Rachel Marian Procter, James Douglas Crowley, Lucas Henry Beierer
Repairing proximal tibial apophyseal-epiphyseal fractures with APTBW as a sole fixation method resulted in a high rate of union and restoration of normal mean TPA and mMPTA. Routine fixation of the epiphysis may not be necessary in this fracture type.
OBJECTIVE: The objective of this study is to report radiographic outcomes and complications following repair of proximal tibial apophyseal-epiphyseal fractures with an apophyseal pin and tension-band wire (APTBW).
STUDY DESIGN: Medical records and radiographs of dogs treated with APTBW alone were retrospectively reviewed. Tibial plateau angle (TPA) and mechanical medial proximal tibial angle (mMPTA) were compared in the fractured limbs at preoperative, postoperative, and follow-up time points and to the contralateral limb, using repeated-measures analysis of variance. Bonferroni-adjusted paired comparisons followed significant omnibus tests.
RESULTS: Thirty-six fractures in 35 dogs were included (median age: 4.4 months). Union was achieved in 34 of 36 (94.4%) fractures, at a median of 4.1 weeks. Mean TPA of fractured limbs was 12.8 degrees higher than contralateral limbs preoperatively (p < 0.001), but no statistically significant difference was detected at union (p = 0.735). Mean mMPTA did not differ significantly across measurement conditions. Three major and four minor complications occurred, including two construct failures before union. Construct failures resulted from Kirschner wire migration (n = 1) and apophyseal shearing (n = 1).
CONCLUSION: Repairing proximal tibial apophyseal-epiphyseal fractures with APTBW as a sole fixation method resulted in a high rate of union and restoration of normal mean TPA and mMPTA. Routine fixation of the epiphysis may not be necessary in this fracture type.