Numerous approaches to the stifle joint have been described for therapy of bone and joint diseases. The ease of these techniques, the adequacy of their exposure, and the presence of the neurovascular plexus in the caudal region of the stifle joint make a caudal approach impractical for routine use. Diseases of the caudal compartment of the stifle joint or neuro-vascular plexus may, however, necessitate surgery in this region. In the case presented, development of an approach to the caudal region was necessary for diagnosis of a distal nerve sheath tumour of a branch of the tibial nerve.
Nerve sheath tumours in the dog occur most commonly in the brachial plexus or nerve roots. They infrequently occur in distal nerves and present with chronic and often severe pain. In this case a nerve sheath tumour of the tibial nerve was identified after a 16-month history of lameness and pain. Diagnosis required development of a caudolateral approach to the caudal compartment of the stifle joint. Amputation of the left hind limb was performed after confirmation of the diagnosis.