Quiz Question

In Muroi 2025 et al., on refracture risk, what factor was significantly associated with refracture in dogs **retaining plates**?

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Correct. In the non-removal group, greater positional change of the distal screw (OR 1.79, p=0.04) was linked to refracture.
Incorrect. The correct answer is Amount of position change of the most distal screw.
In the non-removal group, greater positional change of the distal screw (OR 1.79, p=0.04) was linked to refracture.

🔍 Key Findings

  • Refracture occurred in 5.5% of limbs, with higher incidence in the plate removal group (12.5%) vs. non-removal (3.5%).
  • In the non-plate removal group, refractures occurred at the most distal screw site, linked to greater screw position change during growth (OR 1.79, p=0.04).
  • Screw-to-bone diameter ratio (SBDR) >0.4 was a significant risk factor for refracture in the plate retention group.
  • In the plate removal group, refractures occurred at the original fracture site, associated with lower pixel value ratio (bone mineral density) and reduced radial thickness.
  • Implant-induced osteoporosis (IIO) beneath the plate likely contributed to refracture risk after plate removal.
  • Younger age at fracture (<6 months) was associated with higher refracture risk due to ongoing radial growth and shifting screw position.
  • No significant association was found between refracture and plate type (locking vs conventional), fixation method, or ulnar union.
  • Recommendations include careful SBDR sizing, motion restriction, and cautious plate removal decisions in growing dogs.

Muroi

Veterinary and Comparative Orthopaedics and Traumatology

2

2025

A Retrospective Study of Risk Factors Associated with Refracture after Repair of Radial–Ulnar Fractures in Small-Breed Dogs

2025-2-VCOT-muroi-1

Article Title: A Retrospective Study of Risk Factors Associated with Refracture after Repair of Radial–Ulnar Fractures in Small-Breed Dogs

Journal: Veterinary and Comparative Orthopaedics and Traumatology

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In Von Pfeil 2024 et al., on acute ulnar shortening in dogs, what was the median time to radiographic bone healing?

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Correct. Median bone healing time was 8 weeks, with a range of 4–14 weeks.
Incorrect. The correct answer is 8 weeks.
Median bone healing time was 8 weeks, with a range of 4–14 weeks.

🔍 Key Findings

  • All dogs (11/11) showed improved radiohumeral articulation postoperatively, confirmed arthroscopically.
  • Median shortening: radioulnar (3.2 mm), humeroradial (1.8 mm), humeroulnar (1.2 mm).
  • Median lameness score improved from 2/4 to 1/4 by final follow-up.
  • Bone healing achieved in a median of 8 weeks (range: 4–14 weeks).
  • No major complications; minor issues included 1 screw loosening and 1 superficial infection.
  • Subjective function was graded full in 4 dogs, acceptable in 7.
  • Arthroscopy enabled accurate dynamic joint assessment, preferred over static radiographs.
  • Use of both orthopedic wire and plating provided secure fixation and improved outcomes.

Von Pfeil

Veterinary Surgery

3

2024

Outcomes of 11 dogs with short radius syndrome treated with acute arthroscopically assisted ulnar shortening

2024-3-VS-pfeil-1

Article Title: Outcomes of 11 dogs with short radius syndrome treated with acute arthroscopically assisted ulnar shortening

Journal: Veterinary Surgery

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In Condon 2024 et al., what percentage of fractures were classified as lateral humeral condylar fractures?

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Correct. Lateral fractures made up 69.8% of the 136 elbows in the study:contentReference[oaicite:1]{index=1}
Incorrect. The correct answer is 70%.
Lateral fractures made up 69.8% of the 136 elbows in the study:contentReference[oaicite:1]{index=1}

🔍 Key Findings Summary

  • Lateral humeral condylar fractures = 69.8% of cases; medial = 16.2%; Y/T = 14.0%
  • Falls/stairs were the inciting trauma in 45.6% of cases; significantly younger dogs were more likely to fracture after major trauma (p = 0.01)
  • Complication rate = 22% (10 major, 20 minor); implant migration and seroma most common
  • Fixation method had no significant impact on complication rates (p = 0.87)
  • Epicondylar comminution was significantly associated with complications (p = 0.02, OR = 3.27)
  • Contralateral intracondylar fissure found in 9.8%, none progressed to fracture during study
  • Wide inter-center variation in complication rate (5–62%, p = 0.002)

Condon

Veterinary and Comparative Orthopedics and Traumatology

2

2024

Humeral Condylar Fractures in French Bulldogs—Inciting Cause and Factors Influencing Complications of Internal Fixation in 136 Dogs

2024-2-VCOT-condon-2

Article Title: Humeral Condylar Fractures in French Bulldogs—Inciting Cause and Factors Influencing Complications of Internal Fixation in 136 Dogs

Journal: Veterinary and Comparative Orthopedics and Traumatology

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In Anderson 2023 et al., on French Bulldogs with humeral condylar fractures, which fracture configuration was most common?

