Quiz Question

In Planchamp 2022 et al., on imaging-based AAI diagnosis, what was the cutoff value of the VCI in dogs imaged in flexion?

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Correct. VCI ≥0.20 in flexion yielded 100% sensitivity and 96.67% specificity for diagnosing AAI.
Incorrect. The correct answer is ≥0.20.
VCI ≥0.20 in flexion yielded 100% sensitivity and 96.67% specificity for diagnosing AAI.

🔍 Key Findings

  • Ventral Compression Index (VCI) ≥0.16 (extension) or ≥0.2 (flexion) was diagnostic for AAI with 100% sensitivity and >94% specificity
  • VCI had the highest diagnostic accuracy among all measured variables (AUC > 0.99)
  • C1-C2 overlap ≤2.7 mm (extension) or ≤1.8 mm (flexion) also diagnostic for AAI (sensitivity 84–96%, specificity 81–90%)
  • C1-C2 angle ≥176.9° (extension) or ≥187.4° (flexion) had high sensitivity and specificity (~95%)
  • Basion-dens interval ≥5.9 mm (extension) or ≥3.0 mm (flexion) provided moderate diagnostic accuracy
  • Cranial translation ratio (CTR) ≥0.18 classified dogs as potentially unstable (sensitivity 90%, specificity 78%)
  • VCI ≥0.23 reliably differentiated AAI from potentially unstable cases (sensitivity 94%, specificity 94%)
  • DALR ≤0.24 had high specificity (100%) but low sensitivity for AAI diagnosis

Planchamp

Veterinary Surgery

4

2022

Determination of cutoff values on computed tomography and magnetic resonance images for the diagnosis of atlantoaxial instability in small-breed dogs

2022-4-VS-planchamp-2

Article Title: Determination of cutoff values on computed tomography and magnetic resonance images for the diagnosis of atlantoaxial instability in small-breed dogs

Journal: Veterinary Surgery

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In Story 2024 et al., on surgical correction of excessive tibial plateau angle (eTPA), which group showed significant tibial shortening compared to others?

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Correct. Group B (TPLO + CCWO) was the only group that resulted in tibial shortening relative to baseline length.
Incorrect. The correct answer is TPLO + CCWO.
Group B (TPLO + CCWO) was the only group that resulted in tibial shortening relative to baseline length.

🔍 Key Findings

  • All four techniques achieved TPA <14°, meeting the threshold for acceptable surgical correction in eTPA cases.
  • Group A (CBLO + CCWO) and Group D (PTNWO) showed highest accuracy in achieving target TPA values.
  • Group B (TPLO + CCWO) resulted in significant tibial shortening compared to other techniques.
  • Group A caused the greatest cranial mechanical axis shift, while Group B caused the least.
  • Group C (mCCWO) resulted in consistent under-correction of TPA, despite aiming for 0°.
  • Modified or neutral wedge osteotomies (Groups C and D) had minimal effect on tibial length, making them suitable when preservation is important.
  • All techniques involved mechanical axis shifts, highlighting the importance of preoperative planning to minimize morphologic disruption.
  • Supplemental fixation was standard for all procedures to reduce risks such as tibial tuberosity fracture and plateau leveling loss.

Story

Veterinary Surgery

8

2024

Morphologic impact of four surgical techniques to correct excessive tibial plateau angle in dogs: A theoretical radiographic analysis

2024-8-VS-story-2

Article Title: Morphologic impact of four surgical techniques to correct excessive tibial plateau angle in dogs: A theoretical radiographic analysis

Journal: Veterinary Surgery

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In Pfeil 2024 et al., on fluoroscopic pinning, what was the median time to radiographic bone union?

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Correct. Median healing time was 6 weeks, with a range of 4–12 weeks.
Incorrect. The correct answer is 6 weeks.
Median healing time was 6 weeks, with a range of 4–12 weeks.

