Growth plate fractures, also known as Salter Harris type fractures, are a common cause of lameness seen in young dogs (under 8-12 months of age). The growth plate is a soft area of the bone that is responsible for the increase in the length and formation of bones. Since they are softer spots of the bone they are weaker then the remaining areas and can lead to fractures. Common places include the femoral head (ball of the hip joint), distal femur (above the knee joint), tibial tuberosity (front of the shin bone) and within the distal humerus (above the elbow). Surgery is typically recommended as the primary treatment option since these fractures are usually associated with the joints and can lead to angular deformities or chronic limping if they do not heal properly. The hope is that with surgery the fracture is repaired and some portion of the growth plate continues working, which allows for continued growth.
Last Friday Dr. Schlicksup saw two cases of tibial tuberosity growth plate fractures in a young Yorkie, Prada, and a young mixed breed, Guinness. In this specific type of fracture the patellar ligament (attached to the kneecap and quadriceps muscles) pull the tibial tuberosity (front of the shin bone) loose. In most cases it does not completely break free and instead only partially pulls loose. X-rays show an image of the normal growth plate at the front of Prada’s shin bone (figure 1) and the fractured growth plate in her and Guinness (figure 2 and 3). Surgery is performed to prevent the piece from breaking free completely, because once the tuberosity lifts up, it allows the kneecap to ride higher then normal and can lead to kneecap (patella) luxations. Both cases had surgery early Friday morning. The procedure takes a little over an hour and the fracture is repaired using stainless steel pins and wires (Figure 4) to form a tension band apparatus. Both Prada and Guinness recovered in ICU that night and were discharged early Saturday morning. Recovery is usually around one month at home and most dogs return to full function after the recovery. We wish both of them good luck in their recovery and we will see them in 2 weeks to remove the staples and in one month for follow-up x-rays.