Minimally invasive percutaneous elastic plate osteosynthesis as a treatment option for tibial diaphyseal fracture in skeletally immature dogs.

Background: Pediatric fractures are relatively common in dogs, and several treatment options exist, particularly for fractures in the distal extremities. Regardless of the choice of treatment, the overall goal is rapid restoration and excellent long-term functional recovery, with minimal discomfort and morbidity during healing. This case series aims to report the long-term outcome after minimally invasive percutaneous elastic plate osteosynthesis (MIPEPO) in the treatment of pediatric tibial fractures in dogs and compare this to other treatment options, where all techniques emphasize biological osteosynthesis. We especially accentuate surgery time, patient comfort level during osteosynthesis, time to clinical union, and complications, including long-term follow-up.

Case Description: Medical records of five skeletally immature (juvenile) dogs <6 months old with an isolated tibial diaphyseal fracture or a combination of tibial and fibular diaphyseal fractures, treated with MIPEPO aided by fluoroscopy. All dogs experienced excellent levels of comfort and limb functionality and exhibited preserved muscle mass throughout the healing process. The mean duration until plate removal was 27.6 days, with a standard deviation [(SD) ± 9.61; range of 15-36 days] following the operation. Subsequently, four dogs underwent a follow-up examination approximately 1.5 years after plate removal, during which bilateral orthogonal radiographs of the tibia were obtained. These radiographs revealed minimal discrepancies in terms of limb length, frontal plane alignment, and rotational alignment. Furthermore, the owners expressed complete satisfaction with their dogs' recovery and restoration of intended function.

Conclusion: MIPEPO is quick to perform and well tolerated, with rapid fracture healing in juvenile dogs and excellent long-term outcomes. It can be considered along with external fixators and external coaptation when dealing with juvenile diaphyseal fractures.