Dog hit by a car with a femoral fracture: what to assess first
4-year-old crossbreed dog, 22 kg, hit by a car an hour ago. Non-weight-bearing on the left hindlimb with crepitus in the thigh. HR 150 bpm, slightly pale mucous membranes, RR 44 bpm with a mildly increased respiratory effort.
What is the priority before planning repair of the femoral fracture?
chevron_right Show answer and explanation
A. Radiograph the femur in two views under deep sedation to choose the implant
Implant planning can wait. Deeply sedating a tachypnoeic patient before assessing the thorax may decompensate a pneumothorax or pulmonary contusion.
B. Operate within the first 6 hours to limit swelling and make reduction easier
A closed femoral fracture is not an immediate surgical emergency. Anaesthetising an unstabilised, unassessed trauma patient greatly increases the risk; repair is usually done over the following days, once the patient is stable.
C. Stabilise (oxygen, analgesia, fluids), assess the thorax (radiographs or T-FAST) and confirm bladder integrity
Correct. A substantial proportion of dogs with fractures from road traffic accidents have thoracic injuries (pulmonary contusion, pneumothorax, rib fractures) and some have bladder or ureteral rupture. These injuries kill; the fracture almost never does.
D. Apply a Robert Jones bandage to the thigh to immobilise the fracture
A Robert Jones bandage does not immobilise fractures above the stifle: it ends mid-femur and acts as a pendulum on the fracture. For the femur, cage rest and good analgesia are enough.
lightbulb Key takeaway
Treat the patient, not the radiograph. Before anaesthetising to repair a fracture, rule out pulmonary contusion, pneumothorax, traumatic arrhythmias (they may appear at 24–48 hours) and bladder rupture: a dog that urinates can still have one.
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Updated: October 31, 2026 · Educational content for veterinary professionals. It does not replace current clinical guidelines or the judgement of the attending veterinarian.