Quiz Question

In Ferreira 2025 et al., on tibial torsion measurement, which population was primarily studied?

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Correct. The study focused on dogs with MPL, mostly from small breeds.
Incorrect. The correct answer is Small-breed dogs with MPL.
The study focused on dogs with MPL, mostly from small breeds.

🔍 Key Findings

Objective: Validate a new 3D CT-based method for measuring tibial torsion in dogs with MPL, comparing it to a traditional method.

Sample: 40 tibiae from client-owned dogs with MPL (primarily small-breed).

Repeatability (intraobserver):

  • New method: ICC = 0.99 → excellent agreement

Reproducibility (interobserver):

  • New method: ICC = 0.83 → high agreement
  • Traditional method: ICC = 0.52 → moderate agreement

Torsion angle measurements:

  • New method avg: 16.00° ± 8.77
  • Traditional method avg: 8.76° ± 4.92

Conclusion: The new method is more repeatable, reproducible, and provides higher torsion values than the traditional Aper method, especially reliable for small-breed dogs.

Ferreira

Veterinary Surgery

3

2025

Repeatability and reproducibility of a tomographic method for measuring tibial torsion in dogs with medial patellar luxation

2025-3-VS-ferreira-5

Article Title: Repeatability and reproducibility of a tomographic method for measuring tibial torsion in dogs with medial patellar luxation

Journal: Veterinary Surgery

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In Anderson 2023 et al., on French Bulldogs with humeral condylar fractures, which factor was **not significantly associated** with the presence of a contralateral HIF?

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Correct. HIF presence was not significantly more common in younger dogs (p = .129).
Incorrect. The correct answer is Younger age.
HIF presence was not significantly more common in younger dogs (p = .129).

🔍 Key Findings

  • Lateral humeral condylar fractures (LHCF) were most common, comprising 63.6% of cases.
  • Transcondylar screw (TCS) + K-wire(s) fixation had a 7.62x higher risk of major complications compared to other methods (p = .009).
  • All cases of TCS migration occurred in the TCS + K-wire group; none occurred with plate fixation.
  • Overall complication rate was 40.9%, with 29.5% being major and requiring intervention.
  • Contralateral humeral intracondylar fissures (HIF) were found in 58.1% of French Bulldogs with CT data.
  • No significant association between age and presence of HIF, but fissure length increased with age (R = 0.47, p = .048).
  • Younger, lighter dogs had higher complication and screw migration rates, possibly due to softer bone and smaller condyles.
  • TCS + plate fixation had the lowest complication rate, suggesting biomechanical superiority.

Anderson

Veterinary Surgery

1

2023

Humeral condylar fractures and fissures in the French bulldog

2023-1-VS-anderson-5

Article Title: Humeral condylar fractures and fissures in the French bulldog

Journal: Veterinary Surgery

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In Welsh 2023 et al., on TTAF fixation methods, what was the primary mechanical benefit of two-pin fixation over single-pin fixation?

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Correct. Two-pin fixation had significantly greater stiffness (72 N/mm) and strength (639 N) than single-pin fixation (57 N/mm and 426 N).
Incorrect. The correct answer is Improved stiffness and strength.
Two-pin fixation had significantly greater stiffness (72 N/mm) and strength (639 N) than single-pin fixation (57 N/mm and 426 N).

🔍 Key Findings

  • Two-pin fixation had significantly greater strength (639 N) than single-pin fixation (426 N) in TTAF models (p = .003).
  • Stiffness was also higher with two-pin constructs (72 N/mm vs 57 N/mm); statistically significant (p = .029).
  • Both fixation types withstood loads greater than quadriceps force in dogs at a walk (240 N), indicating clinical viability.
  • Failure was most commonly due to pin bending or pullout (82%), with fewer cases of ligament tearing or epiphyseal fracture.
  • K-wire insertion angle (KWIA) did not significantly differ between fixation types (p = .13).
  • Single larger pins delivered ~68% of the strength and ~83% of the stiffness of two smaller vertically aligned pins.
  • Clinical implication: Two vertically aligned pins are biomechanically superior for TTAF fixation in canine models.
  • Study used mature cadavers, which may underestimate loads and stiffness compared to immature clinical cases.

