🔍 Key Findings
- Lower CTI values were significantly associated with higher risk of both intraoperative and postoperative femoral fractures or fissures (p <.0001).
- The mean CTI for all dogs was 0.285, whereas dogs with fissures/fractures had a mean CTI of 0.246.
- For each 0.001 increase in CTI, odds of fissure/fracture decreased by 2–3% depending on perioperative timing.
- High interobserver reliability (ICC = 0.984) and consistency between pre- and postoperative CTI measurements (ICC = 0.96).
- CTI was the only significant risk factor identified; age, breed, bodyweight, BCS, CFI, or luxoid hips were not significant.
- Prophylactic lateral plating in dogs with low CTI (mean 0.230) resulted in no postoperative fractures.
- Postoperative fractures occurred in 8% of cases, and 93% of dogs returned to full function within one year.
- CTI may be a useful radiographic screening tool, especially when advanced imaging (e.g., DEXA) is unavailable.

