Anatomical and topographic substantiation of various accesses to the proximal epiphysis of the tibia

Abstract

One of the most frequently performed accesses in the practice of an orthopedic veterinarian is access to the proximal epiphysis of the tibia. Access to the proximal epiphysis of the tibia is necessary in many cases of treatment of pathologies of the musculoskeletal system in cats and dogs and can be used in such surgical pathologies. The aim of the study was to consider options for surgical access to the proximal epiphysis of the tibia to perform osteosynthesis of fractures according to the Salter–Harris type, and osteotomy leveling the slope of the tibial plateau (TPLO) with anatomical and topographic justification. The study was conducted in the Network of veterinary centers "Kotonai" and the Department of Animal Anatomy of the St. Petersburg State University of Veterinary Medicine. The object of the study was dogs of small and medium breeds in the number of twelve individuals. The average age of the patients ranged from 6 months to 12 years. The study involved 5 intact females and 7 intact males. The average weight at the time of the study ranged from 2.5 to 21.0 kg. In the process of collecting the life history of all patients, the presence of chronic diseases, allergies and infectious diseases is excluded. The initial examination of the animal included: collection of anamneses of life and illness, general clinical examination, thermometry, neuroorthopedic examination, auscultation of the heart and lungs, X-ray examination under sedation. General clinical examination, thermometry and auscultation of the heart and lungs did not reveal pathological changes in all cases. According to the results of the study, it was found that there were no severe postoperative complications requiring repeated treatment in the studied patients. With the observance of clear anatomical and topographic landmarks in the formation of accesses, a good understanding of the anatomy of the medial and cranial surfaces of the tibia, visualization in the wound during surgical interventions (osteosynthesis of SalterHarris fractures, TPLO osteotomy) in the area of the proximal epiphysis of the tibia is convenient and safe.