To begin the surgery on the anesthetized animal, make a one-centimeter long, full-thickness skin incision vertically along the proximal border of the anteromedial face of the tibia in the metaphysis region to expose the bone. Using small periosteal elevators, fully detach the tissue from the bone. Expose the bone and identify the insertion of the tibialis cranialis muscle, the gracilis, and the gastrocnemius lateral head muscle in the posterior border of the medial aspect of the tibia resembling a fibrous white tissue firmly adhered to the bone.
Using a lance pilot drill at a depth of 2.4 millimeters with a maximum speed of 150 rotations per minute, drill the identified area as described previously under saline solution irrigation while avoiding any muscle injury. Perform a second drilling using a 1.6 millimeters diameter twist design drill at a depth of 2.4 millimeters. To place the titanium implant, first insert it with an intermediary piece attached to the 20:1 reduction contra angle.
Next, clean the implant from any residual chemical sterilant by rotating it in the contra angle with simultaneous saline irrigation for 10 seconds. Then place the implant while making sure to stop the insertion before it completely passes the cortical bone where it is inserted. That is, the flat medial face of the tibia contiguous to the muscle's insertion.
Suture the muscle tissue borders with simple internal sutures using a 4/0 monofilament synthetic resorbable glyconate suture. Finally, perform skin closure with an intradermal suture using the same 4/0 monofilament synthetic resorbable glyconate suture.