Welsh

Veterinary Surgery

5

2023

Biomechanical comparison of one pin versus two pin fixation in a canine tibial tuberosity avulsion fracture model

2023-5-VS-welsh-1

Article Title: Biomechanical comparison of one pin versus two pin fixation in a canine tibial tuberosity avulsion fracture model

Journal: Veterinary Surgery

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In Forzisi 2025 et al., on femoral growth post-THR, what hypothesis regarding trochanteric growth was supported?

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Correct. The 11.5% decrease in trochanteric growth supports the hypothesis that THR reduces growth in this region.
Incorrect. The correct answer is THR reduces trochanteric growth.
The 11.5% decrease in trochanteric growth supports the hypothesis that THR reduces growth in this region.

🔍 Key Findings

Population: 24 dogs (<8.5 months) undergoing unilateral cementless THR.
Growth Impact:

  • Operated femurs showed ~11.5% less trochanteric growth than controls (p = .002).
  • No significant difference in femoral diaphyseal + epiphyseal length (p = .712) or femur overall (p = .465).

Cortical Width:

  • Increased significantly at 10 mm distal to trochanter (4.6% increase, p = .037) and at 50% femoral length (8.5% increase, p = .030).

Clinical relevance: Despite measurable changes, no clinically significant impairment to femoral length occurred.
Effect Sizes:

  • Moderate negative for trochanteric growth.
  • Moderate positive for proximal femoral width.

Forzisi

Veterinary Surgery

1

2025

Evaluation of the effects of cementless total hip replacement on femoral length in skeletally immature dogs

2025-1-VS-forzisi-4

Article Title: Evaluation of the effects of cementless total hip replacement on femoral length in skeletally immature dogs

Journal: Veterinary Surgery

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In Banks 2024 et al., what patient factor was associated with higher preoperative and postoperative TPAs?

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Correct. Small dogs had significantly higher pre- and postoperative TPAs than large dogs.
Incorrect. The correct answer is Small body size.
Small dogs had significantly higher pre- and postoperative TPAs than large dogs.

🔍 Key Findings Summary

  • Study Design: Retrospective study of 100 radiographs using in silico and clinical data
  • Mean preoperative TPA: 28.6°, higher in small dogs than large (p = .02)
  • Mean planned TPA (in silico): 7.6°, not achieving 5° target (p < .01)
  • Median postoperative TPA: 5.5° overall; higher in small dogs (7°) vs large (4.5°) (p = .06)
  • Postoperative ostectomy position: More distal than recommended; average = 8.6 mm
  • Increased distalizationgreater under-correction of TPA (p = .01)
  • Most accurate correction occurred when ostectomy was ≤7.5 mm from patellar tendon
  • Wedge angle categories (TPA-Pre minus 5–2°) were used based on pre-op TPA

Banks

Veterinary Surgery

1

2024

A mismatch of planning and achieved tibial plateau angle in cranial closing wedge surgery: An in silico and clinical evaluation of 100 cases

2024-1-VS-banks-4

Article Title: A mismatch of planning and achieved tibial plateau angle in cranial closing wedge surgery: An in silico and clinical evaluation of 100 cases

Journal: Veterinary Surgery

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In Scheuermann 2023 et al., on MIPO with 3D-printed bone models, what postoperative alignment difference was noted in the FRS group compared to the virtual surgical plan?

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Correct. FRS use caused a small but significant increase in recurvatum (median 2.9°, *P = .03*).
Incorrect. The correct answer is Increased recurvatum.
FRS use caused a small but significant increase in recurvatum (median 2.9°, *P = .03*).

