CC BY 4.0 · VCOT Open 2023; 06(01): e67-e74
DOI: 10.1055/s-0043-57243
Case Report

Corrective Osteotomy in a Dog to Address Increased Distal Femoral Procurvatum Ascribed to a Distal Femoral Salter-Harris Type V Injury

1   Department of Animal Medicine, Productions, and Health, University of Padova, Legnaro, Padova, Italy
2   Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, United States
Massimo Bucci
1   Department of Animal Medicine, Productions, and Health, University of Padova, Legnaro, Padova, Italy
Maurizio Isola
1   Department of Animal Medicine, Productions, and Health, University of Padova, Legnaro, Padova, Italy
› Author Affiliations


Increased distal femoral procurvatum has been reported sporadically in dogs following malunion of Salter-Harris type I, II, and III fractures of distal femur. The resultant increased procurvatum can be poorly tolerated because of subsequent loss of stifle extension. This case report represents a dog with the increased procurvatum of the distal femur ascribed to a previous Salter-Harris type V injury. Surgical planning and successful outcome following the corrective procedures have been documented. A 6.5-month-old fox-terrier presented with a persistent weight bearing left pelvic limb lameness, 2 months after being hit by a car. The predominant orthopaedic finding was a 20-degree decrease in left stifle extension. Radiographic and computerized tomography evaluation revealed premature eccentric closure of the left distal femoral physis ascribed to a previous Salter-Harris type V injury. The left femoral procurvatum was 30 degrees. The left tibial plateau angle was increased by 11.5 degrees compared with the right. The femoral deformity was characterized, and a corrective procedure was planned using Paley's centre of rotation of angulation methodology. A cranial closing wedge ostectomy of the left distal femur was performed and stabilized using a locking plate. Proximal tibial epiphysiodesis was also performed to reduce the tibial plateau slope. Union of the osteotomy site and reduction in tibial plateau angle by 5.4 degrees were documented 50 days after surgery with a good functional outcome.

Authors' Contributions

Parastoo Memarian, DVM, performed the measurements, assisted in surgery, wrote the manuscript, revised and approved the final manuscript; Daniel D. Lewis, DVM, Diplomate American College of Veterinary Surgeons, American College Veterinary Surgeons Founding Fellow, Minimally Invasive Surgery (Small Animal Orthopedics), assisted in records' interpretation, revised the manuscript, read and approved the final manuscript; Massimo Bucci, DVM, PhD, performed the anaesthesia, collaborated in writing the manuscript, read and approved the final manuscript; Maurizio Isola, DVM, PhD, performed the planning and the surgery, revised the manuscript, read and approved the final manuscript.

Publication History

Received: 08 November 2022

Accepted: 26 February 2023

Article published online:
02 May 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

