Case: Tibial fracture in a pup

This young pup fractured its tibia (shin bone). The fracture is not through the cartilaginous growth plates at the ends of the bone, but is through the diaphysis (the shaft) a short way below the growth plates. The proximal (top) part of the fracture has rotated a little way backwards but more significantly it has fallen sideways, towards the outside of the leg. Left to heal in this position, the stifle (knee) and the hock (ankle) joints would not be working in the same plane as they should do. This would likely result in significant disability in the future.

 

The problem in a dog of this age is not so much getting the fracture to heal – this young active bone really “wants” to mend. The problem is getting it to heal straight.

 

The fracture was stabilised with two pins that were driven down from the level of the stifle. The exposure of the bone was minimised to minimally disrupt blood supply, which is essential for healing. Just enough exposure was made to allow the pins and wire to be placed and to guide the pins across the fracture site. The pins entered the tibia on either side of the patella tendon. This tendon is vital for hind limb function. The wire passes behind the tendon and the ends of the pins were bent over and the ends stop the wire from “cheese-wiring” through the tendon.