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Gollnick et al: Tibial fracture associated with use of Arthrex self‐tapping screws during tibial plateau leveling osteotomy in dogs and development of transcortical tibial fracture
Veterinary Surgery 6, 2024

🔍 Key Findings

  • 42% of dogs (33/78) treated with Arthrex 3.5 mm STS during TPLO developed radiographic TCTF
  • TCTFs occurred exclusively distal to the osteotomy
  • 14% of screws (36/250) distal to the osteotomy were associated with TCTFs
  • 6% of dogs with TCTFs developed major complications (e.g., complete tibial fracture requiring surgical revision)
  • Angulation of cortical STS screws, especially in the distal plate holes, was a key contributor to complications
  • Locking screws were also involved, but cortical screws angled improperly were overrepresented in serious outcomes
  • Revision recommendations included preemptive fixation for large TCTFs or angulated screw placements
  • Use of non-self-tapping screws (NSTS) previously showed a <1% TCTF rate, supporting higher risk with STS

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← Articles

Gollnick et al: Tibial fracture associated with use of Arthrex self‐tapping screws during tibial plateau leveling osteotomy in dogs and development of transcortical tibial fracture
Veterinary Surgery 6, 2024

🔍 Key Findings

  • 42% of dogs (33/78) treated with Arthrex 3.5 mm STS during TPLO developed radiographic TCTF
  • TCTFs occurred exclusively distal to the osteotomy
  • 14% of screws (36/250) distal to the osteotomy were associated with TCTFs
  • 6% of dogs with TCTFs developed major complications (e.g., complete tibial fracture requiring surgical revision)
  • Angulation of cortical STS screws, especially in the distal plate holes, was a key contributor to complications
  • Locking screws were also involved, but cortical screws angled improperly were overrepresented in serious outcomes
  • Revision recommendations included preemptive fixation for large TCTFs or angulated screw placements
  • Use of non-self-tapping screws (NSTS) previously showed a <1% TCTF rate, supporting higher risk with STS

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Multiple Choice Questions on this study

In Gollnick 2024 et al., on TCTF risk with Arthrex STS in TPLO, what was the TCTF rate for STS screws placed distal to the osteotomy?

A. 6%
B. 10%
C. 14%
D. 21%
E. 30%

Answer: 14%

Explanation: 14% of STS screws placed distal to the osteotomy exhibited radiographic signs of TCTF.
In Gollnick 2024 et al., on TCTF risk with Arthrex STS in TPLO, what percentage of dogs developed transcortical tibial fractures?

A. 12%
B. 24%
C. 42%
D. 58%
E. 67%

Answer: 42%

Explanation: 42% (33/78) of dogs had radiographic evidence of TCTF following TPLO with Arthrex STS.
In Gollnick 2024 et al., on TCTF risk with Arthrex STS in TPLO, what strategy is recommended to reduce risk of TCTF with angled STS screws?

A. Use shorter plates
B. Pre-place locking screws
C. Drill wider pilot hole
D. Use of a tap before screw insertion
E. Use only monocortical screws

Answer: Use of a tap before screw insertion

Explanation: Using a tap before placing STS (especially when angulation is required) may reduce TCTF development.
In Gollnick 2024 et al., on TCTF risk with Arthrex STS in TPLO, which screw location was most commonly associated with TCTFs?

A. Proximal locking screws
B. Middle screws distal to osteotomy
C. Proximal metaphyseal screws
D. Most proximal screw in plate
E. All screws equally

Answer: Middle screws distal to osteotomy

Explanation: 50% of TCTFs occurred at middle screws in the distal part of the TPLO plate.
In Gollnick 2024 et al., on TCTF risk with Arthrex STS in TPLO, which factor most contributed to serious tibial fracture following TCTF?

A. Screw loosening
B. Locking screw length
C. Plate contour mismatch
D. Angled cortical screw in distal hole
E. Inadequate anesthesia

Answer: Angled cortical screw in distal hole

Explanation: Both major complications were associated with angulated cortical screws in the distal plate holes.

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