🔍 Key Findings

  • Fluoroscopically guided normograde metabone pinning (FGNMP) was used to treat 17 animals (15 dogs and 2 cats) with 57 metabone fractures, including various fracture configurations (short-oblique body, physeal, and comminuted).
  • All 57 fractures were stabilized using intramedullary pins via FGNMP. The study exclusively focused on pin fixation and did not include screws or combined fixation techniques.
  • Median surgical time was 54 minutes (range 26–99 min), indicating efficient procedural execution.
  • Radiographic bone union was achieved in all fractures, with a median time to union of 6 weeks (range 4–12 weeks). Union was confirmed in all initially non-united fractures on follow-up.
  • No major complications were reported. A single pressure sore at the olecranon resolved uneventfully, and no pin migration or osteomyelitis was observed.
  • Pin extensions were noted radiographically (e.g., 42% distal subchondral overextension), but were not associated with clinical problems.
  • Fluoroscopic guidance improved implant accuracy and preserved soft tissue, enabling effective fracture alignment and stabilization using this minimally invasive osteosynthesis (MIO) approach.
  • The authors concluded that FGNMP is an effective, safe, and minimally invasive method for a variety of metabone fracture types, yielding quick recovery, fast healing, and good to excellent long-term functional outcomes in all 17 cases.

Pfeil

Veterinary Surgery

5

2024

Outcomes of 15 dogs and two cats with metabone fractures treated with fluoroscopically guided normograde metabone pinning

2024-5-VS-pfeil-2

Article Title: Outcomes of 15 dogs and two cats with metabone fractures treated with fluoroscopically guided normograde metabone pinning

Journal: Veterinary Surgery

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In Sadowitz 2023 et al., on screw angle & speed, which group served as the control group with 0% TCF rate?

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Correct. Group A served as the control and had zero TCFs, highlighting the safety of coaxial low-speed screw insertion.
Incorrect. The correct answer is Group A (0° at 650 rpm).
Group A served as the control and had zero TCFs, highlighting the safety of coaxial low-speed screw insertion.

2023-8-VS-sadowitz-2

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In Story 2024 et al., on eTPA osteotomy comparison, which technique resulted in the **greatest mechanical axis shift**?

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Correct. Group A (CBLO + CCWO) caused the largest change in mechanical cranial distal tibial angle (mCrDTA), indicating the most mechanical axis shift.
Incorrect. The correct answer is CBLO + CCWO.
Group A (CBLO + CCWO) caused the largest change in mechanical cranial distal tibial angle (mCrDTA), indicating the most mechanical axis shift.

🔍 Key Findings

  • Population: 16 dogs (27 tibias), TPA >34°
  • Techniques analyzed:
    • Group A: CBLO + CCWO
    • Group B: TPLO + CCWO
    • Group C: mCCWO
    • Group D: PTNWO
  • Outcomes:
    • All groups achieved post-correction TPA < 14°.
    • Group A: Slight over-correction (mean TPA 10.47°); greatest mechanical axis shift.
    • Group B: Tibial shortening (~0.58%); least mechanical axis shift.
    • Group C: Lowest post-correction TPA (mean 4.76°); under-correction.
    • Group D: High accuracy, minimal shortening (mean 7.09° post).
  • Statistical Significance:
    • Significant differences in tibial length change and mCrDTA (mechanical axis shift) between groups (p <.05).
    • TPA correction accuracy: Group A (1.02), B (0.95), C (0.89), D (0.98).

Story

Veterinary Surgery

1

2024

Morphologic impact of four surgical techniques to correct excessive tibial plateau angle in dogs: A theoretical radiographic analysis

2024-1-VS-story-1

Article Title: Morphologic impact of four surgical techniques to correct excessive tibial plateau angle in dogs: A theoretical radiographic analysis

Journal: Veterinary Surgery

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In Pfund 2025 et al., on femoral cortical thickness, what was the observed effect of a 0.001 increase in CTI on fracture risk?

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Correct. Each 0.001 increase in CTI reduced fissure/fracture odds by 2–3% depending on timing.
Incorrect. The correct answer is Decreased risk by 2–3%.
Each 0.001 increase in CTI reduced fissure/fracture odds by 2–3% depending on timing.

