Introduction: Transcortical tibial fractures (TCTFs) secondary to screw implantation have been
identified in a TPLO in vitro model and a clinical TPLO retrospective report. The
objectives of this study were to determine TCTF incidence in canine TPLOs using Arthrex
3.5 mm TPLO plates with self-tapping screws (STS) that were hand-driven or power-assisted,
identify the most common location for TCTFs, and assess complication development.
It was hypothesized that Arthrex 3.5 mm TPLO plates with STS have a lower incidence
of TCTFs than previously reported, and that hand-driven screws would have fewer incidences
of TCTFs than power-assisted insertions.
Materials and Methods: Two hundred TPLO cases were randomly selected from two speciality clinics. Postoperative
radiographs were assessed by a surgical intern and a board-certified veterinary radiologist
for evidence of TCTFs. TCTF-associated complications were evaluated.
Results: The power-assisted screws had twice as many TCTFs (n = 32) identified compared with hand-driven (n = 15). Within standard and small-sized plates, the odds of TCTF development were
significantly higher at the distal screw hole. Broad plates did not show any significance
for screw hole position. One patient (0.05%) had a minor complication due to screw
loosening at the proximal segment, no corrective surgical measures were taken in this
or any other case.
Discussion/Conclusion: Overall, our incidence of TCTFs in Arthrex 3.5 mm TPLO plates was lower when compared
with previous reports. TCTFs are commonly identified postoperatively but likely of
low clinical significance as they did not lead to additional intervention or failure
in this case series.
Acknowledgment
Two co-authors are consultants with Arthrex.
