Case: Tibial crest avulsion fracture in a puppy

These are common fractures, typically occurring in 5 month old Staffordshire Bull Terriers. These dogs are very active and well muscled and the quadriceps muscle on the front of the thigh pulls on the tibial crest via a tendon and pulls it away from the rest of the tibia. The growth plate separates from the tibia through the weak fault line of the cartilaginous growth plate. Interestingly, similar injuries occur in athletic teenagers as sporting injuries.

These are straightforwards fractures to fix with one or two pins and a tension wire to resist the pull of the quadriceps muscle while the injury heals. Like all fracture fixations though, there are pitfalls for the unwary. The fixation involves pinning a small soft fragment of bone in a boisterous active youngster, and fragmentation of the tibial crest fragment can occur during or following surgery without proper technique or without proper exercise restriction in the early weeks after surgery.

The wire is often removed a few weeks after surgery to try to prevent premature closure of the tibial crest growth plate.

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