Objective The aim of this study was to report the clinical experience with fluoroscopically guided tibial apophyseal percutaneous pinning (TAPP) for tibial tuberosity avulsion fractures (TTAF).

Study Design This is a retrospective case series.

Materials and Methods Medical records of skeletally immature dogs (n = 25) were reviewed. The association of pin design [smooth (SP); negatively threaded (NTP)], pin insertion angles, TTAF-type, age and breed with various outcome variables was statistically evaluated. Long-term follow-up was assessed via direct examination, radiographs, questionnaires and videos.

Results Mean age, weight and surgery times were 6.2 months, 9.6 kg and 21 minutes respectively. No major complications occurred among the 19 SP and 6 NTP; no pin broke. Seromas and patellar desmitis rates were higher with SP (11/19; 16/19) versus NTP (0/6; 2/6) (p = 0.02; 0.03). The median horizontal pin cross angles for cases without and with desmitis were 40 and 26 degrees respectively (p = 0.047). Explantation was needed in 5/19 SP and 0/6 NTP cases. The mean tibial plateau angle (TPA) changed significantly between initial (25.6 degrees) and follow-up (18.8 degrees) radiographs (p = 0.0002). Long-term outcome, obtained at a mean of 19.9 months, was excellent in all cases.

Conclusion Tibial apophyseal percutaneous pinning can be considered to treat TTAF. Divergent pin placement and using NTP might reduce complications. Tibial plateau angle should be monitored until skeletal maturity has been reached. Long-term outcome post TAPP can be expected to be excellent.

目的 本研究的目的是报告透视引导下胫骨骨突经皮钉扎术（TAPP）治疗胫骨结节撕脱骨折（TTAF）的临床经验。

研究设计 这是一个回顾性病例系列。

材料和方法 回顾 了骨骼未成熟犬（n = 25）的医疗记录。针脚设计的联想【smooth(SP); 负螺纹 (NTP)]、针插入角度、TTAF 类型、年龄和品种与各种结果变量进行了统计评估。长期随访通过直接检查、X光片、问卷和视频进行评估。

结果 平均年龄、体重和手术时间分别为 6.2 个月、9.6 公斤和 21 分钟。19例SP和6例NTP未发生重大并发症；没有针坏了。SP (11/19; 16/19) 与 NTP (0/6; 2/6) ( p  = 0.02; 0.03)相比，血清肿和髌骨韧带炎发生率更高。无结膜炎病例和有结膜炎病例的中位水平销交叉角分别为 40 度和 26 度（p  = 0.047）。5/19 SP 和 0/6 NTP 病例需要外植。平均胫骨平台角 (TPA) 在初始 (25.6 度) 和后续 (18.8 度) 射线照片之间显着变化 ( p  = 0.0002)。在平均 19.9 个月时获得的长期结果在所有情况下都非常好。

结论 胫骨骨突经皮穿刺可考虑治疗TTAF。不同的引脚放置和使用 NTP 可能会减少并发症。应监测胫骨平台角直至骨骼成熟。预计 TAPP 后的长期结果会非常好。