The use of transarticular external skeletal fixation in the management of failed tibial tuberosity transposition in five dogs

2010 ◽  
Vol 23 (02) ◽  
pp. 109-113 ◽  
Author(s):  
A. Coughlan ◽  
R. Pettitt ◽  
N. MacDonald ◽  
J. Innes ◽  
M. Owen ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Tibial Tuberosity ◽  
Fracture Reduction ◽  
Bone Stock ◽  
Tibial Tuberosity Fracture ◽  
Long Term Follow Up ◽  
Fixation Techniques ◽  
Implant Size

SummaryThe management of tibial tuberosity fracture-avulsion after tibial tuberosity transposition can be challenging. Implants must be able to resist the strong distractive force of the quad-riceps mechanism, yet implant size is limited by the amount of tuberosity bone stock available. Revision fixation is compromised further by fragmentation of the tubercle. Five stifle joints had temporary transarticular external skeletal fixators applied to manage complications of tibial tuberosity transposition. Fracture reduction was confirmed in four out of five tibial tuberosity fractures. Frames were in place for a mean of 44 days. Frame associated complications occurred in four out of five limbs, the most common being pin tract discharge and associated osteolucency. All frame-associated complications resolved. Long-term follow-up information was available for three of the five animals at 13 to 18 months after frame removal. All three owners reported occasional lameness, but this was attributed to concurrent orthopaedic disease. Transarticular external skeleton fixation protects internal fixation techniques, and good limb function was achieved in most cases. Transarticular external skeleton fixation can be successfully used to augment repair of tibial tuberosity fracture after tibial tube-rosity transposition.

Cranial tibial plating in the management of failed tibial tuberosity advancement in four large breed dogs

2014 ◽  
Vol 27 (03) ◽  
pp. 236-242 ◽  
Author(s):  
N. D. Lorenz ◽  
R. Pettitt
Keyword(s):  
Avulsion Fracture ◽  
Telephone Interview ◽  
Dynamic Compression ◽  
Tibial Tuberosity ◽  
Bone Stock ◽  
Radiographic Evidence ◽  
Mode Of Failure ◽  
Long Term Follow Up

SummaryThe management of failed surgical procedures involving osteotomy for tibial tuberosity advancement can be demanding due to the limited available bone stock, which must be large enough to counteract the powerful proximal and cranial distractive forces exerted by the quadriceps mechanism. Initial mode of failure may be related to implant failure, fracture of the tibial tuberosity, or a combination of both. The complications and management of the cases reported here were all associated with avulsion fracture of the tibial tuberosity following tibial tuberosity advancement. In all cases, a cranial tibial dynamic compression plate was applied to reduce the fractures and stabilize the osteotomy. No further major complications associated with the implants or fracture occurred. Radiographic evidence of progression of fracture healing was documented in all four cases at the six to eight-week postoperative follow-up. Long-term follow-up information was available for three out of four cases at nine to 23 months after surgery by telephone interview and validated owner questionnaires. Owners reported return to normal exercise with intermittent lameness occurring in two of the three cases. The authors concluded that this technique offers an alternative technique for the management of such fractures, in particular in large breed dogs where sufficient tibial tuberosity bone stock remains.

Tibial tuberosity fracture as a complication of tibial tuberosity advancement

2014 ◽  
Vol 27 (02) ◽  
pp. 148-154 ◽  
Author(s):  
J. Aisa ◽  
D. Chase ◽  
P. Garcia-Fernandez ◽  
F. San Roman ◽  
D. Bennett ◽  
...  
Keyword(s):  
Medical Records ◽  
Incidental Finding ◽  
Weight Bearing ◽  
Sudden Onset ◽  
Tibial Tuberosity ◽  
Tibial Tuberosity Fracture ◽  
Long Term Follow Up ◽  
Surgical Group

SummaryTo retrospectively compare two clinical subsets of dogs suffering tibial tuberosity (TT) fracture (incidental finding or sudden onset severe lameness) as a complication of tibial tuberosity advancement (TTA) and to report the surgical management and outcome of TT fracture as a complication of TTA.The medical records of 10 dogs with eleven TT fractures or crest fractures after TTA were reviewed. The outcome and complications were determined from clinical and radiographic follow-up examinations. Limb function was evaluated between six and 12 weeks postoperatively. Owners were contacted by phone for long-term follow-up at least six months after the last examination.Four dogs required surgical stabilization and six dogs had conservative management. In the surgical group, every case experienced a sudden non-weight-bearing lameness after the initial TTA surgery. In three of the four cases an attempt was made to stabilize the TT and crest fracture while maintaining the TT advancement. Postoperative complications were encountered in three of the four surgically treated cases. Functional outcome was considered excellent in seven cases and good in the other three.Tibial tuberosity fracture is a complication of TTA that seems to have a favourable prognosis, although it can result in significant morbidity and in some cases revision surgery may be required.

scholarly journals Long-term assessment of a modified tibial tuberosity advancement technique in dogs

2018 ◽  
Vol 70 (4) ◽  
pp. 1053-1059 ◽  
Author(s):  
R.M. Medeiros ◽  
M.A.M. Silva ◽  
P.P.M. Teixeira ◽  
D.G. Chung ◽  
M.E.B.A.M. Conceição ◽  
...  
Keyword(s):  
Gait Analysis ◽  
Positive Response ◽  
Tibial Tuberosity ◽  
Compression Tests ◽  
Radiographic Evidence ◽  
Long Term Follow Up

