Percutaneous tibial physeal fracture repair in small animals: technique and 17 cases.

Vet Comp Orthop Traumatol

Dirsko J. F. von Pfeil, Dr.med.vet, DVM, Diplomate ACVS, Diplomate ECVS, Diplomate ACVSMR, Friendship Surgical Specialists of the Friendship Hospital for Animals, 4105 Brandywine Street NW, Washington, DC 20016, United States, Phone: +1 202 363 7300, Fax: +1 202 363 7126, E-mail:

Published: July 2017

Objectives: To retrospectively describe cases treated via percutaneous tibial physeal fracture repair (PTPFR), using intra-operative fluoroscopy (IFL) or digital radiography (DR). To describe a technique ("spiking"), used to treat tibial tuberosity avulsion fractures.

Methods: Clinical data of 14 dogs and three cats were included. The "spiking" technique was described.

Results: Intra-operative fluoroscopy (n = 11) and DR (n = 6) were successfully used in 11 tibial tuberosity avulsion fractures, one combined proximal physeal and tibial tuberosity avulsion fracture, and five distal tibial/fibular physeal fractures. Surgery times ranged from eight to 54 minutes. The "spiking" technique was successfully applied in six tibial tuberosity avulsion fracture cases. Return to function was at a mean (± standard deviation) of 1.9 (± 1.6) weeks. Long-term (>12 months; n = 17) follow-up was available at a mean of 40.6 (± 13.4) months. Major complications consisted of skin irritation from a pin (distal tibia / fibula physeal fracture case; 8 weeks post-PTPFR), and a bilateral grade II medial patella luxation (tibial tuberosity avulsion fracture case; 1.5 years post-PTPFR). One case developed a mild tibial tuberosity avulsion fracture re-avulsion. All conditions in these three cases were not of clinical concern at follow-up and final outcome was graded as good in these and excellent in the other 14 cases.

Clinical Significance: Percutaneous tibial physeal fracture repair can be considered as a technique to treat tibial physeal fractures. The "spiking" technique was successfully applied in six dogs. A larger, prospective case series is indicated to provide additional clinical information.

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http://dx.doi.org/10.3415/VCOT-16-07-0102DOI Listing

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