Fractures too complicated to meet the requirements for a cast can be stabilized with external fixation, intramedullary pins, orthopedic wire, bone plates, or any combination of these. Shown in the accompanying diagram, from least surgically invasive to most, are an external fixation, an intramedullary pin, and a bone plate. An external fixation consists of a rigid metal or acrylic frame outside the broken limb. Long metal pins go through the broken bone pieces and attach to the external frame. External fixation requires intensive postoperative care by the pet's owner, including daily water massage, by whirlpool or hose, of the limb and limited postoperative activity of the pet.
Intramedullary pins are stainless steel rods inserted inside the broken bone.
They hold the pieces of bone together like beads on a string. Their use requires limiting the pet's postoperative exercise to prevent the rods from being dislodged, but they do not require intensive postoperative care. Orthopedic wire is used to wire together fragments of bone or to anchor bone to intramedullary pins, providing additional stability. Misuse leads to problems such as cutting off the blood supply, which will prevent the fracture from healing. An advantage of using intramedullary pins and orthopedic wires is that the animal is able to use the fractured limb fairly well early in the postoperative period.