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Correct. LHCF was the most frequent, representing 63.6% of fractures.
Incorrect. The correct answer is Lateral condylar fracture.
LHCF was the most frequent, representing 63.6% of fractures.

🔍 Key Findings

  • Lateral humeral condylar fractures (LHCF) were most common, comprising 63.6% of cases.
  • Transcondylar screw (TCS) + K-wire(s) fixation had a 7.62x higher risk of major complications compared to other methods (p = .009).
  • All cases of TCS migration occurred in the TCS + K-wire group; none occurred with plate fixation.
  • Overall complication rate was 40.9%, with 29.5% being major and requiring intervention.
  • Contralateral humeral intracondylar fissures (HIF) were found in 58.1% of French Bulldogs with CT data.
  • No significant association between age and presence of HIF, but fissure length increased with age (R = 0.47, p = .048).
  • Younger, lighter dogs had higher complication and screw migration rates, possibly due to softer bone and smaller condyles.
  • TCS + plate fixation had the lowest complication rate, suggesting biomechanical superiority.

Anderson

Veterinary Surgery

1

2023

Humeral condylar fractures and fissures in the French bulldog

2023-1-VS-anderson-1

Article Title: Humeral condylar fractures and fissures in the French bulldog

Journal: Veterinary Surgery

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In Story 2024 et al., on eTPA osteotomy comparison, which technique resulted in the **greatest mechanical axis shift**?

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Correct. Group A (CBLO + CCWO) caused the largest change in mechanical cranial distal tibial angle (mCrDTA), indicating the most mechanical axis shift.
Incorrect. The correct answer is CBLO + CCWO.
Group A (CBLO + CCWO) caused the largest change in mechanical cranial distal tibial angle (mCrDTA), indicating the most mechanical axis shift.

🔍 Key Findings

  • Population: 16 dogs (27 tibias), TPA >34°
  • Techniques analyzed:
    • Group A: CBLO + CCWO
    • Group B: TPLO + CCWO
    • Group C: mCCWO
    • Group D: PTNWO
  • Outcomes:
    • All groups achieved post-correction TPA < 14°.
    • Group A: Slight over-correction (mean TPA 10.47°); greatest mechanical axis shift.
    • Group B: Tibial shortening (~0.58%); least mechanical axis shift.
    • Group C: Lowest post-correction TPA (mean 4.76°); under-correction.
    • Group D: High accuracy, minimal shortening (mean 7.09° post).
  • Statistical Significance:
    • Significant differences in tibial length change and mCrDTA (mechanical axis shift) between groups (p <.05).
    • TPA correction accuracy: Group A (1.02), B (0.95), C (0.89), D (0.98).

Story

Veterinary Surgery

1

2024

Morphologic impact of four surgical techniques to correct excessive tibial plateau angle in dogs: A theoretical radiographic analysis

2024-1-VS-story-1

Article Title: Morphologic impact of four surgical techniques to correct excessive tibial plateau angle in dogs: A theoretical radiographic analysis

Journal: Veterinary Surgery

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In Pfund 2025 et al., on femoral cortical thickness, what was the key preoperative radiographic predictor of femoral fissure or fracture in dogs undergoing THR?

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Correct. CTI was the only statistically significant risk factor associated with perioperative fractures.
Incorrect. The correct answer is Femoral cortical thickness index.
CTI was the only statistically significant risk factor associated with perioperative fractures.

🔍 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.

Pfund

Veterinary Surgery

6

2025

Femoral cortical thickness index in a population of dogs undergoing total hip replacement

2025-6-VS-pfund-1

Article Title: Femoral cortical thickness index in a population of dogs undergoing total hip replacement

Journal: Veterinary Surgery

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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?

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Correct. Small proximal calcaneal fragments limited conventional screw fixation, necessitating tendon anchoring.
Incorrect. The correct answer is The proximal bone fragments were too small for screw purchase.
Small proximal calcaneal fragments limited conventional screw fixation, necessitating tendon anchoring.

🔍 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.

Evers

Veterinary Surgery

5

2022

Use of a bone‐to‐tendon plate to stabilize a comminuted calcaneus fracture in a dog

2022-5-VS-evers-1

Article Title: Use of a bone‐to‐tendon plate to stabilize a comminuted calcaneus fracture in a dog

Journal: Veterinary Surgery

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In Danielski 2022 et al., on PAUL complications, what percentage of limbs experienced major complications?

