Presentation
Presents with acute left pelvic limb lameness after playing with another dog. The stifle is swollen and painful.
Patient Data
Left stifle: There is increased lucency between the epiphysis and metaphysis of the cranioproximal tibia. In addition, there is a fracture through the caudoproximal tibial metaphysis with mild caudal displacement. The tibial tuberosity is displaced dorsally and cranially with a small fragment.
Right stifle: Normal for comparison.
Type II Salter Harris fracture of the left proximal tibia and avulsion fracture of the tibial tuberosity.
The previously described fracture of the proximal tibial physis with extension into the caudal metaphysis is again identified. There is moderate remodeling with rounding of the fracture margins and mild, irregular periosteal proliferation. No significant bony bridging is identified. The tibial tuberosity is static in position. The small fragment at the distal extent of the tibial tuberosity has become smaller and irregular in the recheck interim and there is moderate periosteal proliferation extending down the tibial crest.
Case Discussion
Tibial tuberosity avulsion and physeal fracture. The apophysis joining the separate center of ossification of the tibial tuberosity to the tibial metaphysis is weaker until fused, and trauma or excess tension on the patellar ligament can cause this type of fracture.
The fracture was treated with strict rest, and at a two week recheck was healing well.
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