🔍 Key Findings

• PTDO restored normal patellar tracking in 96% (51/53) of stifles, supporting its use for PL associated with abnormal tibial torsion.
• Clinical function was full in 72% and acceptable in 24%, giving a combined full/acceptable outcome in 96% of cases.
• External tibial torsion predominated in MPL: CT demonstrated a mean tibial torsion angle of 8.8° ± 4.7°, with external torsion identified in 22/23 CT-assessed MPL limbs.
• CT helps distinguish true tibial torsion from tibial tuberosity displacement: despite apparent medial tibial tuberosity positioning on caudocranial radiographs, mean CT tibial tuberosity location was central.
• PTDO corrects torsion by rotating the distal tibial fragment opposite the deformity; for external torsion, the distal fragment was internally rotated until appropriate pes–tibial tuberosity alignment was achieved.
• Radiographic union occurred at a mean of 2.7 ± 0.5 months, with relatively few bone-healing complications despite the unstable nature of the osteotomy.
• Overall complications occurred in 33% (18/53), including 11% major and 22% minor complications; PTDO failure, persistent PL, and DFO failure accounted for the major events.
• Rigid locking fixation is clinically important because detorsion creates cortical mismatch and poor bone-to-bone contact; the authors emphasize locking implants and accurate plate contouring for construct stability.