Heather Henson; Gregory Lewbart; Denis J. Marcellin-Little; Simon Roe; Michael
Stoskopf
North Carolina State University, College of Veterinary Medicine, Raleigh,
NC
Abstract
In the past, several popular methods have been used to repair fractures in
various chelonian species. The majority of these have consisted of using various epoxy and resin
substances to effectively "glue" the fracture site together.1 This method
was based on the principle of secondary or tertiary intent healing. The fractures were reduced
and granulation tissue formed between opposing sides. Reported healing times with this
methodology have ranged from one to two years.2
An alternative method for fracture reduction was developed at the North
Carolina State University College of Veterinary Medicine and applied on turtles previously hit by
a car. This method is a combination of orthopedic fracture fixation techniques. The fractures are
repaired with multiple screws connected by orthopedic wire. The screws are placed 1 to 2
centimeters from the fractured edge. The line connecting the screw heads is approximately
perpendicular to the fracture line. The screw head is tilted away from the fracture to provide
interfragmentary compression. Surgical wire is then placed in a figure-eight fashion around the
screws in order to maintain proper fracture reduction. This method allows for primary intention
healing and therefore greatly reduces the healing time. In most cases, the screws are removed six
months to a year postoperatively.
The primary species on which this technique has been applied are the eastern
box turtle (Terrapene carolina carolina) and the yellow bellied slider (Chrysemys
scripta scripta). Due to the fact that the box turtle is a land animal and the slider an
aquatic one, this technique has been shown to be as effective in water as out. Another
consideration when testing the technique on these two species is the fact that they are greatly
different in size. The box turtle weighs approximately 400 grams while sliders can weigh up to 2
kilograms. This results in the need for slightly different supplies for the two types of turtles.
A 0. 73 mm-diameter (22 Ga.) wire and 2.7 mm cortical bone screws were used in both species.
Because of differences in shell thickness, the screw lengths were 6 mm and 8 mm, in the box
turtles and sliders, respectively. The length of the screw depends greatly on the thickness of
the shell at the fracture sight.
The main advantages of this technique are the greater likelihood of primary
intention healing versus secondary and the shorter time to return of normal shell strength.
Additionally, the technique has possibilities of being used on other chelonian species including
endangered sea turtles.
References
1. Ed. Kirk. 1989. Current Veterinary Therapy. W.B. Saunders
Company, Philadelphia, Pennsylvania, Pp. 789-791.
2. Mader, Douglas T. 1996. Reptile Medicine and Surgery. W.B.
Saunders Company, Philadelphia, Pennsylvania, Pp. 413-417.