Avulsion of origin CCL in a 12 week old puppy

Re: Avulsion of origin CCL in a 12 week old puppy

Malcolm Ness — Mon, 03 Nov 2014 15:04:24 GMT

I would leave this alone, at least in the first instance. NSAIDs and normal activity - there is nothing to be gained from resting this dog.

The injury is almost certainly an avulsion of the insertion rather than the origin of the CCL - i.e. the tibial attachment. There is nothing to be gained from removing the fragment or debriding the ligament. It is tempting to consider re-attaching the fragment but it is too small to allow a mechanically competent repair.

Even without a stable joint, the dog may go on to do surprisingly well. However, lameness may persist and if that is the case, I would delay surgery for as long as practical (to get the dog as close to skeletal maturity as possible) before doing a mechanical modification procedure - tibial tuberosity advancement or tibial plateau levelling osteotomy.

Re: Avulsion of origin CCL in a 12 week old puppy

Malcolm Ness — Sun, 02 Nov 2014 16:40:50 GMT

[quote user="John Taylor"]

Not insured (typical!) - is this a surgical case, or is rest + nsaids indicated?

Thanks all!

[/quote]

What kind of dog s it?

Re: Avulsion of origin CCL in a 12 week old puppy

Martin Atkinson — Fri, 31 Oct 2014 15:18:42 GMT

I'm sure an othopod will be along soon but I would go in and remove the fragment and as much of the ACL stump as possible, hopefully no meniscal damage also in such a young dog, then do a lateral stabilisation suture.

Re: Avulsion of origin CCL in a 12 week old puppy

Anthony Dennison — Fri, 31 Oct 2014 12:53:12 GMT

Ah ok sorry, stupidly thought it was a bone fragment on palpation!

Re: Avulsion of origin CCL in a 12 week old puppy

John Taylor — Fri, 31 Oct 2014 12:35:34 GMT

I don't think so (the right doesn't have this fragment!):

Re: Avulsion of origin CCL in a 12 week old puppy

Anthony Dennison — Fri, 31 Oct 2014 12:10:46 GMT

Is it definitely that or could it be a fracture of the tibial crest growth plate?