Urgent Consultation: New Fracture Following Implant Removal

I’d really appreciate your help!   My 5-year-old Canaan dog (43 kg) had a distal radius-ulna fracture in his left front leg about three years ago, treated with a titanium plate and 12 locking screws. Since the surgery, he remained mildly lame but otherwise active and functioning well.   Recently, the lameness worsened - he began avoiding the leg completely. A CT scan indicated reasons to remove the implant, and a week and a half ago we went ahead with the removal surgery. He showed improvement over the next two days, but on day three, after suddenly jumping up in fear, he stopped using the leg again. An X-ray revealed a new fracture near the previous fixation site.   The vet offered immediate revision surgery with two new plates, but seeing our hesitation, also suggested trying a cast first and reassessing in two weeks. We chose casting to buy time and consider our options carefully.   We’re honestly very confused and scared about what to do. We just want our dog to go back to running happily like he used to. We’d really appreciate any advice on what the best next step might be 🙏🙏🙏   Attaching: CT before implant removal + Radiograph post-removal showing the new fracture.

Hello and thankyou for sharing this difficult and frustrating story with us.  What has improved such that your vets are now expecting revision surgery to work?   It didn't work first time and second repairs in my experience - ask your vet to look it up for you in the literature, specific to that fracture site - are generally less likely to be successful, rather than more so. If they aren't able to explain what studies have already found in this area, I would expect a vet at this point to consult an external opinion, perhaps the help of an experienced specialist to try to pinpoint the reason that the repair didn't work.  Is this something that can be fixed?  Have they ruled out infection or underlying illness such as bone cancer or nutritionally driven?  Is the fracture sufficiently far away from the joint / growth plate?  Does your dog have the metabolic capacity to heal?   Can they point you to the academic articles or studies supporting the decision they are making?  What alternatives (casting?  Even amputation?) exist? We cannot review radiographs for you on this site.  I am not an orthopaedic specialist and know less about this case than your vet.   However my priorities at this point as the owner would be to understand what the underlying research on this area says and if your vet doesn't happen to be a specialist with access to this data, then to ask for a second, more specialist, opinion.