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Zweig et al: Treatment outcome and radiographic appearance of healed tibial tuberosity avulsion fractures in skeletally mature dogs: 21 cases (2016–2023)
Veterinary and Comparative Orthopaedics and Traumatology 6, 2025

🔍 Key Findings

  • Surgically managed TTAF resulted in excellent clinical outcomes at skeletal maturity, with all dogs having normal limb function and no stifle instability.
  • Surgical treatment significantly altered proximal tibial morphology, including decreased tibial plateau angle (TPA) and increased patellar position (PP) compared with the contralateral limb.
  • Axial tibial tuberosity position (TTP-A) increased and transverse position (TTP-T) decreased in surgically treated stifles, indicating distal and caudal tuberosity migration.
  • Non-surgically managed TTAF did not significantly alter tibial morphology or PP, but outcomes were more variable.
  • Medial patellar luxation developed in 2/6 non-surgically treated dogs, whereas none occurred in surgically managed cases.
  • Pins-only and pin–tension band constructs produced similar radiographic changes and outcomes.
  • Despite morphologic changes, no dogs developed cruciate ligament instability at follow-up.
  • Non-surgical management yielded good to excellent owner-reported outcomes, but carried a potential increased risk of patellar luxation.

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← Articles

Zweig et al: Treatment outcome and radiographic appearance of healed tibial tuberosity avulsion fractures in skeletally mature dogs: 21 cases (2016–2023)
Veterinary and Comparative Orthopaedics and Traumatology 6, 2025

🔍 Key Findings

  • Surgically managed TTAF resulted in excellent clinical outcomes at skeletal maturity, with all dogs having normal limb function and no stifle instability.
  • Surgical treatment significantly altered proximal tibial morphology, including decreased tibial plateau angle (TPA) and increased patellar position (PP) compared with the contralateral limb.
  • Axial tibial tuberosity position (TTP-A) increased and transverse position (TTP-T) decreased in surgically treated stifles, indicating distal and caudal tuberosity migration.
  • Non-surgically managed TTAF did not significantly alter tibial morphology or PP, but outcomes were more variable.
  • Medial patellar luxation developed in 2/6 non-surgically treated dogs, whereas none occurred in surgically managed cases.
  • Pins-only and pin–tension band constructs produced similar radiographic changes and outcomes.
  • Despite morphologic changes, no dogs developed cruciate ligament instability at follow-up.
  • Non-surgical management yielded good to excellent owner-reported outcomes, but carried a potential increased risk of patellar luxation.

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Multiple Choice Questions on this study

In Zweig 2025 et al., on healed tibial tuberosity avulsion fractures, what conclusion was reached regarding non-surgical management?

A. It resulted in poor outcomes
B. It caused severe tibial deformities
C. It is acceptable but may increase patellar luxation risk
D. It prevented morphologic change and complications
E. It is superior to surgery

Answer: It is acceptable but may increase patellar luxation risk

Explanation: Non-surgical management resulted in good to excellent outcomes but was associated with medial patellar luxation in some dogs.
In Zweig 2025 et al., on healed tibial tuberosity avulsion fractures, which radiographic change was associated with surgical management?

A. Decreased axial tibial tuberosity position
B. Increased transverse tuberosity position
C. Increased axial tibial tuberosity position
D. Unchanged patellar position
E. Increased TPA

Answer: Increased axial tibial tuberosity position

Explanation: Surgical fixation resulted in increased axial (distal) tibial tuberosity position compared with normal stifles.

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Treatment outcome and radiographic appearance of healed tibial tuberosity avulsion fractures in skeletally mature dogs: 21 cases (2016–2023)