Permanent Iatrogenic Fibular Nerve Injury following Tibial Plateau Levelling Osteotomy

Abstract

The aim of this study was to describe three dogs with permanent fibular nerve injury following tibial plateau levelling osteotomy (TPLO). Fibular nerve injury following TPLO led to atrophy of the cranial tibial muscle, absent hock flexion and a mild lameness. Fibular nerve injury was confirmed in one case with electrodiagnostics. All three cases had a drill tract in the same location, on the caudal aspect of the tibia, immediately distal to the tibial osteotomy. Permanent fibular nerve injury following TPLO occurred with a more caudally positioned plate and care should be taken when drilling the tibia from medial to lateral in the region described. Careful gait assessment at routine follow-up was required to identify this complication.

Keywords

fibular nerve injury - peroneal nerve - TPLO

Authors' Contributions

O.A. contributed to the study design, acquisition and interpretation of data, drafting and revising the manuscript and approval of the submitted version. S.M. helped in the acquisition and interpretation of data, drafting and revising the manuscript and approval of the submitted version. D.C. was involved in the study conception, study design, acquisition and interpretation of data, drafting and revising the manuscript and approval of the submitted version. K.P. contributed to the study conception, study design, acquisition and interpretation of data, drafting and revising the manuscript and approval of the submitted version.

Publication History

Received: 28 July 2023

Accepted: 13 February 2024

Article published online:
06 March 2024

• References

• 1 Slocum B, Slocum TD. Tibial plateau leveling osteotomy for repair of cranial cruciate ligament rupture in the canine. Vet Clin North Am Small Anim Pract 1993; 23 (04) 777-795
• 2 Pacchiana PD, Morris E, Gillings SL, Jessen CR, Lipowitz AJ. Surgical and postoperative complications associated with tibial plateau leveling osteotomy in dogs with cranial cruciate ligament rupture: 397 cases (1998-2001). J Am Vet Med Assoc 2003; 222 (02) 184-193
• 3 Coletti TJ, Anderson M, Gorse MJ, Madsen R. Complications associated with tibial plateau leveling osteotomy: a retrospective of 1519 procedures. Can Vet J 2014; 55 (03) 249-254
• 4 Priddy II NH, Tomlinson JL, Dodam JR, Hornbostel JE. Complications with and owner assessment of the outcome of tibial plateau leveling osteotomy for treatment of cranial cruciate ligament rupture in dogs: 193 cases (1997-2001). J Am Vet Med Assoc 2003; 222 (12) 1726-1732
• 5 Gatineau M, Dupuis J, Planté J, Moreau M. Retrospective study of 476 tibial plateau levelling osteotomy procedures. Rate of subsequent ‘pivot shift’, meniscal tear and other complications. Vet Comp Orthop Traumatol 2011; 24 (05) 333-341
• 6 Fitzpatrick N, Solano MA. Predictive variables for complications after TPLO with stifle inspection by arthrotomy in 1000 consecutive dogs. Vet Surg 2010; 39 (04) 460-474
• 7 Carey K, Aiken SW, DiResta GR, Herr LG, Monette S. Radiographic and clinical changes of the patellar tendon after tibial plateau leveling osteotomy 94 cases (2000-2003). Vet Comp Orthop Traumatol 2005; 18 (04) 235-242
• 8 Forterre F, Tomek A, Rytz U, Brunnberg L, Jaggy A, Spreng D. Iatrogenic sciatic nerve injury in eighteen dogs and nine cats (1997-2006). Vet Surg 2007; 36 (05) 464-471
• 9 Evans HE, Miller ME. Miller's Anatomy of the Dog. 3rd edition.. Missouri, United States: W.B. Saunders; 1993
• 10 Hoerlein BF. Canine Neurology: Diagnosis and Treatment. Missouri, United States: W.B. Saunders; 1965: 81
• 11 Vettorato E, Bradbrook C, Gurney M, Aprea F, Clark L, Corletto F. Peripheral nerve blocks of the pelvic limb in dogs: a retrospective clinical study. Vet Comp Orthop Traumatol 2012; 25 (04) 314-320