Figure 4.

Failure of a bridging plate construct used to treat an open comminuted right tibial diaphyseal fracture in an eight-year-old Labrador retriever (A,B). The fracture was stabilized with a 12-hole 3.5 mm DCP (AMI = 46.7 mm⁴) and 2 independent 2.4 mm lag screws with 10 cortices engaged above the fracture and 12 cortices below the fracture. Two independent 2.4 mm cortical screws were placed in lag fashion. Two holes over the fracture site were left empty and the fracture was grafted with autogenous cancellous bone graft from the right proximal tibia. Plate span was 72%. The dog was discharged without external coaptation. (C) Bending of the plate was found at the level of the fracture and empty screw holes at 2 weeks, causing tibial valgus. (D) The fracture construct was revised using an 8-hole 4.5 mm narrow limb-lengthening plate (AMI = 54.9 mm⁴) and the fracture was re-grafted with autogenous cancellous bone. (E) Implant removal was performed after clinical union.