Summary
The 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.
Keywords
Tibial tuberosity advancement - fracture - implant failure - cranial plate - dogs