🔍 Key Findings

  • Lower CTI values were significantly associated with higher risk of both intraoperative and postoperative femoral fractures or fissures (p <.0001).
  • The mean CTI for all dogs was 0.285, whereas dogs with fissures/fractures had a mean CTI of 0.246.
  • For each 0.001 increase in CTI, odds of fissure/fracture decreased by 2–3% depending on perioperative timing.
  • High interobserver reliability (ICC = 0.984) and consistency between pre- and postoperative CTI measurements (ICC = 0.96).
  • CTI was the only significant risk factor identified; age, breed, bodyweight, BCS, CFI, or luxoid hips were not significant.
  • Prophylactic lateral plating in dogs with low CTI (mean 0.230) resulted in no postoperative fractures.
  • Postoperative fractures occurred in 8% of cases, and 93% of dogs returned to full function within one year.
  • CTI may be a useful radiographic screening tool, especially when advanced imaging (e.g., DEXA) is unavailable.

Pfund

Veterinary Surgery

6

2025

Femoral cortical thickness index in a population of dogs undergoing total hip replacement

2025-6-VS-pfund-3

Article Title: Femoral cortical thickness index in a population of dogs undergoing total hip replacement

Journal: Veterinary Surgery

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In Jourdain 2024 et al., on fluoroscopic fixation of feline SIL, what percentage of screws had ≥60% purchase within the sacral body?

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Correct. 14 of 17 screw placements (82%) had ≥60% purchase within the sacral body, a threshold for biomechanical stability.
Incorrect. The correct answer is 82%.
14 of 17 screw placements (82%) had ≥60% purchase within the sacral body, a threshold for biomechanical stability.

🔍 Key Findings

  • Minimally invasive fluoroscopic technique yielded median reduction of 94.1% immediately postoperative.
  • Screw purchase ≥60% in sacral body achieved in 82% of cases, with median purchase of 73.3%.
  • One screw exited caudally; no dorsal, ventral, or cranial exits reported.
  • At 7-week follow-up, reduction and purchase slightly declined but remained effective (p = .008 and p = .013).
  • No screw loosening observed, even in suboptimal reductions or purchases.
  • Pelvic canal width and symmetry (PCDR and HCWR) were restored and maintained.
  • Excellent long-term function: FMPI ≥0.98 in 9 of 10 cats; owners reported 10/10 satisfaction.
  • Fluoroscopy enabled accurate screw placement and minimized tissue trauma, contributing to rapid recovery.

Jourdain

Veterinary Surgery

4

2024

Fluoroscopically-assisted closed reduction and percutaneous fixation of sacroiliac luxations in cats using 2.4 mm headless cannulated compression screws: Description, evaluation and clinical outcome

2024-4-VS-jourdain-2

Article Title: Fluoroscopically-assisted closed reduction and percutaneous fixation of sacroiliac luxations in cats using 2.4 mm headless cannulated compression screws: Description, evaluation and clinical outcome

Journal: Veterinary Surgery

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In Scheuermann 2023 et al., on femoral MIPO alignment, which reduction system resulted in longer surgical times?

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Correct. FRS procedures were significantly longer than IMP (median 43 vs 29 min; P = .011).
Incorrect. The correct answer is Fracture Reduction System (FRS).
FRS procedures were significantly longer than IMP (median 43 vs 29 min; P = .011).

🔍 Key Findings

  • Precontoured plates using 3D-printed femoral models achieved near-anatomic alignment in all cadaver limbs.
  • Fracture reduction system (FRS) required significantly fewer fluoroscopy images than intramedullary pin (IMP) methods (7 vs 26, P = .001).
  • Despite longer surgical time (43 vs 29 minutes, P = .011), FRS showed equally accurate or better alignment compared to IMP.
  • Femoral length, frontal, sagittal, and axial alignment were all within near-anatomic thresholds (<10 mm or <5° deviation) in both groups.
  • FRS was associated with more consistent length maintenance, with IMP showing a median shortening of 2.3 mm (P = .03).
  • Axial plane deviation was statistically different in the FRS group (P = .04), but still clinically acceptable.
  • Study highlights potential for custom 3D-printed guides to reduce radiation exposure and improve precision in MIPO procedures.
  • Authors caution that FRS was time-consuming and cumbersome, suggesting design refinements needed for clinical use.

