Risk Factors for Fibular Fracture after TPLO

Abstract

To determine (1) risk factors for fibular fracture after tibial plateau leveling osteotomy (TPLO) and (2) if a single postoperative radiographic measurement or measurement ratio of the proximal tibial fragment can be used as a predictor for fibular fracture. Multivariate retrospective clinical study. Dogs (n=326) with cranial cruciate ligament rupture that had TPLO (n=355). Medical records (January 2004-November 2007) and radiographs of dogs that had TPLO were reviewed. TPLO plate type, distance between tibial plateau and proximal screw, proximodistal tibial plateau fragment length, tibial plateau width, the presence of a fibular drill hole filled with a screw or not, and fibular fractures were recorded. The odds of having a fibular fracture were 10 times greater in dogs with a fibular drill hole than in dogs without a drill hole. The odds of having a fibular fracture were 1.46 times greater for every 4.5 g increase in body weight. Tibial plateau angle (TPA) at the time of reevaluation was larger than the postoperative TPA and TPA increase was larger in dogs with fibular drill holes than without (P<.01) and in dogs with fibular fractures than without (P<.01). An unfilled fibular drill hole and increased body weight are risk factors for fibular fracture.