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Adams et al: Prospective evaluation of the surgical stabilization and outcome of canine tibial plateau fractures in three cases
Veterinary Surgery 6, 2024

🔍 Key Findings

  • Tibial plateau fractures (TPF) are rare in dogs, but can be surgically stabilized with good outcomes even in complex trauma cases.
  • Lateral TPFs (Unger type 41-B1) were approached via caudolateral arthrotomy, with elevation of the lateral meniscus for visualization and use of lag screws and K-wires for fixation.
  • Medial TPF (Unger type 41-B2) was addressed via medial parapatellar approach using K-wires and a figure-of-eight tension band.
  • One minor complication occurred: implant yield at 2 weeks in a case with a concurrent fibular fracture, resulting in a 0.8 mm step defect.
  • No major complications were recorded, and all dogs achieved clinical union with full function by 8–10 weeks.
  • Long-term owner-reported outcomes (LOAD scores) were excellent (5/52), indicating minimal osteoarthritis or chronic pain.
  • Concurrent fibular fractures may increase risk of implant failure and should influence implant selection (e.g., considering buttress plating).
  • Arthroscopic-assisted techniques may be applicable in select cases, but open reduction was preferred due to fragment displacement or concurrent injuries.

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← Articles

Adams et al: Prospective evaluation of the surgical stabilization and outcome of canine tibial plateau fractures in three cases
Veterinary Surgery 6, 2024

🔍 Key Findings

  • Tibial plateau fractures (TPF) are rare in dogs, but can be surgically stabilized with good outcomes even in complex trauma cases.
  • Lateral TPFs (Unger type 41-B1) were approached via caudolateral arthrotomy, with elevation of the lateral meniscus for visualization and use of lag screws and K-wires for fixation.
  • Medial TPF (Unger type 41-B2) was addressed via medial parapatellar approach using K-wires and a figure-of-eight tension band.
  • One minor complication occurred: implant yield at 2 weeks in a case with a concurrent fibular fracture, resulting in a 0.8 mm step defect.
  • No major complications were recorded, and all dogs achieved clinical union with full function by 8–10 weeks.
  • Long-term owner-reported outcomes (LOAD scores) were excellent (5/52), indicating minimal osteoarthritis or chronic pain.
  • Concurrent fibular fractures may increase risk of implant failure and should influence implant selection (e.g., considering buttress plating).
  • Arthroscopic-assisted techniques may be applicable in select cases, but open reduction was preferred due to fragment displacement or concurrent injuries.

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Multiple Choice Questions on this study

In Adams 2024 et al., on canine tibial plateau fractures, what surgical construct was used for the medial TPF in Case 3?

A. Two 2.0 mm lag screws with washers
B. Two 0.9 mm K-wires with tension band wire
C. Lateral buttress plate with locking screws
D. Two cortical screws with TPLO plate only
E. Two lag screws with an external fixator

Answer: Two 0.9 mm K-wires with tension band wire

Explanation: Medial TPF in Case 3 was repaired using two 0.9 mm K-wires and a figure-of-eight tension band wire.
In Adams 2024 et al., on canine tibial plateau fractures, what minor complication was observed postoperatively in Case 2?

A. Complete implant failure with luxation
B. Soft tissue infection around implants
C. Screw and K-wire yield with step defect
D. Plate migration into stifle joint
E. Meniscal incarceration after fixation

Answer: Screw and K-wire yield with step defect

Explanation: Case 2 experienced implant yield at 2 weeks, leading to a 0.8 mm step defect on CT.
In Adams 2024 et al., on canine tibial plateau fractures, what factor contributed to the implant yield in Case 2?

A. Over-torqued screws during insertion
B. Unrecognized infection post-op
C. Failure to use bone grafts
D. Concurrent fibular fracture reducing construct stability
E. Early weightbearing with aggressive rehab

Answer: Concurrent fibular fracture reducing construct stability

Explanation: The authors note that reduced stability due to the concurrent fibular fracture likely contributed to implant yield.
In Adams 2024 et al., on canine tibial plateau fractures, which approach was used for lateral TPFs?

A. Medial parapatellar arthrotomy
B. Lateral retinacular arthrotomy
C. Cranial approach through extensor tendon
D. Lateral approach with lateral meniscus elevation
E. Caudomedial retroarticular exposure

Answer: Lateral approach with lateral meniscus elevation

Explanation: The lateral approach included caudolateral arthrotomy with elevation of the lateral meniscus for visualization.
In Adams 2024 et al., on canine tibial plateau fractures, what was the long-term functional outcome for the two cases that completed LOAD questionnaires?

A. Severe dysfunction, LOAD >25
B. Moderate dysfunction, LOAD 12–15
C. Mild dysfunction, LOAD 6–10
D. Excellent function, LOAD 5
E. Normal scores not reported

Answer: Excellent function, LOAD 5

Explanation: Both cases that completed LOAD surveys had excellent scores of 5/52, indicating minimal long-term dysfunction.

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