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DOI: 10.3415/VCOT-11-12-0170
Minimally displaced tibial tuberosity avulsion fracture in nine skeletally immature large breed dogs
Publication History
Received
05 December 2011
Accepted
27 June 2012
Publication Date:
19 December 2017 (online)
Summary
Objective: The objective of this study was to describe the clinical and radiographic features, as well as the treatment and outcome of minimally displaced tibial-tuberosity-avulsion-fractures (MDTTAF).
Materials and methods: Signalment, history, diagnostics, therapy, and outcome were recorded. Follow-up was documented as re-examination, radiographic assessment or telephone conversation.
Results: Nine large breed dogs that were presented with lameness originating from the proximal tibia were included. All showed signs of pain when pressure was applied to the tibial tuberosity. There was no stifle instability or intra-articular disease. The main feature on mediolateral radiographs was a widened tibial-tuberosity-physis with reactive new bone and loss of edge definition of the epiphyseal and metaphyseal margins. Non-surgical treatment was chosen in eight dogs, and surgery in one dog. Radiographic follow-up showed progressive closure of the tibial-tuberosity-physis and healing. Clinical signs resolved at a median of 28 days (range: 14–120).
Discussion: Minimally displaced tibial-tuberosity-avulsion-fractures should be a differential diagnosis in skeletally immature large breed dogs older than nine months of age with signs of subtle pelvic-limb lameness, and signs of proximal tibial pain, but no evidence of stifle joint disease. Thorough clinical examination and critical review of bilateral radiographs are important to diagnose MDTTAF. The outcome in these cases suggests that the prognosis for MDTTAF is excellent. Age and size of the affected dogs in this study differ from an earlier publication that illustrated more severely displaced tibial tuberosity avulsion fractures, occurring mainly in terriers around five months of age.
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References
- 1 Ehrenborg G, Olsson S-E. Avulsion of the tibial tuberosity in the dog. A comparative roentgenologic study with special reference to the Osgood-Schlatter lesion in man. Acta Chir Scand 1962; 123: 28-37.
- 2 Ehrenborg G, Engfeldt B, Olsson S-E. On the etiology of the Osgood-Schlatter lesion. An experimental study in dogs. Acta Chir Scand. 1961 122. 445.
- 3 Skelly CM, McAllister H, Donnelly WJ. Avulsion of the tibial tuberosity in a litter of greyhound puppies. J Small Anim Pract 1997; 38: 445-449.
- 4 Gower JA, Bound NJ, Moores AP. Tibial tuberosity avulsion fracture in dogs: a review of 59 dogs. J Small Anim Pract 2008; 49: 340-343.
- 5 Goldsmid S, Johnson KA. Complications of canine tibial tuberosity avulsion fractures. Vet Comp Orthop Traumatol 1991; 4: 54-58.
- 6 Dingwall JS, Sumner-Smith G. A technique for repair of avulsion of the tibial tubercle in dogs. J Small Anim Pract 1971; 12: 665-671.
- 7 Pratt JN. Avulsion of the tibial tuberosity with separation of the proximal tibial physis in seven dogs. Vet Rec 2001; 149: 352-356.
- 8 Schmökel H, Weber U, Hartmeier G. Salter-II fracture of the proximal tibia with avulsion of the tuberositas tibiae in the dog. Schweizer Archiv für Tierheilkunde 1995; 137: 124-128.
- 9 Withrow S, DeAngelis M, Arnoczky S. et al. Treatment of fractures of the tibial tuberosity in the dog. J Am Vet Med Assoc 1976; 168: 122-124.
- 10 Power JW. Avulsion of the tibial tuberosity in the greyhound. Aust Vet J 1976; 52: 491-495.
- 11 Pettit GD, Slatter DH. Tension-band wires for fixation of an avulsed canine tibial tuberosity. J Am Anim Hosp Assoc 1973; 163: 242-244.
- 12 Sanders N. Lameness and allied conditions in the greyhound. Aust Vet J 1962; 38: 239-243.
- 13 Gannon JR. Stress fractures in the greyhound. Aust Vet J 1972; 4: 244-250.
- 14 Von Pfeil DJF, DeCamp CE, Diegel KL. et al. Does Osgood-Schlatter Disease exist in the dog? Review of human and canine literature and proposedclassification system for tibial tuberosity avulsions in the immature dog. Vet Comp Orthop Traumatol 2009; 22: 257-263.
- 15 Weinstein MJ, Smith GK. Partial avulsion of the tibial tuberosity (Osgood-Schlatter lesion) in a litter of greyhound pups and their dam. Proceedings of the 20th Annual Conference of the Veterinary Orthopedic Society. 1993. February 27 – March 6 Lake Louise, Alberta, Canada: pg. 22.
- 16 Montgomery R. Miscallenous Orthopaedic Diseases. In: Slatter D. editor. Textbook of Small Animal Surgery. Philadelphia: W.B. Saunders; 2002. pg. 2256-2258.
- 17 Gholve PA, Sicher DM, Khakharia S. et al. Osgood Schlatter syndrome. Curr Opin Pediatr 2007; 19: 44-50.
- 18 Bloom OJ, Mackler L, Barbee J. Clinical inquiries. What is the best treatment for Osgood-Schlatter disease? J Fam Pract 2004; 53: 153-156.
- 19 Hamilton SW, Gibson PH. Simultaneous bilateral avulsion fractures of the tibial tuberosity in adolescence: A case report and review of over 50 years of literature. Knee 2006; 13: 404-407.
- 20 Athanasou NA. Osteonecrosis. In: Athanasou NA. editor. Pathological Basis of Orthopaedic and Rheumatic Disease. London: Arnold; 2001. pg. 33.
- 21 Clements DN, Gemmill T, Corr SA. et al. Fracture of the proximal tibial epiphysis and tuberosity in 10 dogs. J Small Anim Pract 2003; 44: 355-358.
- 22 Hauler AD, Ferguson RG. Avulsed tibial crest in the Greyhound and Whippet. In: Hungerford T. editor. Newsletter“Control and Therapy”. of the Post Graduate Foundation in Veterinary Scinece (now known as the Centre for Veterinary Education). Sydney: The University of Sydney; 1978. Issue 698, no page number available
- 23 Sumner-Smith G. Observations on epiphyseal fusion of the canine appendicular skeleton. J Sm Anim Pract 1966; 7: 303-311.
- 24 Smith RN. Epiphyseal fusion in the greyhound. Vet Rec 1960; 72: 765-769.