Ch 63 - Fractures of the Tibia and Fibula Flashcards
What major muscles attach to the tibia and what is their function?
- Quadriceps femoris (stifle extension)
- Biceps femoris (stifle flexor)
- Caudal part of sartorius (stifle flexor)
- Cranial tibial muscle (tarsal flexor)
List the 4 epiphyses of the tibia
- Proximal epiphysis
- Tuberosity epiphysis
- Distal epilphysis
- Medial malleolar epiphysis
What is an apophysis?
A traction epiphysis such as the tibial tuberosity
How much of the longitudinal length of the tibia is from the proximal and distal epiphyses respectively?
- Proximal 40%
- Distal 60%
At what age does the tuberosity epiphysis fuse with the proximal epiphysis?
At what age does the tuberosity physis normally close?
- Fuses to proximal epiphysis 5-9m in large dogs
- Physis closes over 12m in large dogs
At what age does the medial malleolar epiphysis fuse to the distal epiphysis?
Very early, approx 4-5m in large breeds.
What part of the tibial plateau is articular?
The caudal 1/2
What muscles attach to the tibial tuberosity?
- Quadriceps femoral
- Parts of biceps femoris and sartorius
What are the main vessels which supply blood to the tibia and fibula?
Tibia
- Cranial tibial artery
Fibula
- Cranial tibial artery (head)
- Peroneal artery (fibula)
What vessels and nerves surround the tibia
- Medial saphenous artery and vein and saphenous nerve obliquely cross the medial tibia
- Tibial and popliteal artery along lateral and caudal aspect
- Peroneal and cutaneous nerves along lateral and caudal aspects
What can result in a tibial tuberosity avulsion?
Contraction of the quadriceps while the stifle is flexed and the foot is firmly on the ground
What is Osgood Schlatter disease?
Considered to be a form of osteochondrosis but has been suggested that it should be classified as a minimally displace tibial tuberosity fracture
What leg position can aid in reduction of a tibial tuberosity fracture? What are the repair options?
Hip flexed and stifle extended
Repair options:
- 2 K-wires in a caudoproximal direction (very young small dogs with minimal displacement)
- Pin and tension band (preferred)
- Reattachment of patella tendon to bone tunnel if not enough bone to reattach
What are the repair options for a proximal physeal fracture?
Pinning!
- At least 2 cross pins
- Third pin through tuberosity recommened for better stability
What are the repair options for proximal metaphyseal fractures?
- IM pin, cross pins, plate, lag screws
- If fibular head had detacted from tibia, should be reattached with screws
- If comminuted, plate must be placed on side of comminution to act as buttress plate