🔍 Key Findings

  • Precontoured plates based on 3D-printed femurs produced accurate femoral alignment (median deviations <3 mm or <3° in all planes).
  • Both fracture reduction system (FRS) and intramedullary pin (IMP) methods achieved near-anatomic alignment in cadaveric femoral fractures.
  • FRS required fewer fluoroscopic images (median 7 vs. 26, P = .001), but longer surgical time (median 43 vs. 29 min, P = .011).
  • Sagittal plane alignment: FRS led to mild increased recurvatum (median 2.9°), but still within near-anatomic limits (<5°).
  • Axial alignment: Both groups achieved near-anatomic torsion (<10°), though one IMP case had acceptable (not near-anatomic) alignment.
  • Custom drill guides and FRS improved fluoroscopy efficiency but were cumbersome and time-consuming to use. Authors do not recommend current prototype for clinical use.
  • Clinical significance: 3D printed models allow accurate precontouring, reducing intra-op plate adjustment; custom guides may reduce radiation exposure for the surgical team.

Scheuermann

Veterinary Surgery

7

2023

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

2023-7-VS-scheuermann-3

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 de Moya 2023 et al., on FGPP of femoral capital physeal/neck fractures, which factor was most associated with poor outcomes requiring salvage procedures?

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Correct. Dogs presenting >15 days post-injury with remodeling had higher risk of implant failure and malunion.
Incorrect. The correct answer is Chronicity with radiographic remodeling.
Dogs presenting >15 days post-injury with remodeling had higher risk of implant failure and malunion.

🔍 Key Findings

  • 11 dogs, 13 fractures (mostly Salter-Harris type I) were repaired with FGPP using Kirschner wires.
  • 10/13 fractures achieved satisfactory healing with good limb function at ~43 days median follow-up.
  • Major complications occurred in 5 dogs: intra-articular pin placement, implant migration (2), implant failure with nonunion, and malunion.
  • 2 dogs presenting >15 days post-injury with radiographic remodeling were poor candidates → higher risk of nonunion/malunion.
  • Preoperative displacement was mostly mild (10/13 fractures); these had better outcomes than chronic or severely displaced cases.
  • Median surgical time: 60 minutes (range 45–75), all performed percutaneously without conversion to open.
  • Elective pin removal was performed in 5 cases; migration occurred with both short and long cut wires.
  • Femoral neck resorption (“apple-coring”) was rare (2/10 healed cases) and thought to be less frequent than after ORIF due to reduced vascular disruption.

de Moya

Veterinary Surgery

7

2023

Closed reduction and fluoroscopic-guided percutaneous pinning of femoral capital physeal or neck fractures: Thirteen fractures in 11 dogs

2023-7-VS-demoya-2

Article Title: Closed reduction and fluoroscopic-guided percutaneous pinning of femoral capital physeal or neck fractures: Thirteen fractures in 11 dogs

Journal: Veterinary Surgery

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In Muroi 2025 et al., on refracture risk, what screw-to-bone diameter ratio (SBDR) is suggested as a **threshold** for increased refracture risk in growing dogs?

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Correct. An SBDR over 0.4 may weaken bone, especially when screws become relatively large due to growth.
Incorrect. The correct answer is >0.4.
An SBDR over 0.4 may weaken bone, especially when screws become relatively large due to growth.

🔍 Key Findings

  • Refracture occurred in 5.5% of limbs, with higher incidence in the plate removal group (12.5%) vs. non-removal (3.5%).
  • In the non-plate removal group, refractures occurred at the most distal screw site, linked to greater screw position change during growth (OR 1.79, p=0.04).
  • Screw-to-bone diameter ratio (SBDR) >0.4 was a significant risk factor for refracture in the plate retention group.
  • In the plate removal group, refractures occurred at the original fracture site, associated with lower pixel value ratio (bone mineral density) and reduced radial thickness.
  • Implant-induced osteoporosis (IIO) beneath the plate likely contributed to refracture risk after plate removal.
  • Younger age at fracture (<6 months) was associated with higher refracture risk due to ongoing radial growth and shifting screw position.
  • No significant association was found between refracture and plate type (locking vs conventional), fixation method, or ulnar union.
  • Recommendations include careful SBDR sizing, motion restriction, and cautious plate removal decisions in growing dogs.

