Monday 14th Dec, 2020
River is a lively and boisterous 7mth old German Shepherd who presented with 10/10 lameness after enthusiastically jumping for a ball... and then landing with a nasty ‘crack’ coming from her back-left leg - ouch!
Which method would you choose to repair this fracture and why? What factors would influence what you decide do?
River’s fracture had a good prognosis – particularly since River was young and the fracture was incomplete. This meant there were various options for how we could have repaired the fracture.
We did consider an external fixator placed using a minimal or closed approach and this would have been a good choice. River was however not going to tolerate the fixator, even if only on for 3-4 weeks, so this put us off the ESF idea.
Instead, we chose to reduce and plate the fracture, first using a cranially placed lag screw to pull the fracture back together. We then placed a second lag screw across the fracture through the medial plate itself. This helped to further reduce and compress the fracture and also pull the plate onto the tibia.
An advantage of the plate we used was that it allowed us to place an angled cortical screw proximally avoiding the proximal tibial growth plate.
The rest of the plate screws were ‘locking screws’ which rigidly stabilised the reduced and lag-screw compressed fracture.
How did River recover?
‘Taking it easy’ is not in River’s vocabulary meaning the repair/implants have been tested from day 1! The good news is that River is weight bearing well and no lameness apparent at the 4-week postop check.