Patellar fracture and patellar tendon rupture in a dog
The case of a patellar fracture in a 2-year-old male Chow Chow dog was reported. Clinical examination showed a few superficial wounds, erythema, a slight edema on the lateral aspect of the knee joint, and mild to moderate limping in the right hind leg. The patella was palpated more proximally than expected, while an acute ridge was felt at its distal pole. X-ray examination indicated that it had been fractured into 3 fragments. Following routine surgical preparation and inhalation anesthesia, the right knee joint was accessed through a lateral parapatellar incision. Spongious bone tissue was visible in the articular space due to erosion and loss of both femoral condylar cartilages. Small pieces, which made up the distal fragment, were excised, being considered inadequate for reconstruction. A transverse hole was drilled in the tibial crest, cerclage wire was looped over the proximal patella and led through the mentioned hole and stretched adequately to allow tension-free suturing of the ruptured ends of the patellar tendon, and the wire ends were then secured by a knot. Another thicker cerclage wire was led successively through the quadriceps tendon, the patellar ligament, and the already mentioned hole in the tibial crest and fixed. In conclusion, the removal of smaller fragments from a patellar fracture does not seem to impair articular movement. A patellar tendon rupture can be successfully repaired by the method described here.
Patellar fracture and patellar tendon rupture in a dog
The case of a patellar fracture in a 2-year-old male Chow Chow dog was reported. Clinical examination showed a few superficial wounds, erythema, a slight edema on the lateral aspect of the knee joint, and mild to moderate limping in the right hind leg. The patella was palpated more proximally than expected, while an acute ridge was felt at its distal pole. X-ray examination indicated that it had been fractured into 3 fragments. Following routine surgical preparation and inhalation anesthesia, the right knee joint was accessed through a lateral parapatellar incision. Spongious bone tissue was visible in the articular space due to erosion and loss of both femoral condylar cartilages. Small pieces, which made up the distal fragment, were excised, being considered inadequate for reconstruction. A transverse hole was drilled in the tibial crest, cerclage wire was looped over the proximal patella and led through the mentioned hole and stretched adequately to allow tension-free suturing of the ruptured ends of the patellar tendon, and the wire ends were then secured by a knot. Another thicker cerclage wire was led successively through the quadriceps tendon, the patellar ligament, and the already mentioned hole in the tibial crest and fixed. In conclusion, the removal of smaller fragments from a patellar fracture does not seem to impair articular movement. A patellar tendon rupture can be successfully repaired by the method described here.
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- Brinker, O.W., Piermettei, D.L., Flo, G.L.: Handbook of Small Animal Orthopedics and Fracture Treatment. 2nd ed., W.B. Saunders Company, Philadelphia, USA. 1990; 134–138.
- Vasseur, P.B.: Stifle Joint. In: Slatter, D., Ed. Textbook of Small Animal Surgery. 3rd ed., Saunders, Philadelphia, USA. 2003; 2126–2128.
- Wright, R.P.: Surgical repair of a comminuted patellar fracture in a dog. Vet. Med. Small Anim. Clin., 1983; 78: 511–517.
- Kılıç, E., Özaydın, İ.: Repairing of the experimentally induced patellar avulsion of the patellar ligament with stainless steel and PDS-II (Polydioxanon in dogs). Kafkas Üniv. Vet. Fak. Derg., 1999; 5: 179–188. (Original in Turkish).
- Yücel, R.: Veterinary Special Surgery. Pethask, Kocaeli, Turkey. 1992; 349–352. (Original in Turkish).
- Deny, H.R.: Surgery of the Stifle Joint: A Guide to Canine Orthopedic Surgery. 2nd ed. Blackwell Science Ltd., Oxford, UK. 1985; 238–255.
- Aslanbey, D.: Veterinary Orthopedics and Traumatology. Medisan, Ankara, Turkey. 1996; 164. (Original in Turkish).
- Yanık, K.: Orthopedics and Traumatology. Uludağ University Printing House, Bursa, Turkey. 2004; 220–223. (Original in Turkish).
- Newton, C.D.: Fractures of Small Bones. http://www.ivis.org/ special_books/ortho/chapter_33/ivis.pdf. Accessed: 31.10.2012.
- Anderson, J.: The Stifle. In: Houlton J.E.F., Collinsin R.W., Eds. Manual of Small Animal Arthrology. Iowa State University Press, USA. 1994; 289–297.
- Tomlinson, J.: Fractures of the Patella. In: Johnson, A.L., Houlton, J.E.F., Vannini, R., Eds. AO Principles of Fracture Management in the Dog and Cat. AO Publishing, Switzerland. 2005; 304–309.
- Betts, C.W., Walker, M.: Lag screw fixation of a patellar fracture. J. Small. Anim. Pract., 1975; 16: 21–25.
- White, R.A.: Bilateral patellar fracture in a dog. J. Small Anim. Pract., 1977; 18: 261–265.
- Alvarenga, J.: Patellar fracture in the dog. Mod. Vet. Pract., 1973; 54: 43–44.
- Dernell, W.S., Harari, J.: Surgical management of a comminuted patellar fracture and avulsion of the patella. Canine Practice, 1993; 18: 7–11.
- Deneuche, A., Moissonnier, P.: Bilateral patellar ligament rupture in a dog. Annales De Medicine Veterinarie, 2000; 144: 237–244.
- Langley-Hobbs, S.J.: Survey of 52 fractures of the patella in 34 cats. Vet. Rec., 2009; 164: 80–86.