Subscribe to RSS
Download PDF
DOI: 10.3415/VCOT-16-11-0154
Proximal tibial metaphyseal fractures in immature dogs
Publication History
Received:
15 November 2016
Accepted:
20 February 2017
Publication Date:
23 December 2017 (online)
Summary
Objective: To describe proximal tibial metaphyseal fractures in immature dogs.
Materials and methods: Medical records of immature dogs with metaphyseal fractures of the proximal tibia were reviewed and data were collected on signalment and history of trauma. Craniocaudal and mediolateral radiographs were evaluated for the determination of the bones fractured, location of the fracture within the bone, fracture configuration, and the presence of fracture segment displacement and angulation.
Results: Eighteen dogs with 22 proximal tibial metaphyseal fractures fulfilled the inclusion criteria. All fractures had a curvilinear, complete fracture of the proximal tibial metaphysis. Displacement was identified in 16 fractures and angulation in 15 fractures. All affected breeds were terrier or small breed dogs less than six months of age. The majority of dogs weighed 5 kg or less at the time of injury. The most common type of trauma that occurred was a jump or fall from a short distance.
Clinical significance: Proximal tibial metaphyseal fractures are an uncommon injury that occur in skeletally immature dogs from minimal trauma. Proximal tibial metaphyseal fractures have a characteristic curvilinear fracture configuration that affects mainly small breed dogs with a predominance for terrier breeds.
Supplementary Material to this article is available online at https://doi.org/10.3415/VCOT-16-11-0154
-
References
- 1 Boone EG, Johnson AL, Hohn RB. Distal tibial fractures in dogs and cats. J Am Vet Med Assoc 1986; 188: 36-40.
- 2 Boone EG, Johnson AL, Montavon P. et al. Fractures of the tibial diaphysis in dogs and cats. J Am Vet Med Assoc 1986; 188: 41-45.
- 3 Johnson JA, Austin C, Breuer GJ. Incidence of canine appendicular musculoskeletal disorders in 16 veterinary teaching hospitals from 1980-1989. Vet Comp Orthop Traumatol 1994; 7: 56-69.
- 4 Unger M, Montavon PM, Heim UFA. Classification of fractures of long bones in the dog and cat: introduction and clinical application. Vet Comp Orthop Traumatol 1990; 3: 41-50.
- 5 Seaman JA, Simpson AM. Tibial fractures. Clin Tech Small Anim Pract 2005; 19: 151-167.
- 6 Pratt JN. Avulsion of the tibial tuberosity with separation of the proximal tibial physis in seven dogs. Vet Rec 2001; 149: 352-356.
- 7 Clements DN, Gemmill T, Corr SA. et al. Fracture of the proximal tibial epiphysis and tuberosity in 10 dogs. J Small Anim Pract 2003; 44: 355-358.
- 8 Hayashi K, Kapatkin AS. Fractures of the tibia and fibula. In Tobias K, Johnston S. editors Veterinary Surgery: Small Animal. 1st ed. St.Louis Missouri: Elsevier; 2012: 999-1005.
- 9 Schwartz G. Fractures of the proximal tibia. In Johnson AL, Houlton JEF, Vannini R. Editors AO Principles of Fracture Management in the Dog and Cat.. Davos, Switzerland: AO Publishing; 2005: 311
- 10 McKee M, Gemmill T, Pink J. et al. Unusual proximal metaphyseal-diaphyseal tibial fracture in skeletally immature dogs. Vet Rec 2010; 167: 390.
- 11 Denny HR, Butterworth SJ. The tibia and fibula. In: A Guide to Canine and Feline Orthopaedic Surgery. 4th ed. Oxford: Blackwell Science; 2000. Pg 554-574.
- 12 Saglam M, Kaya U. Treatment of proximal tibial fractures by cross pin fixation in dogs. Turk J Vet Anim Sci 2004; 28: 799-805.
- 13 Mubarak SJ, Kim JR, Edmonds EW. et al. Classification of proximal tibial fractures in children. J Child Orthop 2009; 3: 191-197.
- 14 Gower JA, Bound NJ, Moores AP. Tibial tuberosity avulsion fracture in dogs: a review of 59 dogs. J Small Anim Pract 2008; 49: 340-343.
- 15 Ehrenborg G, Olsson S-E. Avulsion of the tibial tuberosity in the dog. A comparative roentgenologic study with special reference to the Osgood-Schlatter lesion in man. Acta Chir Scand 1962; 123: 28-37.
