Page 342 - Canine Lameness

314 19 Stifle Region

19.3 Fractures of the Stifle Region

Fractures of the stifle joint region are common and include fractures of the distal femur, proximal
tibia/fibula, and patella. Mature animals most commonly sustain fractures of the diaphyseal area.
These fractures are easily identified radiographically, and treatment frequently requires surgical
intervention, particularly if substantial displacement is present. Fractures involving the articular
surface (Figure 19.3) are rare but are likely to result in osteoarthritis. These fractures also have the
potential to cause meniscal and cruciate ligament damage. As the stifle joint has a voluminous
outpouching at the distal femur, even distal femur fractures have the potential to affect the stifle
joint. Patellar fractures and fractures of the tibial tuberosity affect the quadriceps mechanism and
may make weight-bearing impossible. Inappropriate healing (e.g. malunion) of fractures affecting
the stifle region (in particular tibial tuberosity and distal femur fractures) can affect the
quadriceps-patellar mechanism and thereby may result in secondary patellar luxation. This should
be considered when making treatment decisions during initial presentation.
Fractures of the stifle region are frequently caused by severe trauma including vehicular collisions,
gunshot, kicks, etc. Therefore, careful evaluation of the entire patient for concomitant non-orthopedic

STIFLE REGION (A) (C) (E) (G)

(B) (D) (F) (H)

Figure 19.3 Examples of stifle region fractures in four patients. Patient I (A, B) severely displaced SH Type I
fracture of the distal femur. Note the typical configuration of the distal femoral physis (white arrows).
Patient II (C, D) moderately displaced articular fracture of the proximal tibia in a mature patient. These
fractures are rare but require precise reconstruction since due to their disruption of the articular surface.
Patient III (E, F) comminuted fracture of the patella (white arrows). Patient IV (G, H) comminuted, SH Type IV
fracture of the distal femur. The white arrow indicates the articular component of the fracture, which is
important to recognize per-operatively.