Tibial Tuberosity Avulsion Fracture in Puppies

Little Toby, the 6-month-old Cavoodle visited us with a very sore right hind leg after having jumped off a couch.

Toby, a cavoodle with Tibilial Tuberosity

When it first happened, he could not put any weight on his leg and was taken straight to an out-of-hours emergency centre. At the emergency centre the ICU vets noticed swelling in his right knee and pain while bending it. X-rays were subsequently done which showed that a small part of the tibia seemed to have been pulled off compared to the left knee. This is a common fracture in puppies known as a tibial tuberosity avulsion fracture.

A X-ray of a tibial tuberosity

Pictured Above: Toby’s left knee x-ray compared to his right knee x-ray, where the fracture is clearly visible!

What is a Tibial Tuberosity Avulsion fracture?

Tibial tuberosity avulsion refers to the separation of the tibial tuberosity, a bony prominence located just below the knee joint, from the tibia (the larger bone in the lower leg). This type of fracture primarily affects young puppies during their active growth phase when they have an open growth pate in the Tibia, which is not as strong as normal bone.

The Tibial Tuberosity serves as the attachment site for the patellar ligament, which connects the quadriceps muscle to the tibia. When excessive force is applied, such as during rough play or falls, the ligament can pull its attachment away from the bone, resulting in an avulsion fracture.

Little Toby had jumped off the couch and landed on the floor in such a way that the force from the quadriceps muscle was enough to pull off the small fragment of bone through the weak growth plate causing the fracture.

What are the Signs and Symptoms of Tibial Tuberosity in a Puppy?

Recognising the signs and symptoms of tibial tuberosity avulsion and other serious musculoskeletal injuries in a puppy is crucial for prompt diagnosis and treatment. Look out for the following indications:

  1. Acute lameness: Sudden onset of limping or reluctance to put weight on the affected leg.
  2. Pain and swelling: The injured leg may appear swollen, and your puppy may exhibit signs of discomfort or pain when the affected area is touched.
  3. Difficulty moving: Puppies with tibial tuberosity avulsion fractures may have difficulty walking or running normally. They may also exhibit a limited range of motion in the affected leg.
  4. Altered behaviour: Puppies in pain may become more subdued, reluctant to engage in physical activities, or show signs of distress.

How do you fix a Tibial Tuberosity Avulsion Fracture?

With orthopedic surgery!

After a diagnosis of his injury, young Toby needed orthopedic surgery. This involved placing a metal pin into the fragment and attaching it back to the bone from which it had been pulled off. In addition, pin wires were used to secure the pine and fragment in place.

Xray of a dog after tibial tuberosity surgery

Pictured above: Toby’s right left after his surgery, having had pins placed to secure the knee.

Each time the knee is used the fragments are forced back into place, thanks to the pins and wires, instead of pulling it away…Magic !

What happens after Tibial Tuberosity surgery?

Strict rest is required for 6 weeks post-surgery. By the end of this period, we remove the implants to allow the bone to grow normally and Toby should be back to normal in no time.

Tuberosity avulsion fractures in puppies can be concerning for puppy owners. Understanding the causes, recognising the signs, and seeking appropriate treatment at the right time can contribute to a successful recovery. Remember, always consult with a veterinarian for an accurate diagnosis and tailored treatment plan for your puppy.

With proper care and attention, Toby will overcome this fracture and get to back to life as normal. We wish Toby an uneventful recovery!

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