This week’s case is a 2-year-old female Golden Retriever that jumped to catch a ball and became non-weight bearing lame on the left pelvic limb. How would you describe this fracture?
Initial images: There is a spiral fracture of the distal tibial diaphysis with slight proximal and caudal displacement. There is soft tissue swelling surrounding the fracture site. A fissure line is visible in the proximal tibia running to the epiphysis. There is a large butterfly fragment. There is also a fracture with mild comminution through the mid diaphysis of the left fibula.
2 month recheck: . On today’s exam, the surgical implants are static in location. There is a slight periapical lucency surrounding the tip of the second most distal screw. There is moderate bony callus formation surrounding the tibial fracture site and the previously described fracture lines are increasingly indistinct. There is also moderate focal bony callus formation surrounding the fibular fracture. The previously described small mineral fragment distal to the medial malleolus is unchanged.
Tibial and fibular fractures.
2 month recheck: Healing fractures of the left tibia and fibula. Static surgical implants. The slight periapical lucency surrounding the second most distal screw tip may represent evidence of motion or surgery induced necrosis. An infection is thought less likely given the lack of soft tissue swelling.
The postop radiographs are two months after internal fixation. There is excellent healing with smooth callus.