Case 3 - Ralph

Tibial tuberosity avulsion fracture - FBD, 25-week-old, male entire

Ralph presented with non-weight-bearing lameness in his left pelvic limb following a jump over a baby gate. On examination, there was localized pain and inflammation over the tibial crest.

Lateral radiographs revealed a complete avulsion of the left tibial crest (Fig. 1), along with a mild lesion at the distal pole of the patella. For comparison, a lateral view of the right limb is included, demonstrating a normal appearance of the tibial crest growth plate (Fig. 2).

Surgical repair was performed using a medial approach to the proximal tibia. The avulsed tibial tuberosity fragment was identified, anatomically repositioned, and stabilized with two 1.2 mm Kirschner pins and a 1 mm tension band wire (Figs. 3 and 4).

At the first post-operative recheck (3 days), Ralph was already weight-bearing with moderate lameness, and the surgical wound demonstrated excellent early healing.

Six-week follow-up radiographs showed good ossification and healing of the fracture line, with progressive improvement also noted in the patellar avulsion lesion (Figs. 5 and 6).

Fig. 1

Fig. 2

Fig. 3

Fig. 4

Fig. 5

Fig. 6