Two Cases of Tibial Proximal Methaphisis Fracture after TPLO
WSAVA 2002 Congress
*José Luis Vérez-Fraguela, Miguel Angel Vives Vallés
*Hospital Veterinario Ultramar
Ferrol, Coruña, ES
ultramar@ultramar.es

HISTORY

Two clinical cases of proximal tibial fracture after surgery of LCA are presented. Both cases involve small sized animals with weights ranging from 8 to 10 kilograms, treated by means of the technique introduced by Slocum for the leveling of the tibial plateau.

The first case was Gorki, an 8-year-old crossbreed with a diagnosed rupture of CrCL that, after a TPLO, suffered a fracture of the tibial crest, just below the insertion of the rotulian tendon. This fracture was satisfactory resolved by means of a tension band.

The second case was Tobi, a 12-year-old male dog with earlier surgery of Cr CL by means of De Angeles technique with a metallic suture of the lateral fabella to the tibial crest . This surgery had been carried out two years before with acceptable results, although not excellent due to the fact that the animal had lost an important range of movements in the knee. In any case, the dog now came with a lifting lameness which had started one month before. The limp had began a month earlier and had been suitably treated with anti- inflammatory drugs (carprofeno) without satisfactory results. We therefore decided to intervene surgically for the removal of the wire and to carry out TPLO to stabilize the joint, also carrying out a medial meniscectomy, 16 days after surgery the animal presented a sudden lifting lameness. The x-ray showed a proximal longitudinal fracture of the tibia. The dog was operated again to reposition the implant in a new position and thus resolve the fracture. The evolution after this new surgery was satisfactory.

DISCUSSION

The discussion is based in the possible causes of both fractures due to a fault in the technique or predisposition of size and weight of the animals for the application of this TPLO technique are discussed.

The first case seems to have already been described by Slocum himself as a postoperative or interoperative complication, through fracture by avulsion of the tibial crest after surgery. The second case does not appear documented in literature. In our opinion, the main cause was excessive moulding of the implant which increased the stress in the focal point and provoked the fracture. Is discussed too in this second case, the role of the first extracapsular technique with wire and without surgery of the meniscus and its influence in all the subsequent process are discussed. Finally is discussed to the fact that in both cases Slocum´s Technique was able to satisfactorily solve both complications without need to resort to other techniques or procedures is also discussed.

Speaker Information
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José Luis Vérez-Fraguela
Hospital Veterinario Ultramar
C/Nueva, 167, BJ
Ferrol, A Coruña, Spain 15404 ES

Miguel Angel Vives Vallés
Hospital Veterinario Ultramar


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