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Evers et al: Use of a bone‐to‐tendon plate to stabilize a comminuted calcaneus fracture in a dog
Veterinary Surgery 5, 2022

🔍 Key Findings

  • Bone-to-tendon plate fixation allowed successful stabilization of a highly comminuted calcaneus fracture in a dog with fragments too small for traditional fixation.
  • The plate was sutured to the common calcaneal tendon using a figure-of-8 pattern, bypassing the need for screw fixation into small proximal fragments.
  • Radiographic union was achieved by 17 weeks, though considered delayed, with the dog returning to normal function by 36 weeks post-op.
  • A second surgery was required to replace the tendon-anchored plate with a calcaneus-only plate due to skin ulceration and implant prominence.
  • Implant-associated infection was suspected; cultures confirmed Staphylococcus pseudintermedius, managed with doxycycline and clindamycin.
  • Use of human placental matrix (hPM) and both autogenous and allogenic bone grafts supported healing, though their specific contribution remains uncertain.
  • Postoperative complications included delayed union and skin ulceration, emphasizing challenges of implant design and soft tissue management.
  • This is the first report of using a bone-to-tendon plate for a calcaneus fracture in dogs and demonstrates its potential in cases where traditional methods are not viable.

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← Articles

Evers et al: Use of a bone‐to‐tendon plate to stabilize a comminuted calcaneus fracture in a dog
Veterinary Surgery 5, 2022

🔍 Key Findings

  • Bone-to-tendon plate fixation allowed successful stabilization of a highly comminuted calcaneus fracture in a dog with fragments too small for traditional fixation.
  • The plate was sutured to the common calcaneal tendon using a figure-of-8 pattern, bypassing the need for screw fixation into small proximal fragments.
  • Radiographic union was achieved by 17 weeks, though considered delayed, with the dog returning to normal function by 36 weeks post-op.
  • A second surgery was required to replace the tendon-anchored plate with a calcaneus-only plate due to skin ulceration and implant prominence.
  • Implant-associated infection was suspected; cultures confirmed Staphylococcus pseudintermedius, managed with doxycycline and clindamycin.
  • Use of human placental matrix (hPM) and both autogenous and allogenic bone grafts supported healing, though their specific contribution remains uncertain.
  • Postoperative complications included delayed union and skin ulceration, emphasizing challenges of implant design and soft tissue management.
  • This is the first report of using a bone-to-tendon plate for a calcaneus fracture in dogs and demonstrates its potential in cases where traditional methods are not viable.

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Multiple Choice Questions on this study

In Evers 2022 et al., on bone-to-tendon plate fixation, what was the purpose of using human placental matrix (hPM)?

A. To prevent infection
B. To encourage granulation tissue
C. To stimulate angiogenesis and support healing
D. To lubricate the tendon sheath
E. To replace bone grafts

Answer: To stimulate angiogenesis and support healing

Explanation: hPM was used for its pro-angiogenic and regenerative properties, despite uncertain efficacy in this case.
In Evers 2022 et al., on bone-to-tendon plate fixation, what fixation technique was used to secure the plate to the tendon?

A. Krackow suture pattern
B. Simple interrupted sutures
C. Figure-of-8 pattern with Prolene
D. Stapling with metallic clips
E. Locking bone anchors

Answer: Figure-of-8 pattern with Prolene

Explanation: A figure-of-8 suture pattern with 0-Prolene was used to anchor the plate to the tendon.
In Evers 2022 et al., on bone-to-tendon plate fixation, what was the primary reason for anchoring the plate to the tendon instead of the bone?

A. The calcaneal base was unstable
B. The calcaneal tuber was intact
C. The proximal bone fragments were too small for screw purchase
D. Soft tissue swelling precluded bone fixation
E. A tendinous attachment was avulsed

Answer: The proximal bone fragments were too small for screw purchase

Explanation: Small proximal calcaneal fragments limited conventional screw fixation, necessitating tendon anchoring.
In Evers 2022 et al., on bone-to-tendon plate fixation, which complication prompted the second surgery?

A. Nonunion at 12 weeks
B. Infection with fever
C. Screw pull-out of the plantar plate
D. Skin ulceration over the plate
E. Migration of the unsecured tuber fragment

Answer: Skin ulceration over the plate

Explanation: Skin pressure necrosis occurred at the proximal edge of the tendon plate, prompting plate revision.
In Evers 2022 et al., on bone-to-tendon plate fixation, what was the final functional outcome for the patient at 8.5 months?

A. Persistent lameness and reduced range of motion
B. Full function with mild thickening of tendon
C. Weight-bearing lameness and implant failure
D. Continued use of support bandaging
E. Arthrodesis was ultimately required

Answer: Full function with mild thickening of tendon

Explanation: The dog returned to normal function without lameness, though tendon thickening remained.

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