- 16 Piermattei DL, Flo GL, DeCamp CE. Fractures of the tibia and fibula. In: Brinker, Piermattei and Flo’s Handbook of Small Animal Orthopedics and Fracture Repair. 4th ed. St.Louis, Missouri, USA: Saunders; 2006: 633
- 17 Clements DN, Clarke SP, Mosley JR. et al. Management of laterally displaced proximal tibial physeal fractures in 3 dogs. J Small Anim Pract 2009; 50: 662-666.
- 18 Cozen L. Fracture of proximal portion of tibia in children followed by valgus deformity. Surg Gynecol Obstet 1953; 97: 183-188.
- 19 Kakel R. Trampoline fracture of the proximal tibial metaphysis in children may not progress into valgus: A report of seven cases and a brief review. Orthop Traumatol Surg Res 2012; 98: 446-449.
- 20 Skak SV, Jensen TT, Poulsen TD. Fracture of the proximal metaphysis of the tibia in children. Br J Surg 1987; 18: 149-156.
- 21 Setter KJ, Palomino KE. Pediatric tibia fractures: current concepts. Curr Opin Pediatr 2006; 18: 30-35.
- 22 Boyer RS, Jaffe RB, Nixon GW. et al. Trampoline fracture of the proximal tibia in children. AJR Am J Roentgenol 1986; 146: 83-85.
- 23 Stranzinger E, Leidolt L, Eich G. et al. The anterior tilt angle of the proximal tibia epiphyseal plate: A significant radiological finding in young children with trampoline fractures. Eur J Radiol 2014; 83: 1433-1436.
- 24 Bruyeer E, Geusens E, Catry F. et al. ‘Trampoline Fracture’ of the proximal tibia in children: Report of 3 cases and review of literature. JBR-BTR 2012; 95: 10-12.
- 25 Wagle S, Phelps AS, MacKenzie J. “Weak Links” of the pediatric Skeleton: Common foci for disease and trauma. Part 2 -Areas of weakness beyond bone and cartilage transitions. Curr Radiol Rep 2016; 4: 7.
- 26 Tsai A, McDonald AG, Rosenberg AE. et al. High-resolution CT with histopathological correlates of the classic metaphyseal lesion of infant abuse. Pediatr Radiol 2014; 44: 124-140.
- 27 Kleinman PK. Problems in the diagnosis of metaphyseal fractures. Pediatr Radiol 2008; 38: 388-394.
- 28 Schmökel H, Weber U, Hartmeier G. Salter-II fracture of the proximal tibia with avulsion of the tuberositas tibiae in the dog. Schweizer Archiv fur Tierheilkunde 1995; 137: 124-128.
- 29 Tuten HR, Keeler KA, Gabos PG. et al. Posttraumatic tibia valga in children. A long-term follow-up note. J Bone Joint Surg 1999; 81: 799-810.
- 30 Haynes KH, Biskup J, Freeman A. et al. Effect of tibial plateau angle on cranial cruciate ligament strain: an ex vivo study in the dog. Vet Surg 2015; 44: 46-49.
- 31 von Pfeil DJF, DeCamp CE, Diegel KL. et al. Does Osgood -Schlatter Disease exist in the dog? Review of human literature and canine literature and proposed classification system for tibial tuberosity avulsions in the immature dog. Vet Comp Orthop Traumatol 2009; 22: 257-263.
- 32 Gholve PA, Sicher DM, Khakharia S. et al. Osgood Schlatter syndrome. Curr Opin Pediatr 2007; 19: 44-50.
- 33 Uhry Jr E. Osgood-Schlatter’s disease. Arch Surg 1944; 48: 406.
- 34 Ehrenborg G, Engfeldt B, Olsson S-E. On the etiology of the Osgood-Schlatter lesion. An experimental study in dogs. Acta Chir Scand 1961; 122: 445-457.
- 35 Sumner-Smith G. Observations on epiphyseal fusion of the canine appendicular skeleton. J Small Anim Pract. 1966; 7: 303-311.
- 36 Brammar TJ, Rooker GD. Remodeling of valgus deformity secondary to proximal metaphyseal fracture of the tibia. Injury 1998; 29: 558-560.
- 37 Müller I, Muschol M, Mann M. et al. Results of proximal metaphyseal fractures in children. Arch Orthop Trauma Surg 2002; 122: 331-333.