technique. An Esmarch bandage may be placed to provide a bloodless surgical field. Surgical scrub is routine, using chlorhexidine or similar to produce an aseptic field. There are many specific equipment requirements for various orthopedic surgeries. Some common orthopedic instruments include gelpi retractors, periosteal elevators, orthopedic forceps, bone saws, orthopedic drills, as well as many types of plates, screws, pins, and wires. For minimally invasive plate osteosynthesis, locking plate systems are recommended over traditional dynamic compression plating, as they do not require precise contouring and may provide some mechanical advantages. However, pure locking systems do not assist fracture reduction and can be challenging to angle screws correctly, therefore implants allowing the use of both locking and conventional screws are preferred. The use of intraoperative radiography or fluoroscopy is highly recommended when using this technique, as it allows for precise positioning of implants and accurate evaluation of bone reduction. Peri-operative care includes surgical monitoring and analgesia. Peri-operative anesthetic monitoring is typically straightforward in fracture repairs, consisting of heart rate, ECG, respiratory rate, capnography, SPo2, ETC02, blood pressure, and temperature. Some animals may have a degree of shock due to traumatic injury, however they should ideally be stabilized prior to surgery. The pre-operative combination of opioids and NSAIDS should continue during surgery, with the addition of local anesthetic blocks. For fractures in the radius or ulna, suitable analgesic blocks include the brachial plexus block, and the RUMM (radial, median, musculocutaneous, and ulnar) nerve block. Complete healing post fracture repair typically takes a minimum of 6-8 weeks and comprises of a detailed recovery plan from immediately post-operation to long term rehabilitation. Immediate post-operative recovery consists of pain management, wound care, patient positioning, ambulatory assistance, and nutrition. Post-operatively, analgesia should be continued for as long as necessary, based off the patients’ pain score. Typically, a long-acting transdermal fentanyl patch is placed during surgery, which takes 12 hours to start working and may last up to 72 hours, however recently a long-acting topical form of fentanyl has been approved for use in dogs, which absorbs within 4 hours and provides up to 96 hours of pain relief. Once these long-acting drugs are working, other opioid pain relief can be decreased until no longer necessary. Frequently other modes of pain relief such as meloxicam or paracetamol are used concurrently for up to 14 days post-surgery. Wound care primarily involves infection control via covering all surgical wounds, wearing gloves when changing bandages, and appropriate use of antibiotics to avoid post-surgical infections. Cryotherapy with towel-wrapped ice applied to the surgical area, as well as appropriate bandaging can help with wound swelling, however bandages can cause significant complications and must be checked daily. Patients should also wear an Elizabethan-collar to prevent self-trauma to the limb. Patient positioning is important to avoid pressure sores & decubital ulcers, thus recumbent animals should be turned every 4 hours, along with providing soft bedding or orthopedic mattresses. Ambulatory assistance initially consists of passive range of motion physiotherapy. The use of slings and harnesses to support body weight and encourage standing and short, slow lead walks is also beneficial to fracture healing, however, animals should be on crate rest apart from these short periods of physiotherapy to avoid injury. Proper nutrition is a critical factor in any surgical recovery, as malnutrition has been found to cause poor surgical recovery, decreased immune function, and prolonged hospitalization. A feeding plan following the animals resting energy rate (RER) should be followed to ensure adequate nutrition during recovery. Short to long-term rehabilitation post discharge from hospital comprises of increasing levels of physiotherapy. Common long-term physiotherapy options include cryotherapy, heat therapy, massage, passive exercise, hydrotherapy, and increasing weight baring exercises. The injured limb should be x-rayed after 6-8 weeks to confirm complete healing. Physiotherapy should then continue until function in the limb is as close to normal as possible. Thank you for watching.