Tibia Flashcards
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?
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
Deahl, VCOT, 2017:
Characteristics of proximal tibial metaphyseal fractures?
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
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?
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
What did Zide et al VCOT 2020 conclude about pin and tension band constructs for the tibial tuberosity?
Vertical vs horizontal pin placement not different from each other
-Tension band constructs the strongest - failed at similar loads to intact bones
Muscles of attachment to the tibia
Stifle joint extensor:
-Quadriceps femoris
Stifle joint flexor:
-Biceps femoris
-Caudal sartorius
Tarsal flexor:
-Cranial tibial
Physeal growth of tibia
Proximal 40%
Distal 60%
Blood supply to the tibia
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
Diaphyseal Tibial fracture pathology
-Most common pattern
-Fractures more common in young vs. mature animals
Most common pattern
-Oblique and spiral
Fractures more common in young vs. mature animals
-Comminuted and open in mature
Repair options of tibial diaphysis fractures
External Fixators
IM Pin Fixation
IM Pin and Auxiliary Fixation
Interlocking Nail
Plates
Plate-Rod Combination
MIPO
Tibial Ex Fix Stability
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
Tibial fixture with IM pin
What % fill at isthmus
What fractures appropriate for
50% diameter
- otherwise deformity of tibia
Stable fracture in small animal
IM pin and Auxiliary fixation
What are the Auxiliary fixations
What fractures appropriate for
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
Tibial fracture repair for Transverse and Short Oblique Fractures
Compression plate fixation
Ex Fix
-Type I
-Type Ib
-Type II
Ex Fix with IM pin
Interlocking nail
Tibial fracture repair for Long Oblique and Spiral Fractures
IM pin with auxiliary fixation
Neutralization plating with lag screws
Ex Fix
-Type Ib
Type II
Ex Fix with IM pin
Nail
Tibial fracture repair for Reducible Comminuted Fractures
IM pin with cerclage
Neutralization plate with lag. screws
Ex Fix
-Type Ib
-Type II
-Type III
