Posted December 07, 2023

After Hana the dog suffered dramatic injuries from a car collision, a chain of mentorship led her to orthopedic expertise at Michigan State University—more than 600 miles away from her home. Thanks to two Spartan-patented surgical innovations, Hana made a previously unthinkable recovery.

Hana Beautiful Portrait
Hana

One evening, the Franzetti household experienced what every pet owner dreads: Hana, their young Staffordshire terrier mix, slipped out of their home in a new neighborhood. She set off to explore at a quick pace—too quick for her family to keep up.

The Franzettis had almost reached Hana when a fast-moving car struck her.

They rushed Hana to the nearest emergency veterinary clinic, where imaging showed multiple severe fractures of her pelvis and femur, as well as a dislocated hip. The injuries were bad, they were told, and the clinic would only be able to stabilize Hana.

600 Miles Away

At the emergency clinic, the Franzettis met Dr. Raphael Repellin, who had completed a residency in Small Animal Surgery at the Michigan State University Veterinary Medical Center a few years prior. Repellin said that there were only a few surgeons in the world he could recommend for Hana’s injuries.

“MSU was at the top of the list,” says Nick Franzetti. “Dr. Repellin spoke very highly of his mentor, who had taught him a lot about trauma surgery and the issues that Hana now had.”

Resident Repellin

Dr. Raphael Repellin completed a one-year internship and later a three-year residency at the MSU College of Veterinary Medicine. Upon completing his residency in 2021, Repellin went straight into practice in Maryland. He adapted what he learned at MSU about coordinating patient consultations and surgery scheduling to suit patient needs at his new clinic.

His advice to early-career veterinarians: “Trust what you’ve learned and don’t be afraid to voice your opinion and make sure you are heard. Trust your instincts.”

Repellin’s mentor was Dr. Loïc Déjardin, W. O. Brinker Endowed Chair of Veterinary Surgery at the MSU College of Veterinary Medicine and head of the MSU Veterinary Medical Center’s Orthopedic Surgery Service. With decades of surgery, research, and innovation under his belt, Déjardin has designed multiple surgical implants and instruments, and is a highly regarded clinician and educator. Given the complexity of Hana’s injuries and the surgeries she needed, Repellin’s recommendation was to rely on Déjardin’s expertise.

The only problem: the Franzettis lived in Maryland, and MSU was more than 600 miles away.

“Dr. Repellin took the initiative to call Déjardin and see if MSU could take Hana,” says Franzetti. “We made the decision to load Hana in the car and drive to Michigan.”

The I-Loc and SILIS-MILAD

It took nearly 12 hours to carefully journey from Maryland to Michigan with an injured dog resting in the back of the car, but the overnight trip made it possible for Hana to go under the knife the very next morning.

Multiple surgeries were required to address Hana’s injuries. Each procedure employed surgical techniques and tools that stem from the minds of Spartan veterinary orthopedic surgeons, including Déjardin. For instance, the hip displacement surgical technique used on her was pioneered by Dr. Terry Braden, who mentored Déjardin.

First, Déjardin’s team addressed the fracture in Hana’s right leg.

The bone had broken into pieces, which had to be carefully realigned in surgery before being stabilized with an I-Loc Interlocking Nail, the first of Déjardin’s patents to be used on Hana. Déjardin implanted a thin, metal rod in the hollow part of the femur, and locked the nail into place with small bolts.

The I-Loc was a major reason that Repellin referred Hana to MSU. A mechanical interlocking mechanism between the nail and the bolts reduces the slack present in older nails. The interlock supports weight-bearing after surgery, which enables patients to get back on their feet faster, often within just 24–48 hours. This locking function makes the I-Loc multipurpose; it can be used in many kinds of fractures, including Hana’s multi-fractured bone.

Shows I Loc
An x-ray showing the I-Loc interlocking nail in Hana's bone.

“The I-Loc would have made the surgery simple and faster; it was the best treatment for that femur,” he says. “It was a no-brainer.”

In the following days, Déjardin’s team addressed Hana’s other injuries through additional procedures—on both sides of her body—that used surgical systems developed by Déjardin at MSU.

The Sacroiliac Luxation Instrument System (SILIS) was devised for use on injured sacroiliac joints (where the spine connects to the pelvis). The SILIS is used in connection with the Minimally Invasive Lucent Aiming Device (MILAD), which functions like the scope of a rifle to offer surgeons greater accuracy during sacroiliac joint repairs.