  • References

  • 1 Johnston SA, Tobias KM. Veterinary Surgery Small Animal. 2nd ed. Elsevier, St. Louis, MO; 2018: 2887-2910
  • 2 Berg RJ, Egger EL, Konde LJ, McCurnin DVM. Evaluation of prognostic factors for growth following distal femoral physeal injuries in 17 dogs. Vet Surg 1984; 13 (03) 172-180
  • 3 Kim SE, Lewis DD. Corrective osteotomy for procurvatum deformity caused by distal femoral physeal fracture malunion stabilised with String-of-Pearls locking plates: results in two dogs and a review of the literature. Aust Vet J 2014; 92 (03) 75-80
  • 4 Smalle TM, Coetzee GL, Naude SH. Corrective wedge ostectomy for an atypical femoral procurvatum deformity stabilised with a supracondylar bone plate. J S Afr Vet Assoc 2018; 89 (00) e1-e6
  • 5 Jones SC, Tryon EK, Kieves NR, Dyce J. Simple ostectomy to address quadriceps impingement caused by distal femoral malunion in four dogs. J Small Anim Pract 2021; 62 (05) 397-402
  • 6 Lazarus MA, Lewis DD, Johnson MD, Porter EG. Use of a circular fixator construct to facilitate closed reduction and percutaneous stabilization of a distal femoral physeal fracture in a dog. Open Vet J 2021; 11 (01) 89-95
  • 7 Peterson JL, Torres BT, Hutcheson KD, Fox DB. Radiographic determination of normal canine femoral alignment in the sagittal plane: a cadaveric pilot study. Vet Surg 2020; 49 (06) 1230-1238
  • 8 Johnson JM, Johnson AL, Eurell JA. Histological appearance of naturally occurring canine physeal fractures. Vet Surg 1994; 23 (02) 81-86
  • 9 Culvenor JA, Hulse DA, Patton CS. Closure after injury of the distal femoral growth plate in the dog. J Small Anim Pract 1978; 19 (10) 549-560
  • 10 Blaeser LL, Gallagher JG, Boudrieau RJ. Treatment of biologically inactive nonunions by a limited en bloc ostectomy and compression plate fixation: a review of 17 cases. Vet Surg 2003; 32 (01) 91-100
  • 11 DeTora MD, Boudrieau RJ. Complex angular and torsional deformities (distal femoral malunions). Preoperative planning using stereolithography and surgical correction with locking plate fixation in four dogs. Vet Comp Orthop Traumatol 2016; 29 (05) 416-425
  • 12 Petazzoni M, Palmer RH. Femoral angular correction and lengthening in a large-breed puppy using a dynamic unilateral external fixator. Vet Surg 2012; 41 (04) 507-514
  • 13 Aghapour M, Bockstahler B, Vidoni B. Evaluation of the femoral and tibial alignments in dogs: a systematic review. Animals (Basel) 2021; 11 (06) 1-24
  • 14 Paley D. Normal lower limb alignment and joint orientation. In: Principles of Deformity Correction. Springer, Berlin, Heidelberg; 2002: 1-18
  • 15 Kim SE, Jones SC, Lewis DD. et al. In-vivo three-dimensional knee kinematics during daily activities in dogs. J Orthop Res 2015; 33 (11) 1603-1610
  • 16 Jandi AS, Schulman AJ. Incidence of motion loss of the stifle joint in dogs with naturally occurring cranial cruciate ligament rupture surgically treated with tibial plateau leveling osteotomy: longitudinal clinical study of 412 cases. Vet Surg 2007; 36 (02) 114-121
  • 17 Petazzoni M, Jaeger GH. Atlas of Clinical Goniometry and Radiographic Measurements of the Canine Pelvic Limb. 2nd ed. Milan: : Merial; 2008: 1-97
  • 18 Vezzoni A, Bohorquez Vanelli A, Modenato M, Dziezyc J, Devine Slocum T. Proximal tibial epiphysiodesis to reduce tibial plateau slope in young dogs with cranial cruciate ligament deficient stifle. Vet Comp Orthop Traumatol 2008; 21 (04) 343-348
  • 19 Nagamine R, Kawasaki M, Kim K-I, Sakai A, Suguro T. The posterior tibial slope is mainly created by the posterior rotation of the tibial condyles. J Orthop Surg (Hong Kong) 2020; 28 (03) 2309499020975580
  • 20 D'Andrea CR, Alfraihat A, Singh A. et al. Part 1. Review and meta-analysis of studies on modulation of longitudinal bone growth and growth plate activity: a macro-scale perspective. J Orthop Res 2021; 39 (05) 907-918
  • 21 Kara ME, Sevil-Kilimci F, Dilek ÖG, Onar V. Proximal and distal alignment of normal canine femurs: a morphometric analysis. Ann Anat 2018; 217: 125-128
  • 22 Yasukawa S, Edamura K, Tanegashima K. et al. Evaluation of bone deformities of the femur, tibia, and patella in Toy Poodles with medial patellar luxation using computed tomography. Vet Comp Orthop Traumatol 2016; 29 (01) 29-38
  • 23 Pavarotti GS, Boudrieau RJ. Treatment of a paediatric distal femoral malunion deformity. Vet Comp Orthop Traumatol 2018; 31 (03) 222-228
  • 24 Memarian P, Pishavar E, Zanotti F. et al. Active materials for 3D printing in small animals: current modalities and future directions for orthopedic applications. Int J Mol Sci 2022; 23 (03) 1045