Objective: To determine outcome and prognostic factors after radius and ulna fracture repair with a modified IMEX miniature circular external skeletal fixation (MCESF) in small and toy breed dogs. Study design: Retrospective study. Sample population: Thirty-seven young small and toy breed dogs with 41 radial and ulnar fractures. Methods: Records of radial and ulnar fractures repaired with a modified IMEX MCESF were reviewed. Constructs included 3-4 complete rings, 2 threaded rods, 4 mm-diameter nuts and 6-8 transfixation wires. MCESF configuration, type of fracture reduction, dynamization of the apparatus, inclusion of a dowel pin, and implantation of allograft were recorded. Outcome measures included complications, limb alignment, time to clinical union, and functional outcomes, scored as excellent, good, fair, or poor. Results: Radiographic union was achieved in 40/41 fractures. Fractures reached bony union within 33-84 days after repair. Time to union was not influenced by the type of fracture reduction (P=.11), use of a dowel pin (P=.099), or implantation of an allograft (P=.45). Fracture dynamization delayed radiographic union (P=.0005). At implant removal, mean frontal (FPA) and mean sagittal plane alignments (SPA) were 7.9°±6.5° and 7.5°±5.8°, respectively. Limb alignment did not differ between radiographs obtained immediately after surgery and those obtained at time of radiographic union in the frontal (P=.062) or sagittal (P=.14) planes. Ninety-five percent of cases had good-to-excellent outcomes, based on return to function at final re-evaluations. Conclusion: This modified IMEX MCESF construct provided an effective alternative to treat young small and toy breed dogs with radius and ulna fractures.
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