Tibial Apophyseal Percutaneous Pinning in Skeletally Immature Dogs: 25 Cases (2016-2019)

The aim of this study was to report the clinical experience with fluoroscopically guided tibial apophyseal percutaneous pinning (TAPP) for tibial tuberosity avulsion fractures (TTAF).

This is a retrospective case series that reviewed the medical records of skeletally immature dogs (n=25). The association of pin design [smooth (SP); negatively threaded (NTP)], pin insertion angles, TTAF-type, age, and race with various outcome variables was statistically evaluated.

Long-term follow-up was assessed by direct examination, x-rays, questionnaires, and videos.

Mean age, weight, and surgical time were 6.2 months, 9.6 kg, and 21 minutes, respectively. There were no major complications between the 19 SP and the 6 NTP and no pins broke. Incidence rates for seromas and patellar desmitis were higher for SP pins (11/19; 16/19) than for NTP pins (0/6; 2/6) (p = 0.02; 0.03). The median horizontal pin crossing angles for cases without and with desmitis were 40 and 26 degrees, respectively (p = 0.047). Explantation was necessary in 5/19 SP cases and 0/6 NTP. The mean tibial plateau angle (TPA) changed significantly between initial (25.6 degrees) and follow-up (18.8 degrees) radiographs (p = 0.0002). The long-term outcome, obtained at a mean of 19.9 months, was excellent in all cases.

Finally, it was concluded that tibial apophyseal percutaneous pinning can be considered in the treatment of TTAF. Divergent pin placement and use of NTP-type pins can reduce complications. The tibial plateau angle should be monitored until skeletal maturity is reached. The long-term outcome post TAPP procedure can be expected to be excellent.

The authors of the article have stated that there is no conflict of interest.

von Pfeil DJF, Megliolia S, Malek S, Rochat M, Glassman M. Tibial Apophyseal Percutaneous Pinning in Skeletally Immature Dogs: 25 Cases (2016-2019). Vet Comp Orthop Traumatol. 2021 Mar;34(2):144-152. doi: 10.1055/s-0040-1719091. Epub 2020 Nov 19. PMID: 33212512.