Prevalence of incomplete ossification of the humeral condyle in the limb opposite humeral condylar fracture: 14 dogs

R. B. Martin; L. Crews; T. Saveraid; M. G. Conzemius

doi:10.3415/VCOT-09-08-0082

Veterinary and Comparative Orthopaedics and Traumatology, Table of Contents

Vet Comp Orthop Traumatol 2010; 23(03): 168-172
DOI: 10.3415/VCOT-09-08-0082

Original Research

Schattauer GmbH

Prevalence of incomplete ossification of the humeral condyle in the limb opposite humeral condylar fracture: 14 dogs

R. B. Martin

¹University of Minnesota, Veterinary Medical Science, College of Veterinary Medicine, Veterinary Medical Center, St. Paul, Minnesota, USA

,

L. Crews

¹University of Minnesota, Veterinary Medical Science, College of Veterinary Medicine, Veterinary Medical Center, St. Paul, Minnesota, USA

,

T. Saveraid

²Inver Grove Animal Hospital, Minneapolis, Minnesota, USA

,

M. G. Conzemius

³University of Minnesota, Clinical Sciences, Minneapolis, Minnesota, USA

› Author Affiliations

Abstract

PDF Download

Summary

Objective: The objectives of this study were to determine the frequency of incomplete ossification of the contralateral humeral condyle (IOHC) in mature dogs with unilateral, atraumatic humeral condylar fracture (HCF), and to determine the sensitivity of radio-graphs as a diagnostic tool for IOHC.

Methods: Computed tomography and radio-graphs were obtained for both elbows of 14 dogs with unilateral HCF. The images were evaluated by two boarded radiologists and the prevalence of IOHC in the limb contralaterla to the HCF was identified. Sensitivity and specificity of the radiographic diagnosis of IOHC were determined.

Results: Incomplete ossification of the humeral condyle was present in six of 14 dogs, however IOHC was incomplete in three of the six affected dogs. Plain radiographs had a sensitivity of 0.83 (CI 95%: 0.36 to 0.99) and specificity of 1 (CI 95%: 0.60 to1). The Kappa coefficient between radiologists for radio-graphic examination was 0.714. Of the Spaniel breeds, four out of eight had IOHC in the limb contralateral to the HCF.

Clinical significance: Computed tomography evaluation is more sensitive than radiographs for diagnosis of IOHC, particularly when assessing partial or incomplete IOHC. However, sensitivity of radiographic diagnosis is good and should be adequate in most cases. Clinical suspicion of IOHC in the contralateral limb to the unilateral HCF should be present however overall frequency may not be as high as previously reported.

Keywords

Humeral condylar fracture - incomplete ossification of the humeral condyle - Salter-Harris Type IV - Cocker Spaniel

PDF (136 kb)

References

References
1 Bardet JF, Hohn RB, Rudy RL. et al. Fractures of the humerus in dogs and cats: a retrospective study of 130 cases. Vet Surg 1983; 12: 73-77.
2 Denny HR. Condylar fractures of the humerus in the dog; a review of 133 cases. J Small Anim Pract 1983; 24: 185-197.
3 Cockett PA, Jones DGC. The incidence of humeral condylar fractures in the dog: a survey of seventy-nine cases. J Small Anim Pract 1985; 26: 437-444.
4 Vannini R, Smeak DD, Olmstead ML. Evaluation of surgical repair of 135 distal humeral fractures in dogs and cats. J Am Anim Hosp Assoc 1988; 24: 537-545.
5 Marcellin-Little DJ, DeYoung DJ, Ferris KK. et al. Incomplete ossification of the humeral condyle in spaniels. Vet Surg 1994; 23: 475-487.
6 Vannini R, Olmstead ML, Smeak DD. Humeral condylar fractures caused by minor trauma in 20 adult dogs. J Am Anim Hosp Assoc 1988; 24: 355-362.
7 Kaderly RE, Lamothe M. Incomplete humeral condylar fracture due to minor trauma in a mature Cocker Spaniel. J Am Anim Hosp Assoc 1992; 28: 361-364.
8 Murtagh K, Guerin S. Incomplete ossification of the humeral condyle in a Springer Spaniel. Ir Vet J 2006; 59: 399-400.
9 Cook JL, Tomlinson JL, Reed AL. Fluoroscopically guided closed reduction and internal fixation of fractures of the lateral portion of the humeral condyle: prospective clinical study of the technique and results in ten dogs. Vet Surg 1999; 28: 315-321.
10 Meyer-Lindenberg A, Heinen V, Fehr M. et al. Incomplete ossification of the humeral condyle as the cause of lameness in dogs. Vet Comp Orthop Traumatol 2002; 15: 187-194.
11 Larsen LJ, Roush JK, McLaughlin RM. et al. Micro-angiography of the humeral condyle in Cocker Spaniel and non-Cocker Spaniel dogs. Vet Comp Orthop Traumatol 1999; 12: 134-137.
12 Brown DC, Conzemius MG, Shofer FS. Body weight as a predisposing factor for humeral condylar fractures, cranial cruciate rupture and intervertebral disc disease in Cocker Spaniels. Vet Comp Orthop Traumatol 1996; 9: 38-41.
13 Gnudi G, Martini FM, Zanichelli S. et al. Incomplete humeral condylar fracture in two English Pointer dogs. Vet Comp Orthop Traumatol 2005; 18: 243-245.
14 Carrera I, Hammond GJ, Sullivan M. Computed tomographic features of incomplete ossification of the canine humeral condyle. Vet Surg 2008; 37: 226-231.
15 Gabriel P, Pfeil A, Ludewig E. et al. Magnetic resonance imaging diagnosis: incomplete ossification of the humeral condyle in a German shepherd dog. J Small Anim Pract 2009; 50: 92-94.
16 Fitzpatrick N, Smith TJ, O'Riordan J. et al. Treatment of incomplete ossification of the humeral condyle with autogenous bone grafting techniques. Vet Surg 2009; 38: 173-184.
17 Moores A. Humeral condylar fractures and incomplete ossification of the humeral condyle in dogs. In Pract 2006; 28: 391-397.
18 Chuang JH. Information page – Jen-Hsiang Chuang. Agreement between Categorical Statisitics: Kappa Statistics [document on internet]. Home-pages – Columbia University Department of Biomedical Informatics. [updated 2001 July 1; cited 2009 June 22] Available from: http://www.dmi.columbia.edu/homepages/chuangj/kappa/
19 Rorvik AM. Risk factors for humeral condylar fractures in the dog: a retrospective study. J Small Anim Pract 1993; 34: 277-282.
20 Butterworth SJ, Innes JF. Incomplete humeral condylar fractures in the dog. J Small Anim Pract 2001; 42: 394-398.
21 Rovesti G, Fluckiger M, Margini A. et al. Fragmented coronoid process and incomplete ossification of the humeral condyle in a Rottweiler. Vet Surg 1998; 27: 354-357.
22 Charles EA, Ness MG, Yeadon R. Failure mode of transcondylar screws used for treatment of incomplete ossification of the humeral condyle in 5 dogs. Vet Surg 2009; 38: 185-191.