Tibial Fractures


Key Points

Because the tibia bone is just beneath the skin on the inner side of the limb, there is increased risk for a sharp bony fragment to penetratrate throught the skin; this can be prevented by supporting the limb with a splint before the surgery is performed

Tibial fractures are usually repaired using a plate and screws, but other forms of repair are also possible

These type of fractures do not respond well to casting

 

Anatomy

  • The tibia bone is the shin bone
  • The top of the tibia bone forms the knee joint with the femur bone
  • The bottom of the tibia bone forms the ankle or hock joint with the bones of the paw

 

Considerations

  • Tibial fractures in young dogs heal very quickly
  • Young dogs have open growth plates, which are the soft regions of the bone (at the ends) which are susceptible to fracture

 

Surgery

  • The entire limb is shaved
  • An incision is made on the inner side of the tibia
  • The fracture is reduced and stabilized with one of the following
    • Plate and screws
    • Pins
    • Wires
    • External skeletal fixator
    • Combination of above
  • A bone graft from the top of the pelvis or bone bank may be used to stimulate healing of complicated tibial fractures (multiple pieces)
  • The radiographs below show a transverse fracture of the tibia bone
  • In the radiographs below, a long plate and screws were used to repair the fracture.
  • In the photo below, the plate and screws have been secured to the bone to reduce the fracture.  The band of red tissue crossing over the plate is the saphenous nerve, artery and medial saphenous vein.

Aftercare

  • The limb may be bandaged for about 5 days
  • Watch incision for signs of infection
  • Limit activity until the fractures have healed which is about 2 months
  • No jumping, running, rough play
  • Pet should be kept indoors other than short leash walks for elimination purposes
  • Activity can return to normal once we have determined that the fractures have healed (based on radiographs)
  • Prevent licking of the incision
  • Licking the surgical site
    • can open the incision
    • can introduce infection
    • does not help to heal the wound
  • Licking can be deterred by
    • placing an Elizabethan collar on your pets neck
    • applying a combination of bitter apple solution and liquid heet (2:1) around the incision
    • applying liquid bandage (facilitator) onto the incision
  • Radiographs (x-rays) should be taken about 2 months after surgery to evaluate healing of the fracture

 

Potential complications

  • Anesthetic death
  • Infection
  • Breakage of the implants if exercise has not been restricted during the healing phase
  • Cancer of the bone induced by the implants is a very rare, but potential complication; therefore we recommend removal of plates and screws

 

Timing of removal of plates and screws

  • Mature animals = 1 year after surgery
  • Immature animals = same amount of time after surgery as the age of animal (example 4 month old dog can have implants removed in 4 months)
  • Reasons to remove implants
    • cold sensitivity – lameness when dog is outdoors in winter
    • infection
    • implants can induce a bone cancer – very unusual, but occasionally will occur
    • osteoporosis due to bone relying on plate for strength
    • the surgeon will make recommendations on the need to remove implants in your pet

← Back to all Pet Conditions