Treatment Outcome and Radiographic Appearance of Healed Tibial Tuberosity Avulsion Fractures in Skeletally Mature Dogs: 21 Cases (2016–2023)

Abstract The aim of this study was to evaluate the function and radiographic appearance of healed tibial tuberosity avulsion fractures (TTAF) in dogs after they achieve skeletal maturity. This was a retrospective, single-centre cohort study. The medical records of skeletally mature dogs with previously treated TTAF were reviewed. Bilateral mediolateral stifle radiographs were obtained. Radiographic measurements of tibial plateau angle, patellar position (PP) and axial and transverse tibial tuberosity position were statistically evaluated. Treatment outcome was assessed via direct examination and owner evaluation. Twenty-one dogs were included. Treatment groups were open reduction and internal fixation with pins only (n = 9), open reduction and internal fixation with pins and tension band (n = 6) and non-surgical management with a cast (n = 6). In surgically managed cases, the tibial plateau angle and transverse tibial tuberosity position of TTAF stifles decreased while PP and axial tibial tuberosity position increased. Changes were not observed in the non-surgically managed group. The outcome of surgically managed cases was excellent. The outcome of non-surgically managed cases was reported by owners as good to excellent, although medial patellar luxation was observed in two dogs. Surgically managed TTAF result in altered tibial tuberosity and PP but lead to excellent outcomes despite morphologic changes at skeletal maturity. Non-surgically managed TTAF do not significantly alter tibial tuberosity and PP and result in good to excellent outcomes but may increase the risk of patellar luxation.