🔍 Key Findings

Internal fixation (IF) group (n=59):

• Complication rate: 20.3%
• Major complications: 15.3%
• Longer time to discharge if complications occurred (median: 12.5 weeks)

External skeletal fixation (ESF) group (n=36):

• Complication rate: 55.6% (p < .001 vs IF)
• Major complications: 52.8%
• Most common issue: pin tract morbidity

Multivariable analysis:

• Use of IF significantly reduced odds of complications (OR 0.23, p = .004)
• Use of post-op antibiotics associated with increased odds of complications (OR 3.53, p = .028)

Fixation choice influenced by age:

• Older puppies more likely to receive IF (OR 1.25 per week increase in age, p < .001)

Breed & fracture distribution:

• Common breeds: Labrador, Border Collie, Whippet
• Common fracture sites: middle and proximal third of tibia

🔍 Key Findings Summary

• 89 French Bulldogs with HCF; 40.4% (36/89) had contralateral HIF
• Prophylactic transcondylar screws placed in 20/36 HIF; no complications in these
• Complication rate for HCF repair = 13.4% (6.7% minor, 6.7% major)
• Most complications occurred with Kirschner wire fixation
• Short-term outcome: Bone healing observed in all, but 14/45 had persistent intracondylar gap
• Long-term outcomes (n=27):
  • Excellent = 66.7%
  • Good = 29.6%
  • Fair = 3.7%
• Complication-free dogs significantly more likely to have excellent/good outcomes (p = 0.007)

🔍 Key Findings

Study size: 105 dogs (73 ORPS; 32 MIPO)

MIPO vs ORPS differences:

• Surgical time: MIPO median 130 min vs ORPS 85 min (p < .001)
• Explant rate: MIPO 25% vs ORPS 4.1% (p = .003)
• Time to clinical union: MIPO 85 days vs ORPS 57 days (p = .010)
• Frontal alignment deviation: MIPO 3.5° vs ORPS 2.0° (p = .047)
• Comminution more frequent in MIPO (41% vs 16%; p = .012)

Significant predictors for MIPO use: More proximal fracture margin (p = .004), surgeon identity (p < .001)

No significant difference: Sagittal alignment, radial length, union rate, or complication rate by surgeon

Implant preference: Fixin plates used in 84% of MIPO; locking plates more common in ORPS

🔍 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

🔍 Key Findings Summary

• ILP and MIP: No significant differences in leak pressure between HSA, FEESA, and SS techniques (p > .05).
• Construct Time:
  • FEESA (no oversew) fastest: 79 ± 30 s
  • HSA-SI slowest: 397 ± 70 s (p < .001)
• Tissue Thickness:
  • Jejunum thickest: 2.28 ± 0.30 mm
  • Stomach thinnest: 1.66 ± 0.28 mm
• Staple Malformation: Noted in 2 FEESA-O constructs, vertical staple line.
• Leak Locations:
  • HSA: All leaked from suture bites
  • FEESA: Leaks from vertical and horizontal staple lines
  • SS: Mostly from staple holes

🔍 Key Findings

• TCF risk increased significantly with 10° insertion angle at both 650 rpm (12.5%) and 1350 rpm (17.5%), compared to 0% in the control group (0° at 650 rpm).
• Hand insertion at 10° angle resulted in only 3.75% TCF rate, suggesting lower insertion speed reduces risk.
• No TCFs occurred when screws were inserted coaxially (0°) at either 650 or 1350 rpm, indicating angle is a critical factor.
• Screw speed alone did not increase TCF risk unless combined with off-axis insertion.
• Radiographically detectable TCFs were only considered; actual rates may be higher with direct bone inspection.
• Cutting flutes engaging undrilled bone during off-axis insertion likely contribute to TCF formation.
• Clinical implication: Ensure screws are inserted coaxially and at lower speeds to reduce TCF risk during procedures like TPLO.
• Statistically significant differences were found between control and high-angle insertion groups: Group C (p = .001), Group E (p < .001).

🔍 Key Findings

• Oxley's modified CCWO did not achieve the target TPA of 5° in most cases, even with planning.
• Mean planned TPA was 7.6°, higher than target, and consistent across dog sizes.
• Postoperative TPAs were significantly higher in small dogs (median 7°) than in large dogs (median 4.5°).
• Distalization >7.5 mm of the osteotomy from the patellar tendon led to increased under-correction of TPA.
• Only dogs with preoperative TPA >35° achieved post-planning TPAs close to the 5° target.
• Postoperative osteotomy positions were generally more distal than recommended (8.6 mm median).
• Virtual plate fit was appropriate for all dogs at 5 mm or 7.5 mm positions, suggesting no need for excessive distalization.
• Excessive correction leading to negative TPAs occurred in some cases, risking caudal cruciate ligament strain.

🔍 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

🔍 Key Findings

• A linear relationship was observed between wedge angle and tibial plateau angle (TPA) correction across all four CCWO techniques.
• All techniques produced predictable TPA corrections using linear regression-derived equations, allowing wedge angle extrapolation to achieve a target postoperative TPA of 5°.
• TLA shift (tibial long axis) increased with wedge angle and influenced final TPA; greatest in Frederick & Cross method.
• Tibial shortening (mTL%) varied by technique, being most severe (up to 40.9%) in traditional Slocum & Devine CCWO and least in newer techniques (7.5–12%).
• The Oxley mCCWO technique showed lower TLA shift compared to the Frederick & Cross and Christ techniques, though similar to Slocum & Devine; tibial shortening was more pronounced than other modified techniques at wedge angles ≤40°.
• Techniques varied in craniocaudal translation and wedge apex positioning, influencing planning accuracy and mechanical axis alignment.
• The corrective wedge angle equations reliably predicted TPA within 4–6° across varied tibial conformations.
• The study supports equation-based planning over static TPA–5° subtraction to reduce risk of under- or over-correction.

🔍 Key Findings Summary

• 3 dogs developed permanent fibular nerve dysfunction following TPLO
• Common findings:
  • Drill hole or screw in caudal tibial cortex just distal to osteotomy
  • Caudal malpositioning of TPLO plate (esp. right limb of case 3)
  • Post-op signs: cranial tibial atrophy, knuckling, exaggerated gait, no hock flexion
• One case had confirmed deep/superficial fibular neuropathy via electrodiagnostics
• Recommended prevention: avoid overly caudal drill paths; careful gait assessment at follow-up is key