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.
Keywords
Tibial tuberosity avulsion fracture - dog - stifle - pelvic-limb-lameness