ABSTRACT The purpose of study was to assess long-term clinical and radiographic aspects of dogs’ stifle joints which had undergone a modified tibial tuberosity advancement technique (mTTA). A total of 15 stifles that had undergone mTTA for CCL disease of 11 patients were included in this study. Assessments involved patient’s gait analysis, cranial drawer and tibial compression tests, stifle goniometry range of articular motion, thigh and leg girth and radiographic evidence of progression of osteoarthrosis. Variables were compared between operated and healthy limbs and among moments (M0) on the early postop; (M1) 120 days postop; and (M2) approximately 5 years following surgery. A questionnaire regarding owner’s perceptions after approximately 5 years of surgery was assessed. Most dogs presented positive response to cranial drawer and tibial compression tests on operated knees. There was also decrease on goniometry and thigh girth and increase in leg girth. Radiographic evidence of progression of osteoarthritis was seen especially on the long-term follow-up (M2). On gait analysis, most animals presented some degree of lameness in different conditions, in contrast to owners’ perceptions. Osteoarthritis still develops in dogs following mTTA surgery for CCL disease. However, owners were overall satisfied with their recovery and would be willing to accept indication of mTTA for dogs with ruptured CCL.

scholarly journals Tibial Plateau Leveling Following Tibial Tuberosity Advancement: A Case Series

2022 ◽  
Vol 9 (1) ◽  
pp. 16
Author(s):  
Daniele Serrani ◽  
Pierre Paul Picavet ◽  
Juan Marti ◽  
Bernard Bouvy ◽  
Marc Balligand ◽  
...  
Keyword(s):  
Tibial Plateau ◽  
Case Series ◽  
Major Complication ◽  
Tibial Tuberosity ◽  
Patellar Ligament ◽  
Short Term ◽  
Long Term Follow Up ◽  
Persistent Instability

Persistent stifle instability is a recognized complication following tibial tuberosity advancement techniques (TTAT). The aim of this study is to report the feasibility and outcome of tibial plateau leveling techniques (TPLT) to treat dogs with persistent lameness, suspected to be secondary to persistent stifle instability, following (TTAT). Medical records of dogs presented for persistent lameness after TTAT were reviewed. Preoperative data included orthopedic examination, lameness score and radiographs. Inclusion criteria included performance of a surgery to address persistent lameness and suspected instability. Short-term follow up data included orthopedic examination and radiographs of the stifle. Long-term follow up was based on postoperative Liverpool Osteoarthritis in Dogs (LOAD) questionnaire. Seven dogs were included in the study. Mean subjective preoperative lameness score was 3 ± 1.53. Mean preoperative patellar ligament angle relative to the tibial plateau (PLATP) was 94° and mean tibial plateau angle (TPA) was 28°. Six dogs had tibial plateau leveling osteotomy and one had modified cranial closing wedge ostectomy. Mean postoperative PLATP was 79° and mean TPA was 5°. Mean subjective lameness score at follow up was 0.57 ± 0.49. Minor complications were present in 2 dogs and major complication in 1 dog. Mean LOAD questionnaire score was 6.6/52. TPLT can be performed after TTAT and may improve clinical function and stability in these cases in which persistent instability is suspected.

scholarly journals Bilateral Sander IV calcaneus fractures: Primary fusion or fixation?

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0006
Author(s):  
Rajiv Shah
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Standard Of Care ◽  
Calcaneus Fracture ◽  
Subtalar Fusion ◽  
Fall From Height ◽  
Long Term Follow Up ◽  
Calcaneus Fractures

Category: Trauma Introduction/Purpose: Primary subtalar fusion for Sander IV calcaneus fractures was considered to be the standard of care till recent past. Presently debate is on whether to manage Sander IV calcaneus fracture cases with primary subtalar fusion or with open reduction and internal fixation. Bilateral Sander IV calcaneus fractures are seen in cases with fall from height. No study has ever been conducted till date to compare the results of primary fusion of a Sander IV calcaneus fracture on one side and open reduction and internal fixation on another side in cases with bilateral Sander IV calcaneus fractures. We present a study comparing the results of primary fusion versus open reduction and internal fixation for bilateral sander IV calcaneus fracture cases. Methods: Twelve cases with bilateral closed Sander IV calcaneus fractures where included in the present study. Cases were operated between four to six weeks by a single surgeon after the appearance of wrinkles. All right sided fractures underwent open reduction and internal fixation with proximal tibia grafting. While all left-sided fractures underwent subtalar fusion with the use of ipsilateral anterior iliac crest grafts. Cases were followed up for 24 months. Results: Though operative time was more in the fusion group wound problems were equal in both the groups. Four months of average time to union was the same in both the groups and so was time to return to work. At two years, the AOFAS score was slightly better in the fusion group but it was not statistically significant. Conclusion: Primary subtalar fusion is with almost similar results as those with open reduction and internal fixation in bilateral Sander IV at 24 months. Long term follow up with more number of cases is required to prove the benefit of one over other.

Tibial Spine Fractures: A Long-term Follow-up Study of Open Reduction and Internal Fixation

2009 ◽  
Vol 23 (3) ◽  
pp. 203-207 ◽  
Author(s):  
M V Rademakers ◽  
G M M J Kerkhoffs ◽  
J Kager ◽  
J C Goslings ◽  
R K Marti ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Spine Fractures ◽  
Tibial Spine ◽  
Follow Up Study ◽  
Long Term Follow Up
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