Tibial Crest Avulsion - Jingles
5mo. old female Staffie
During a particularly lively playful episode Jingles gave a cry and began
limping on the 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 crrest) 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 5mo and 10mo. 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 - 12mo. of age these separate
centre of bone growth become fully calcified and joined to the main bone.
Jingles waking up after anaesthetic and X-ray
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 mo. of age.
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 him with
anti-inflammatory medicines and rest. After 10 days he was much improved and
4 weeks later he was walking normally.
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.
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