Tibial fractures account for 5-14% of feline fractures. Repair with external skeletal fixation (ESF) is common; complication rates have been reported to be 42%. The average time to clinical union in one study was 73 days; delayed unions were common 40% taking > 85 days to clinical union. Short distal fragments limit bone stock available for screw placement increasing the possibility of complication following use of single plates or plate rod combinations.

Clinical records and radiographs were reviewed retrospectively of 11 cats and one dog that underwent fixation of comminuted distal tibial fractures between January 2006 and August 2007. A standard craniomedial approach to the tibia was made. The talocrural joint was identified and a 1.5mm hole was drilled from medial to lateral proximal to the medial styloid process. The limb was aligned and bone fragments approximated where appropriate to observe the principles of biological osteosynthesis. A 2.0mm plate was applied to the medial aspect of the tibia with distal and proximal screws placed initially. A cranial plate was applied with the most distal screw inserted immediately proximal to the most distal screw of the medial plate. Screw placement is then staggered between the medial and cranial plate optimising screw purchase in the distal segment.

Age range was 11-105 months (mean 44). Weight range was 2.6-8.4kg (mean 5.05 kg). Breeds included domestic short hair (11) and one Yorkshire terrier. Implants included veterinary cuttable (VCP) (n=15), dynamic compression (DCP) (n=7) and reconstruction (n=2) plates. The mean cranial plate length was 16 holes (range 12-23 holes) and medial plate length 15 holes (range10-20 holes). Radiographic union was documented at 45-73 days (mean 52 days). Subjectively, lameness was not observed after documented radiographic union. Complications included wound breakdown/infection (n=4), implant breakage (n=1) and patellar luxation (n=2).

Distal tibial fracture in feline and toy breed canine patients can be a challenge subsequent to limited bone stock; complications arise subsequent to implant failure and vascular compromise. Fracture stability may be compromised if too small implants are used and larger implants are prone to failure where cortical purchase is reduced. Perpendicularly applied 2.0 mm plates require minimal contouring, increase cortical purchase in limited distal bone stock and provide adequate stability for optimal bone healing, rapid return to function with minimal complications.