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Tibia and fibula: fracture

icanis

Introduction

  • Cause: fractures of the canine tibia and fibula occur predominantly as a result of: 
    • Physeal fractures usually occur as a result of a minor trauma or jump from a low height. 
    • Other fractures occur due to major trauma, usually a road traffic accident or fall from a significant height.  
  • Signs: acute onset severe to non-weight bearing hindlimb lameness is the most common presentation.  
  • Fractures can be divided into regions:   
    • Tibia:   
      • Fractures of the proximal physis: tibial tuberosity and/or tibial plateau.   
      • Curvilinear fractures of the proximal tibial metaphysis.  
      • Diaphyseal fractures.  
      • Fracture of the distal physis. 
      • Distal epiphyseal articular fractures and fissures.  
    • Fibula:       
      • Fractures of the proximal fibula.      
      • Fractures of the diaphysis.   
      • Fractures of the distal fibula.  
  • Treatment: surgical treatment is recommended in the majority of cases. Conservative management can be considered for minimally displaced tibial fractures when the fibula is intact in puppies.  
  • Prognosis:  
    • Tibial tuberosity physeal avulsion fractures: good to excellent.  
    • Tibial plateau physeal fractures: good to excellent, but risk of growth deformity.  
    • Tibial diaphyseal fractures: excellent.   
    • Distal tibial epiphyseal articular fractures: good if articular surface can be preserved / perfectly reconstructed; otherwise guarded prognosis. 

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed Papers

  • Recent references from PubMed and VetMedResource
  • Beale B, McCally R (2020) Minimally Invasive Fracture Repair of the Tibia and Fibula. Vet Clin North Am Small Anim Pract 50(1),183-206 PubMed.  
  • Deahl L, Ben-Amotz R, Caceres A V, Agnello K A (2017) Proximal tibial metaphyseal fractures in immature dogs. Vet Comp Orthop Traumatol 30(4) 237-242 PubMed
  • von Pfeil D J F, Glassman M, Ropski M (2017) Percutaneous tibial physeal fracture repair in small animals: technique and 17 cases. Vet Comp Orthop Traumatol 30(4), 279-287 PubMed.   
  • Kulendra E, Arthurs G I (2014) Management & treatment of tarsal injuries. In Practice 36(3) 119-132 https://doi.org/10.1136/inp.g1434.
  • von Pfeil D J, Decamp C E, Ritter M, Probst C W, Dejardin L M, Priddy N 2nd, Hayashi K, Johnston S A (2012) Minimally displaced tibial tuberosity avulsion fracture in nine skeletally immature large breed dogs. Vet Comp Orthop Traumatol 25(6), 524-531 PubMed.  
  • Pratt J N J (2001) Avulsion of the tibial tuberosity with separation of the proximal tibial physis in seven dogs. Vet Rec 149, 352-356 PubMed
  • Gower J A, Bound N J, Moores A P (2008) Tibial tuberosity avulsion fracture in dogs: a review of 59 dogs. J Small Anim Pract 49(7), 340-343 PubMed.   

Other sources of information

  • Butterworth  (2016) The tibia and fibula. In: BSAVA Manual of Canine and Feline Fracture Repair and Management. Chapter 24. Eds Gemmill T & Clements D, BSAVA publishing. ISBN: 978-1-905-31968-8. 
  • DeCamp C E (2016) Fractures of the tibia and fibula. In: Brinker, Piermattei, and Flo’s Handbook of Small Animal Othopedics and Fracture Repair, 5th edn, Chapter 19. Eds DeCamp C E, Johnston S A, Dejardin L M, Schaefer S L, Elsevier Inc. ISBN: 978-1-4377-2364-9. 

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