Evaluation of the Use of External Skeletal Fixation in Minimally Invasive Fashion for the Treatment of Non-articular Tibial Fractures

Introduction: Many studies have described the use of external skeletal fixation (ESF) for the treatment of tibial fractures, however, there are no large studies evaluating the use of ESF placed using minimally invasive techniques and evaluating post-operative tibial alignment.^1,2 The objective of this study was to evaluate the use of ESF using minimally invasive techniques and report post-operative alignment angles. We hypothesized that the use of ESF would allow for restoration of alignment and would allow bone healing with few complications using minimally invasive techniques.

Materials and Methods: A retrospective study was performed including 55 client owned dogs with non-articular tibial fractures repaired using ESF at a single academic institution between July 2010 and 2020. Outcomes were assessed by radiographic review and physical examination at final follow-up.

Results: All patients reached clinical union of the fracture. The mean ± SD of external fixator removal was 71 ± 48 days (range 22–287 days). A total of 22 (40%) complications occurred. Of these 82% (18/22) were considered minor and 18% (4/22) were considered major. Open fractures had significantly more major complications than closed fractures (p = 0.019). Use of intraoperative fluoroscopy was made in 72% (40/55) of the patients. Alignment (mMPTA, mMDTA, TPA) was not significantly affected by intraoperative fluoroscopy (p = 0.687, p = 0.418, p = 0.344).

Discussion/Conclusion: External skeletal fixation placed using minimally invasive techniques with or without intra-operative fluoroscopy is an effective treatment for non-articular tibia fractures.

Acknowledgement: There was no proprietary interest or funding provided for this project.

Publication History

Article published online:
26 October 2022