Tibia Flashcards

1
Q

Gutbrod, Vet Surg, 2017:
Plate-rod fixation - LCP + IM pin (30%, 40% , 45% and 50% diameter)
Bicortical screws could be inserted in which plate holes?
Which pin size allowed placement of a greater number of bicortical screws?

A

Gutbrod, Vet Surg, 2017:
Bicortical screws could be inserted in all specimens in the 3 most proximal plate holes and in at least 1 of the 3 distal plate holes
The smallest IM pin size (30%) allowed placement of a greater number of bicortical screws

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2
Q

Deahl, VCOT, 2017:
Characteristics of proximal tibial metaphyseal fractures?

A

Deahl, VCOT, 2017:
Proximal tibial metaphyseal fractures have a characteristic curvilinear fracture configuration that affects mainly immature (<6 months) small breed dogs <5kg, with a predominance for terrier breeds

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3
Q

Wagoner, VCOT, 2018:
Fiberglass vs thermoplastic splint materials
Effect of splint location (cranial vs lateral) on construct stiffness?
Differences in interfragmentary motion in the sagittal and frontal planes for cranially applied fiberglass vs thermoplastic splints?
Differences in interfragmentary motion in the frontal plane for laterally applied fiberglass vs thermoplastic splints?

A

Wagoner, VCOT, 2018:
Splint location had no effect on construct stiffness
No difference in interfragmentary motion in the sagittal and frontal planes between fiberglass and thermoplastic splints applied cranially
Interfragmentary motion in the frontal plane was 64% less with fiberglass splints compared to thermoplastic splints when applied laterally

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4
Q

What did Zide et al VCOT 202 conclude about pin and tension band constructs for the tibial tuberosity?

A

Vertical vs horizontal pin placement not different from each other
-Tension band constructs the strongest - failed at similar loads to intact bones

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5
Q

Muscles of attachment to the tibia

A

Stifle joint extensor:
-Quadriceps femoris

Stifle joint flexor:
-Biceps femoris
-Caudal sartorius

Tarsal flexor:
-Cranial tibial

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6
Q

Physeal growth of tibia

A

Proximal 40%

Distal 60%

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7
Q

Blood supply to the tibia

A

cranial tibial a
-nutrient foramen in the caudolateral edge of the proximal 1/3 diaphysis

Fibular head
cranial tibial a

Fibular body
peroneal a

Cranial branch of medial saphenous a, v, n.
-run obliquely across the medial diaphysis

tibial and popliteal a
peroneal and cutaneous n
-run laterally and caudally

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8
Q

Diaphyseal Tibial fracture pathology

-Most common pattern

-Fractures more common in young vs. mature animals

A

Most common pattern
-Oblique and spiral

Fractures more common in young vs. mature animals
-Comminuted and open in mature

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9
Q

Repair options of tibial diaphysis fractures

A

External Fixators
IM Pin Fixation
IM Pin and Auxiliary Fixation
Interlocking Nail
Plates
Plate-Rod Combination
MIPO

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10
Q

Tibial Ex Fix Stability

A

Least to Most

Unilateral Uniplanar Type 1a
+ IM Pin
or if bone load sharing

Bilateral uniplanar Type II
Unilateral biplanar Type Ib
(oblique/spiral fractures)

Unilateral biplanar Type Ib
Bilateral biplanar Type III
(no load sharing)

Circular and hybrid

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11
Q

Tibial fixture with IM pin

What % fill at isthmus

What fractures appropriate for

A

50% diameter
- otherwise deformity of tibia

Stable fracture in small animal

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12
Q

IM pin and Auxiliary fixation

What are the Auxiliary fixations

What fractures appropriate for

A

What are the Auxiliary fixations?
-cerclage wires (proximal 1/2)
-screws in lag fashion (distal 1/2)

What fractures appropriate for
-long oblique
-spiral fractures

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13
Q

Tibial fracture repair for Transverse and Short Oblique Fractures

A

Compression plate fixation
Ex Fix
-Type I
-Type Ib
-Type II

Ex Fix with IM pin

Interlocking nail

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14
Q

Tibial fracture repair for Long Oblique and Spiral Fractures

A

IM pin with auxiliary fixation

Neutralization plating with lag screws

Ex Fix
-Type Ib
Type II

Ex Fix with IM pin

Nail

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15
Q

Tibial fracture repair for Reducible Comminuted Fractures

A

IM pin with cerclage

Neutralization plate with lag. screws

Ex Fix
-Type Ib
-Type II
-Type II

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16
Q

Tibial fracture repair for Nonreducible Comminuted Fractures

A

Ex Fix
-Type II
-Type Ib
-Type III
-Circular
-Hybrid

Bridging plate

Plate-rod combination

Cancellous bone graft

17
Q

Verpaalen VCOT 2021

Tibial Tuberosity Fractures
by pin and tension band wire (PTBW)
by hybrid external fixation (HESF)
by K-wires alone

A

PTBW and HESF > stiffness & load at 3 mm of axial displacement over K-wires

PTBW = HESF
stiffness & load at 3 mm displacement

Failure occurred by bending and pullout of the Kirschner wires for all fixation groups

18
Q

Arun VCOT 2022

Need to explant following Tibial Tuberosity Avulsion

A

Neutered dogs 19 x more likely to require explant compared with intact dogs

Every 0.25 mm increase in average pin size was found to make it 2.5 times
*smallest pins should be used