Treatment of fractures in avian species

External fixation, with coaptation or Kirschner-Ehmer splints, is a viable treatment for many fractures in captive and wild birds. Important considerations in selecting a device are the weight and size of the device, location of the fracture relative to joints, and prognosis associated with location of the fracture(s). A variety of materials, not limited to traditional medical materials, may be used in coaptation splinting. Straws, plastic spoons, and rubber balls can serve as effective splints. Type I and II Kirschner splints are typically used in birds, although large birds may require a type III splint on leg fractures. The most useful configuration for wing fractures is the type Ia single bar splint using epoxy or acrylic for the connecting bar. This splint is lightweight, positioned close to the patient, and stable for most fractures. The type II splint is an excellent choice for leg fractures at the level of the tibiotarsus and below. The destructive character of psittacines requires all splints be protected from the beak of the bird. Clavicular-furcular and coracoid fractures in small birds may be effectively managed with coaptation splinting. In birds over 400 g body weight, open reduction is needed for best results. Since fractures of the foramen triosseum are usually not surgically repairable, they can be stabilized with coaptation splints. Although humeral fractures may be managed with coaptation in some circumstances, firm stabilization with a type I Kirschner-Ehmer splint or internal fixation is best. Single bone fracture(s) of the radius or ulna can usually be managed with minimal treatment, brailling, or figure-of-eight wraps. Fractures of both the radius and the ulna require a type I Kirschner-Ehmer splint for internal fixation. Coaptation splinting alone is usually indicated for carpal or carpometacarpal injuries. Femoral fractures in small birds may be managed with coaptation splinting, although fractures in large birds or unstable fractures require internal fixation or a type I Kirschner-Ehmer splint. Tibiotarsal fractures, in many species, may be managed with internal fixation or a type II Kirschner-Ehmer splint. Tarsometatarsal fractures can be cast or stabilized with a type II Kirschner-Ehmer splint. Phalangeal fractures are best managed with coaptation splinting.