Prospective evaluation of the surgical stabilization and outcome of canine tibial plateau fractures in three cases

Tessa A Adams, Danielle M Marturello, Loïc M Déjardin
Vet Surg. 2024 Mar 22. doi: 10.1111/vsu.14091.

Objective: To report the surgical approaches and stabilization of lateral and medial tibial plateau fractures (TPF), as well as the long-term outcome following repair.

Study design: Prospective series of three client-owned dogs.

Animals: Three dogs.

Methods: For the two lateral TPF cases (Unger type 41-B1), the surgical approach included separation of the lateral collateral ligament and long digital extensor tendon. The lateral meniscus was elevated to allow visualization of the tibial surface and assess fracture reduction. The first case was repaired using two 2.0 mm lag screws (with washers). The second case sustained a lateral TPF, fibular fracture and concurrent tubercle of Gerdy fracture. Both tibial fractures were stabilized using two 2.0 mm lag screws with washers and two 0.9 mm Kirschner wires (K-wires). A third case, diagnosed with an Unger type 41-B2 medial TPF, was treated using 0.9 mm K-wires and 22-gauge tension band.

Results: There were no major complications noted. One minor complication occurred (screw yield two weeks postoperatively). By 8 weeks, all patients reached clinical union with good limb function. Owners were contacted 9-36 months postoperatively. LOAD scores and examinations were performed for two of three patients; the third patient was not contactable after relocating out of state. Both cases with completed questionnaires had a LOAD score of 5/52.

Conclusion: Tibial plateau fractures are rare in canine patients. While challenging, they can be successfully managed using a combination of lag screws, K-wires, and tension band.

Clinical significance: Surgical stabilization of TPF is feasible and may reduce the risk of meniscal injury.