Tibial tuberosity avulsion

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The tibial tuberosity avulsion in children and adolescents is a partial tear of the tibia bulge ( tibial tuberosity ), possibly with involvement of the articular surface ( avulsion fracture ). In medicine, the term Avulsio stands for forceful tearing off.

The term tibial tuberosity avulsion is used synonymously in young domestic dogs with the term apophyseal necrosis of the tibial tuberosity for an aseptic disease of the bone . This leads to necrosis and often to detachment (avulsion) of the tibia bulge ( tibial tuberosity ). The disease is similar to Osgood-Schlatter's disease in humans and is also referred to as this in the specialist literature in dogs. Due to some differences, however, the term Osgood-Schlatter disease in dogs should be avoided.

Cause and occurrence

The cause of the disease differs from that of Osgood-Schlatter's disease. It is mainly associated with a steep angle of the tibial plateau (35–55 °). For Greyhounds a genetic predisposition is suspected, an osteochondrosis leads in this area. Frequently occurs, the disease also at Bull Terrier , American Pit Bull Terrier , Afghan , Irish Wolfhound , Borzoi and Rottweiler on. Similar to humans, however, traumatic influences can also lead to the detachment of the tibia.

The disease occurs in dogs according to Pfeil et al. (2009) mostly one-sided, according to Kása et al. (2006) often bilateral, albeit to different degrees. The incidence is 0.08%.

Symptoms and Diagnosis

Affected dogs lose their enjoyment of exercise and often show lameness in the affected limbs. Palpation of the anterior upper end of the tibia and flexion and extension of the knee joint are painful. Soft tissue swelling is only found occasionally.

The diagnosis is confirmed by an X-ray . The complete detachment of the tibia is typical. In contrast to Osgood-Schlatter's disease, there are no bony fragments in the attachment of the kneecap ligament . Using the classification by Pfeil et al. the following types can be distinguished:

  • Type I: Displacement of the tibia bulge by less than 2 mm and reduced apophyseal area
  • Type II: apophyseal fracture with displacement greater than 2 mm
  • Type III: apophysis widely displaced and elevation of the kneecap with step formation in the knee joint.

treatment

Conservative treatment with immobilization, cooling, and anti-inflammatory medication is only indicated for type I. More severe clinical pictures have to be treated osteosynthetically , whereby a wire tension belt is usually used. The prognosis is good.

literature

  • DJF Pfeil et al .: Does Osgood-Schlatter Diesease exist in the dogs? Review of human and canine literature and proposed classification system for tibial tuberosity avulsions in the immature dog. In: Vet. Comp. Orthop. Traumatol. 22 (2009), pp. 257-263.
  • Ferenc Kása et al .: Apophyseal necrosis of the tuberosity tibae (Schlatter-Osgood disease, English Osgood-Schlatter disease). In: PF Suter and B. Kohn (eds.): Internship at the dog clinic. Parey, 10th ed. 2006, pp. 969-970. ISBN 3-8304-4141-X