Tibial crest physeal fractures

Tibial crest fractures are diagnosed in foals and adult horses and can occur from trauma to the stifle or from hyperextension and avulsion of the tibial crest during exercise.
In foals tibial crest fractures may be associated with Salter-Harris Type II fractures of the proximal tibia.
Clinical signs vary from mild to severe lameness depending on the size and degree of displacement of the fragment.
Smaller minimally displaced fractures can show mild lameness and typically have no joint effusion.
Large and complete avulsions of the tibial crest are characterized by an inability to fix the stifle.

Tibial crest fracture in a 30 day old Thoroughbred mare.

Tibial fractures usually develop as a result of trauma, such as kicks or falls. The exception to this are tibial stress fractures, which are an accumulation of cyclic loading and bone fatigue.

The most common types of tibial fractures are:

1. Salter Harris Type II
2. Tibial crest fractures
3. Simple diaphyseal fractures
4. Comminuted diaphyseal fractures
5. Diaphyseal stress fractures
6. Medial malleolus fractures
7. Lateral malleolus fractures
8. Distal physeal fractures

Radiography provides the most meaningful information as to location and configuration of the fracture(s).
In most cases 4 views at 45 degree intervals provide adequate information for an exact diagnosis. For the evaluation of the proximal tibia typically a lateromedial and a caudocranial projection each is enough.
Nuclear scintigraphy is useful in the identification of tibial stress fractures, which may be radiographically inapparent.