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Correct. Major complications occurred in ~25.6% of treated limbs.
Incorrect. The correct answer is 25%.
Major complications occurred in ~25.6% of treated limbs.

🔍 Key Findings

  • Major complications occurred in 25.6% of limbs treated with PAUL, including non-union, implant failure, and infection requiring revision surgery.
  • Increased body weight was significantly associated with a higher risk of complications (7% increased risk per additional kg; p = .04).
  • Post-operative radiographic assessment was unreliable in predicting complications; inter-observer agreement was poor (kappa ≤ 0.12).
  • Expert evaluation of implant or reduction errors had low predictive value (k < 0.2) for postoperative complications.
  • Common major complications included non-union (6 limbs), screw breakage, and surgical site infections.
  • Implant removal was required in 11.5% of limbs, mostly due to non-union or infection.
  • Being a Labrador appeared protective on univariate analysis, but not on multivariate analysis after adjusting for weight.
  • Radiographs showing suboptimal plate placement or osteotomy reduction did not reliably correlate with actual complication occurrence.

Danielski

Veterinary Surgery

1

2022

Complications after proximal abducting ulnar osteotomy and prognostic factors in 66 dogs

2022-1-VS-danielski-4

Article Title: Complications after proximal abducting ulnar osteotomy and prognostic factors in 66 dogs

Journal: Veterinary Surgery

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In Welsh 2023 et al., on TTAF fixation methods, what approximate % of the **strength** did the single-pin construct achieve compared to two-pin fixation?

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Correct. Single-pin constructs had a mean strength that was 68% of that provided by two-pin fixation.
Incorrect. The correct answer is 68%.
Single-pin constructs had a mean strength that was 68% of that provided by two-pin fixation.

🔍 Key Findings

  • Two-pin fixation had significantly greater strength (639 N) than single-pin fixation (426 N) in TTAF models (p = .003).
  • Stiffness was also higher with two-pin constructs (72 N/mm vs 57 N/mm); statistically significant (p = .029).
  • Both fixation types withstood loads greater than quadriceps force in dogs at a walk (240 N), indicating clinical viability.
  • Failure was most commonly due to pin bending or pullout (82%), with fewer cases of ligament tearing or epiphyseal fracture.
  • K-wire insertion angle (KWIA) did not significantly differ between fixation types (p = .13).
  • Single larger pins delivered ~68% of the strength and ~83% of the stiffness of two smaller vertically aligned pins.
  • Clinical implication: Two vertically aligned pins are biomechanically superior for TTAF fixation in canine models.
  • Study used mature cadavers, which may underestimate loads and stiffness compared to immature clinical cases.

Welsh

Veterinary Surgery

5

2023

Biomechanical comparison of one pin versus two pin fixation in a canine tibial tuberosity avulsion fracture model

2023-5-VS-welsh-3

Article Title: Biomechanical comparison of one pin versus two pin fixation in a canine tibial tuberosity avulsion fracture model

Journal: Veterinary Surgery

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In Jourdain 2024 et al., on fluoroscopic fixation of feline SIL, what percentage of screws had ≥60% purchase within the sacral body?

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Correct. 14 of 17 screw placements (82%) had ≥60% purchase within the sacral body, a threshold for biomechanical stability.
Incorrect. The correct answer is 82%.
14 of 17 screw placements (82%) had ≥60% purchase within the sacral body, a threshold for biomechanical stability.

🔍 Key Findings

  • Minimally invasive fluoroscopic technique yielded median reduction of 94.1% immediately postoperative.
  • Screw purchase ≥60% in sacral body achieved in 82% of cases, with median purchase of 73.3%.
  • One screw exited caudally; no dorsal, ventral, or cranial exits reported.
  • At 7-week follow-up, reduction and purchase slightly declined but remained effective (p = .008 and p = .013).
  • No screw loosening observed, even in suboptimal reductions or purchases.
  • Pelvic canal width and symmetry (PCDR and HCWR) were restored and maintained.
  • Excellent long-term function: FMPI ≥0.98 in 9 of 10 cats; owners reported 10/10 satisfaction.
  • Fluoroscopy enabled accurate screw placement and minimized tissue trauma, contributing to rapid recovery.

Jourdain

Veterinary Surgery

4

2024

Fluoroscopically-assisted closed reduction and percutaneous fixation of sacroiliac luxations in cats using 2.4 mm headless cannulated compression screws: Description, evaluation and clinical outcome

2024-4-VS-jourdain-2

Article Title: Fluoroscopically-assisted closed reduction and percutaneous fixation of sacroiliac luxations in cats using 2.4 mm headless cannulated compression screws: Description, evaluation and clinical outcome

Journal: Veterinary Surgery

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Quiz Results

Topic: Fracture Management
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