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Vet Comp Orthop Traumatol 2021; 34(02): 144-152
DOI: 10.1055/s-0040-1719091
Clinical Communication

Tibial Apophyseal Percutaneous Pinning in Skeletally Immature Dogs: 25 Cases (2016–2019)

Dirsko J.F. von Pfeil 
1   Small Animal Surgery Locum, PLLC, Dallas, Texas, United States
,
Sara Megliolia
2   Friendship Surgical Specialists of the Friendship Hospital for Animals, Washington DC, United States
,
Sarah Malek 
3   Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, Indiana, United States
,
Mark Rochat
3   Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, Indiana, United States
,
Mathieu Glassman
2   Friendship Surgical Specialists of the Friendship Hospital for Animals, Washington DC, United States
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Abstract

Objective The aim of this study was to report the clinical experience with fluoroscopically guided tibial apophyseal percutaneous pinning (TAPP) for tibial tuberosity avulsion fractures (TTAF).

Study Design This is a retrospective case series.

Materials and Methods Medical records of skeletally immature dogs (n = 25) were reviewed. The association of pin design [smooth (SP); negatively threaded (NTP)], pin insertion angles, TTAF-type, age and breed with various outcome variables was statistically evaluated. Long-term follow-up was assessed via direct examination, radiographs, questionnaires and videos.

Results Mean age, weight and surgery times were 6.2 months, 9.6 kg and 21 minutes respectively. No major complications occurred among the 19 SP and 6 NTP; no pin broke. Seromas and patellar desmitis rates were higher with SP (11/19; 16/19) versus NTP (0/6; 2/6) (p = 0.02; 0.03). The median horizontal pin cross angles for cases without and with desmitis were 40 and 26 degrees respectively (p = 0.047). Explantation was needed in 5/19 SP and 0/6 NTP cases. The mean tibial plateau angle (TPA) changed significantly between initial (25.6 degrees) and follow-up (18.8 degrees) radiographs (p = 0.0002). Long-term outcome, obtained at a mean of 19.9 months, was excellent in all cases.

Conclusion Tibial apophyseal percutaneous pinning can be considered to treat TTAF. Divergent pin placement and using NTP might reduce complications. Tibial plateau angle should be monitored until skeletal maturity has been reached. Long-term outcome post TAPP can be expected to be excellent.

Keywords

tibial tuberosity avulsion fracture - minimally invasive osteosynthesis - percutaneous pinning - dog - fluoroscopy

Authors' Contributions

D.v.P. contributed to conception of study, study design, acquisition of data, data analysis and interpretation and drafted the manuscript. S. Megliolia contributed to acquisition of data. S. Malek, M.R. and M.G. contributed to acquisition of data, data analysis and interpretation. All authors revised and approved the submitted manuscript.


Supplementary Material



Publication History

Received: 01 April 2020

Accepted: 21 September 2020

Article published online:
19 November 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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