Muroi

Veterinary and Comparative Orthopaedics and Traumatology

2

2025

A Retrospective Study of Risk Factors Associated with Refracture after Repair of Radial–Ulnar Fractures in Small-Breed Dogs

2025-2-VCOT-muroi-2

Article Title: A Retrospective Study of Risk Factors Associated with Refracture after Repair of Radial–Ulnar Fractures in Small-Breed Dogs

Journal: Veterinary and Comparative Orthopaedics and Traumatology

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In Isono 2025 et al., on tibial malalignment in MPL, which statistical trend was observed in toy poodles with grade 3 MPL?

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Correct. Toy poodles with grade 3 MPL had higher PTMTA than normals, indicating breed-specific severity.
Incorrect. The correct answer is Significantly higher PTMTA compared to normals.
Toy poodles with grade 3 MPL had higher PTMTA than normals, indicating breed-specific severity.

🔍 Key Findings

  • Proximal Tibia Metatarsal Angle (PTMTA) was significantly increased in dogs with grade 3 and 4 MPL, making it a useful marker for severity.
  • PTMTA strongly correlated with Tibial Torsion Angle (TTA) (r = 0.733) and Crural Rotation Angle (CRA) (r = 0.643), integrating multiple morphological deformities.
  • Grade 4 MPL cases showed significant internal tibial torsion, increased mMPTA, and decreased MDTT/PTW—indicating both rotation and medial displacement.
  • DTMTA was significantly more negative in grade 4, indicating a consistent pattern of internal foot rotation with disease severity.
  • PTMTA can be visually assessed during palpation, offering preoperative utility without CT.
  • Among toy poodles, PTMTA showed significant differences even between grades 3 and normal, suggesting breed-specific severity patterns.
  • Corrective osteotomy may need to address tibial as well as femoral deformities in severe MPL cases with high PTMTA.
  • Younger dogs with grade 4 MPL had more severe deformities, possibly due to early onset or developmental progression.

Isono

Veterinary and Comparative Orthopaedics and Traumatology

4

2025

Tibial Torsion Malalignment in Small Dogs with Medial Patellar Luxation

2025-4-VCOT-isono-4

Article Title: Tibial Torsion Malalignment in Small Dogs with Medial Patellar Luxation

Journal: Veterinary and Comparative Orthopaedics and Traumatology

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In Carrera 2024 et al., what was the average time to radiographic bone healing following early MPL surgery?

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Correct. Mean time to healing was 55 ± 24 days, consistent across osteotomy techniques:contentReference[oaicite:2]{index=2}
Incorrect. The correct answer is 55 days.
Mean time to healing was 55 ± 24 days, consistent across osteotomy techniques:contentReference[oaicite:2]{index=2}

🔍 Key Findings Summary

  • 5 juvenile dogs (mean age 7.2 months) with grade III–IV MPL were treated surgically.
  • Most had femoral varus + external tibial torsion; some had shallow trochlear grooves.
  • Distal femoral osteotomy was performed in 4/5 dogs; Tibial tuberosity transposition (TTT) in 3/5; Sulcoplasty in 2/5.
  • Mean time to weight bearing: 9.8 ± 5.5 days; healing: 55 ± 24 days
  • No reluxations, and final radiographic values for aLDFA and torsion were maintained at 1 year.
  • One complication due to domestic trauma, not surgical failure.
  • Early surgery appeared to preserve alignment and prevent deformity progression.

Carrera

Veterinary and Comparative Orthopedics and Traumatology

2

2024

Early Surgical Management of Medial Patellar Luxation in Juvenile Dogs

2024-2-VCOT-carrera-3

Article Title: Early Surgical Management of Medial Patellar Luxation in Juvenile Dogs

Journal: Veterinary and Comparative Orthopedics and Traumatology

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Quiz Results

Topic: Pediatrics & Growth Plate Considerations
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