Bilateral proximal tibial epiphysiodesis for management of bilateral partial avulsion fracture of the origin of the cranial cruciate ligaments in a dog

摘要

A five-month-old labrador retriever presented with intermittent pelvic limb lameness. Radiography and CT demonstrated bilateral stifle effusions and bony defects in the caudodistal aspect of the femoral condyles. Stifle arthroscopy confirmed bilateral partial avulsion of the cranial cruciate ligaments from their origin. Epiphysiodesis was performed under fluoroscopic guidance by placement of a 4.0 mm cancellous screw in the cranial aspect of the proximal tibial physis. Radiographs performed at 6, 7, 9 and 18 months of age showed a reduction in the tibial plateau angle from 23 degrees to 6 degrees in the right and from 33 degrees to 10 degrees in the left. Bilateral tibial valgus did develop, but this was not clinically significant, and from 10 weeks postsurgery, on visual assessment, the dog was not lame. Proximal tibial epiphysiodesis was an effective treatment to dynamically reduce the tibial plateau angle in a dog with bilateral partial avulsion of the cranial cruciate ligaments.