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Tibial Crest Avulsion

During a particularly lively playful episode Jingles gave a cry and began limping on her right hind leg.

The next day she was brought to the surgery nearly 100% lame on the right hind and with obvious pain and some swelling on the front of the stifle area.

An X-ray confirmed that she had a partial avulsion of the tibial crest. An avulsion fracture is where a small piece of boney tissue (the tibial crest) is pulled away from the main bone by the action of a tendon.

It's usually self-induced and happens during forceful activity in young dogs between 5 months and 10 months of age, before the bones are fully formed.

The piece of bone pulled away is a separate centre of ossification which is attached to the main bone by soft cartilage tissue.

After 10 - 12 months of age these separate centres of bone growth become fully calcified and joined to the main bone.

Jingles
Jingles waking up after anaesthetic and X-ray

normal
X-ray of the left stifle joint (side view - i.e lateral view)

The upper bone is the femur with a normal patella (kneecap) on the left.

The lower bone is the tibia showing a separate centre of ossification (tibial crest) which, although it looks like a fracture, is normal at 5 months of age.

Partial evulsion
X-ray of the right stifle (side view - i.e lateral view)

The tibial crest of tibia (the lower bone) has been pulled away (avulsed) from the tibia, widening the gap and leaving a boney fragment behind.

Treatment: Tibial crest avulsions usually result in much greater displacement of the boney fragment (see X-ray below) and generally require surgical repair.

As Jingles' fracture was not greatly displaced we decided to treat her with anti-inflammatory medicines and rest.

After 10 days she was much improved and 4 weeks later she was walking normally.

Full evulsion
X-ray of the stifle of another case for comparison, (lateral view) - showing compete avulsion of the tibial crest of the right stifle.​

The avulsed bone has turned through 120 degrees and required surgery to anchor it back in the correct position.

Page updated 19th Mar 2014, 18:19
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