Simultaneous fluoroscopic-guided tibial plateau leveling and fracture reduction for the concurrent treatment of chronic cranial cruciate ligament tear and comminuted diaphyseal fracture of the tibia and fibula in a dog.

CASE DESCRIPTION A 12-year-old obese spayed female American Staffordshire Terrier was admitted for evaluation of acute non-weight-bearing lameness of the right pelvic limb attributed to motor vehicle-related trauma that occurred 2 hours previously. The owners reported a chronic, progressive weight-bearing lameness of the right pelvic limb secondary to a complete cranial cruciate ligament (CrCL) rupture that was diagnosed 6 months previously. They had declined surgery for CrCL repair because of the advanced age of the dog. CLINICAL FINDINGS Physical examination revealed a 2-cm skin wound on the craniomedial aspect of the midtibial region. The dog had non-weight-bearing lameness of the right pelvic limb with associated muscle atrophy and signs of pain on palpation of the right tibia. Radiography was performed, and tibial and fibular fractures were diagnosed. The fractures were classified as second-degree open, severely comminuted, complex nonreconstructible diaphyseal fractures. TREATMENT AND OUTCOME The tibial fracture and CrCL rupture were treated by closed reduction and simultaneous tibial plateau leveling by indirect fluoroscopic-guided alignment, plus stabilization with a monoplanar external fixator. The 2 main tibial fragments were manipulated via the frame clamps to restore limb length and alignment and tibial plateau slope. Both the tibial and fibular fractures healed within 16 weeks after surgery. At the 2-month recheck examination after implant removal, the dog was walking normally. CLINICAL RELEVANCE Simultaneous treatment of tibial fracture and CrCL rupture with unilateral external fixation was successful in this dog and may be helpful in similar cases.

Computed Tomographic Trochlear Depth Measurement in Normal Dogs.

OBJECTIVES: The main purpose of this study was to describe the relationship between patellar maximal craniocaudal thickness and femoral trochlear groove depth in normal dogs and to valuate the intra-observer or inter-observer variability of maximal trochlear depth and maximal patellar craniocaudal thickness using computed tomography. METHODS: Trochlear groove depth and patellar maximal craniocaudal thickness of 40 limbs (20 dogs) were measured by three independent veterinarians using three-dimensional multiplanar reconstruction computed tomography images. The patellar maximal craniocaudal thickness/trochlear depth ratio was determined. RESULTS: The mean ratio of these stifles was 0.46 (range 0.24-0.70), meaning that the mean maximal depth of the trochlea was 46% of the mean maximal-patellar thickness. CLINICAL SIGNIFICANCE: A wide range of maximal-patellar-craniocaudal-thickness/maximal trochlear-depth ratio was found suggesting that breed studies should be performed to determine a breed-specific patellar-thickness/trochlear-depth ratio. To make decisions on when and where to perform a sulcoplasty during patellar luxation surgery, patella/trochlea thickness relationship should be measured for each breed with patellar tracking from stifle hyperflexion to stifle hyperextension.