Vet Comp Orthop Traumatol 2014; 27(03): 179-185
DOI: 10.3415/VCOT-13-05-0063
Original Research
Schattauer GmbH

Clinical assessment of a shaft screw for stabilization of the humeral condyle in dogs

A. P. Moores
1   Anderson Moores Veterinary Specialists, Bunstead Barns, Hursley, Winchester, Hampshire, UK
,
M. S. Tivers
2   Cave Veterinary Specialists, George’s Farm, West Buckland, Wellington, Devon, UK
,
J. Grierson
1   Anderson Moores Veterinary Specialists, Bunstead Barns, Hursley, Winchester, Hampshire, UK
› Author Affiliations
Further Information

Publication History

Received 23 May 2013

Accepted 22 February 2013

Publication Date:
21 December 2017 (online)

Summary

Objective: To report the use of a 4.5 mm shaft screw for the management of humeral condylar fractures (HCF) and incomplete ossification of the humeral condyle (IOHC) in dogs, and to assess risk factors for complications.

Methods: Dogs with HCF or IOHC that were managed with a 4.5 mm shaft screw with a minimum follow-up of six months from surgery were included. Data from the case records were used to identify risk factors for complications. Long-term follow-up was provided by an owner questionnaire and veterinary re-examination.

Results: Forty-three elbows were treated in 40 dogs (14 IOHC, 29 HCF). Minor complications were seen in four cases (9%) and major complications in 10 cases (23%). There were no statistically significant risk factors for major complication. Infection resulted in shaft screw removal from three IOHC cases. Four of eight IOHC cases that had a lateral approach had a major complication compared with zero out of six dogs that had a medial approach, but this difference was not significant (p = 0.085). Nine of 12 IOHC cases and 20/23 HCF cases had excellent or good limb use at the time of long-term follow- up (median of 106 weeks, range 26–227 weeks). All fractures healed but IOHC fissure healing was inconsistent. Fatigue failure of shaft screws was not seen.

Clinical significance: The use of shaft screws for the management of IOHC and HCF is associated with a relatively low rate of complications (compared to previous reports) and a good long-term outcome.

 
  • References

  • 1 Denny HR. Condylar fractures of the humerus in the dog; a review of 133 cases. J Small Anim Pract 1983; 24: 185-197.
  • 2 McCartney WT, Comiskey DP, Mac Donald B. et al. Fixation of humeral intercondylar fractures using a lateral plate in 14 dogs supported by finite element analysis of repair. Vet Comp Orthop Traumatol 2007; 20: 285-290.
  • 3 McKee WM, Macias C, Innes JF. Bilateral fixation of Y-T humeral condyle fractures via medial and lateral approaches in 29 dogs. J Small Anim Pract 2005; 46: 217-226.
  • 4 Marcellin-Little DJ, DeYoung DJ, Ferris KK. et al. Incomplete ossification of the humeral condyle in spaniels. Vet Surg 1994; 23: 475-487.
  • 5 Moores AP, Agthe P, Schaafsma IA. Prevalence of incomplete ossification of the humeral condyle and other abnormalities of the elbow in English Springer Spaniels. Vet Comp Orthop Traumatol 2012; 25: 211-216.
  • 6 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.
  • 7 Butterworth SJ, Innes JF. Incomplete humeral condylar fractures in the dog. J Small Anim Pract 2001; 42: 394-398.
  • 8 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.
  • 9 Hattersley R, McKee M, O'Neill T. et al. Postoperative complications after surgical management of incomplete ossification of the humeral condyle in dogs. Vet Surg 2011; 40: 728-733.
  • 10 Moores A. Humeral condylar fractures and incomplete ossification of the humeral condyle in dogs. In Practice 2006; 28: 391-397.
  • 11 Perren SM, Allgower M, Brunner H. et al. The concept of biological plating using the limited contact-dynamic compression plate (LC-DCP). Perren SM, editor. Injury (Suppl) 1991; 22: 1-41.
  • 12 Klaue K. The dynamic compression unit (DCU) for stable internal fixation of bone fractures. [dissertation] Perren S. editor. University of Basel; 1981
  • 13 Piermattei DL, Johnson KA. Approach to the humeroulnar part of the elbow joint by osteotomy of the tuber olecrani. In: An Atlas of Surgical Approaches to the Bones and Joints of the Dog and Cat. Philadelphia: Saunders; 2004. pg. 2004-194.
  • 14 Beale BS, Hulse DA, Schulz KS. et al. Arthroscopically assisted surgery of the elbow joint. In: Small Animal Arthroscopy. Philadelphia: Saunders; 2003. pg. 2003-51.
  • 15 Morgan ODE, Reetz JA, Brown DC. et al. Complication rate, outcome, and risk factors associated with surgical repair of fractures of the lateral aspect of the humeral condyle in dogs. Vet Comp Orthop Traumatol 2008; 21: 400-405.
  • 16 Hulse D, Hyman W, Nori M. et al. Reduction in plate strain by addition of an intramedullary pin. Vet Surg 1997; 26: 451-459.
  • 17 Muir P, Johnson KA, Markel MD. Area moment of inertia for comparison of implant cross-sectional geometry and bending stiffness. Vet Comp Orthop Traumatol 1995; 8: 146-152.
  • 18 Rahm C, Ito K, Auer J. Screw fixation in lag fashion of equine cadaveric metacarpal and metatarsal condylar bone specimens: A biomechanical comparison of shaft and cortex screws. Vet Surg 2000; 29: 564-571.
  • 19 Fitzpatrick N, Solano MA. Application of a novel osteointegration screw for treatment of incomplete ossification of the humeral condyle in four dogs (six elbows) and humeral unicondylar fracture in addition to a locking plate in four elbows. Proceedings of the Annual Conference of the European College of Veterinary Surgeons. 2012. July 5-7 Barcelona, Spain: pg. 42.
  • 20 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.
  • 21 Witte PG, Bush MA, Scott HW. Propagation of a partial incomplete ossification of the humeral condyle in an American cocker spaniel. J Sm Anim Pract 2010; 51: 591-593.
  • 22 Farrell M, Trevail T, Marshall W. et al. Computed tomographic documentation of the natural progression of humeral intracondylar fissure in a cocker spaniel. Vet Surg 2011; 40: 966-971.