Xraysilis Milad
The Sacroiliac Luxation Instrument System and the Minimally Invasive Lucent Aiming Device view.

The SILIS-MILAD features moveable arms with joints for positioning. The arms latch to the surgical table. One or two arms realign the dislocated or fractured bone (a process known as reduction), while another reconnects the bone with implants, such as surgical nails (known as fixation).

Xraysilismilad 2 Hana
Images from Hana's surgery.

Hana underwent two separate surgeries that used SILIS-MILAD to reconnect her dislocated pelvis to her spine. Her final hip luxation procedure involved a set of bone anchors—a type of implant that provides an eyelet to attach soft tissues to bone—and holes drilled through Hana’s hip, which were threaded together with sutures.

A Chain of Mentorship

The methods used on Hana’s injuries were, in many ways, the fruition of generations of orthopedic mentorship at MSU. Déjardin credits much of his professional success to his training under notable mentors, many of whom taught, practiced, and innovated at MSU.

Brinker
Brinker

One key mentor is the surgeon who Déjardin’s endowed chair position is named for: Wade O. Brinker, who is considered the father of veterinary orthopedic surgery. Brinker brought new technologies and techniques to veterinary medicine, and mentored some of the profession’s most noted small animal surgeons. He retired from MSU in 1978 after teaching a generation of veterinary surgeons, including those who are leaders in orthopedics today.

Other essential mentors in Déjardin’s career have included Dr. Gretchen Flo, who retired from the MSU College of Veterinary Medicine in 2022 after more than a half-century of teaching, clinical service, and research. Flo pioneered surgical techniques that are still in widespread use, and along with Brinker, published a textbook now in its 10th edition. Dr. Terry Braden, another retired faculty from the College, shares these mentors with Déjardin, and patented the hip displacement technique used on Hana. Braden, whose also investigated innovative ways to teach orthopedics to future veterinarians, helped guide Déjardin’s career.

Another mentor and collaborator, Dr. Steven Arnoczky, who previously held the W. O. Brinker chair before he retired in 2017, inspired scientific curiosity and new ways to approach the research process. In 2014, he became the second non-physician to be inducted to the American Orthopedic Society for Sports Medicine Hall of Fame in recognition for his work on ligament and meniscal injuries.

Hana Mitchell Dejardin Owner Nick Franzetti Web
Clincal DVM Student Jenna Mitchell, Hana's owner Nick Franzetti, and Dr. Déjardin kneel with Hana on MSU's campus.

At MSU, Déjardin researches biomechanics, implant design, comparative orthopedics, and the use of robotics in surgery. He also furthers and contributes to the legacies of his mentors by guiding surgeons like Repellin during their residencies, internships, and the clinical years of DVM training.

Repellin recalls that during his residency, he was astonished to learn that his program director, Déjardin, was an author in a textbook he had studied. Repellin went on to gain a mentor who was “pushing the edge and boundaries of orthopedic fracture repair.

“He is very meticulous in surgery,” Repellin continues. “Very clean and methodical. I use a lot of his approach to orthopedic surgery; a lot of his movements and ways to handle tissues.”

‘She’s Back to 100 Percent’

Hana’s prognosis was good after surgery, though it took physical therapy to reach her full potential.

Hana And Family
Hana and her best friends.

“Her left leg was in bad shape,” explains Franzetti. “It was very atrophied, basically half the size of the other leg. But she did six weeks of physical therapy, and that did the trick. She started walking on her leg again.”

Hana’s family—Nick, Erica, Mila, and Marco—remained in close contact with their MSU doctors for advice and guidance through the recovery process. Mila and Marco were diligent in assisting Hana with her recovery and being by her side when she was allowed more physical activity. When Hana returned to MSU for a recheck appointment, her doctors confirmed that she had healed wonderfully.

“She’s back to normal,” says Franzetti. “She can go for 5-mile runs with me. She’s back to 100 percent. Everyone up there, from Dr. D to his staff, are amazing.”

An incalculable number of animals have been served by those who trained with the MSU Orthopedic Surgery Service. Many have stories like Hana’s.

“I was ecstatic that I still had these contacts [at MSU],” says Repellin. “We could still do what was best for this dog. And it shows you how important relationships are in the veterinary world.”

"They said she'd never run again...now here we are."


To learn more about the Orthopedic Surgery Service, visit the Hospital’s website. During treatment, Hana also received a blood transfusion thanks to generous canine donors who support the MSU Blood Donor Program