Scheuermann

Veterinary Surgery

6

2023

Minimally invasive plate osteosynthesis of femoral fractures with 3D‐printed bone models and custom surgical guides: A cadaveric study in dogs

2023-6-VS-scheuermann-2-0341d

Article Title: Minimally invasive plate osteosynthesis of femoral fractures with 3D‐printed bone models and custom surgical guides: A cadaveric study in dogs

Journal: Veterinary Surgery

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In Turner 2025 et al., on TPA changes after SH-1/2 fracture repair, what was the average decrease in tibial plateau angle between injury and first reevaluation?

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Correct. The study found a mean decrease of 5.89° from injury to first reevaluation (p < 0.001).
Incorrect. The correct answer is 5.9°.
The study found a mean decrease of 5.89° from injury to first reevaluation (p < 0.001).

🔍 Key Findings

  • TPA decreased significantly from preoperative to follow-up (mean 5.89°; p < 0.001), and from immediate postoperative to follow-up (mean 2.2°; p = 0.018)
  • Use of tension band in addition to K-wires did not significantly improve TPA reduction compared to K-wires alone
  • Cranial K-wire positioning may attenuate growth at the cranial tibial physis, allowing relative caudal growth to reduce TPA over time
  • Dynamic TPA reduction may reduce risk of cranial cruciate ligament rupture even when initial TPA is high
  • Small breeds (e.g., French Bulldogs) were overrepresented; further research is needed in larger breeds with more growth potential
  • Surgical reduction is difficult, but perfect alignment may not be essential if TPA reduces postoperatively
  • Radiographic TPA measurement was reliably performed with low interobserver variability
  • K-wire removal at 3–8 weeks may facilitate continued growth in growing dogs

Turner

Veterinary and Comparative Orthopaedics and Traumatology

5

2025

Tibial Plateau Angle Changes following Repair of Salter–Harris Type 1 and 2 Fractures in Dogs

2025-5-VCOT-turner-1

Article Title: Tibial Plateau Angle Changes following Repair of Salter–Harris Type 1 and 2 Fractures in Dogs

Journal: Veterinary and Comparative Orthopaedics and Traumatology

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In Peterson 2022 et al., on crescent guide in TPLO, what is a noted **limitation** of the crescent guide compared to a standard TPLO jig?

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Correct. Unlike a TPLO jig, the crescent guide does not provide fragment stability or assist with plateau rotation.
Incorrect. The correct answer is It does not aid in fragment stabilization or rotation.
Unlike a TPLO jig, the crescent guide does not provide fragment stability or assist with plateau rotation.

🔍 Key Findings

  • Crescent guide use resulted in significantly less medial cortical damage (mean 3.8 mm²) than the radial saw guide (35.7 mm²) and standard jig (51.3 mm²) in bone models.
  • No significant difference in osteotomy accuracy (distance of eccentricity, coronal or axial angulation) among crescent guide, radial guide, or standard jig in either bone models or cadavers.
  • Device application time was shortest with the crescent guide and longest for the radial saw guide.
  • Osteotomy time was fastest with the crescent guide compared to the radial saw guide (P = .015).
  • Participants rated the crescent guide easier to apply than both the radial saw guide (P < .005) and the standard jig (P = .015).
  • 5 of 6 novice participants preferred the crescent guide over the other devices for performing TPLO.
  • Subjective ease of osteotomy performance was higher with the crescent guide vs. radial guide (P < .001).
  • Crescent guide does not assist in fragment stabilization or plateau rotation unlike a standard TPLO jig.

Peterson

Veterinary Surgery

3

2022

Evaluation of a crescent saw guide for tibial plateau‐leveling osteotomy: An ex vivo study

2022-3-VS-peterson-5

Article Title: Evaluation of a crescent saw guide for tibial plateau‐leveling osteotomy: An ex vivo study

Journal: Veterinary Surgery

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Quiz Results

Topic: Fracture Management
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