Vet Comp Orthop Traumatol 2024; 37(05): 243-250
DOI: 10.1055/s-0044-1786181
Original Research

Clinical Assessment of a Lateral Epicondylar Anatomical Plate for the Stabilization of Humeral Condylar Fractures in Dogs

Rebecca L. Jones
1   Department of Small Animal Clinical Science, Small Animal Teaching Hospital, University of Liverpool, Cheshire, United Kingdom
,
Andrew W. Tomlinson
1   Department of Small Animal Clinical Science, Small Animal Teaching Hospital, University of Liverpool, Cheshire, United Kingdom
,
Duncan M. Barnes
2   Orthopaedics Department, Eastcott Veterinary Referrals, Wiltshire, United Kingdom
,
Rebecca S. Hood
1   Department of Small Animal Clinical Science, Small Animal Teaching Hospital, University of Liverpool, Cheshire, United Kingdom
,
Jamie P. McClement
3   Orthopaedic Department, Abington Park Referrals, Northampton, United Kingdom
,
Daniel M. Ogden
4   Orthopaedics Department, Bristol Vet Specialists, Bristol, United Kingdom
,
5   Orthopaedic Surgery, Ossicle, Bristol, United Kingdom
,
Jeremy R. Onyett
3   Orthopaedic Department, Abington Park Referrals, Northampton, United Kingdom
,
Myles B. Walton
6   Orthopaedic Department, Movement Referrals, Cheshire, United Kingdom
› Author Affiliations

Abstract

Objective To report the use of a Lateral Epicondylar Anatomical Plate for the management of humeral condylar fractures (HCF) in dogs.

Study Design Medical records of dogs with HCF stabilized using the Lateral Epicondylar Anatomical Plate at six UK veterinary referral centres between April 2018 and February 2021 were reviewed. Long-term follow-up (>6 months) was obtained via owner questionnaire, which incorporated the Liverpool Osteoarthritis in Dogs clinical metrology instrument.

Results Sixty-two HCF were treated in 61 dogs (44 lateral condylar fractures [LCF] and 18 intracondylar (T/Y) fractures [ICF]). Fifty-one dogs were Spaniels or Spaniel crossbreeds. Intraoperative contouring of the plate was required for one dog—a French Bulldog. Postoperative complications occurred in 14/42 LCF and 6/18 ICF; overall there were 14 minor, 8 major, and 2 catastrophic complications. On final follow-up imaging, there was evidence of partial or complete osseous continuity of the condylar part of the fracture 32/53 HCF (24/39 LCF and 8/14 ICF) and lateral epicondylar part of the fracture in 53/53 HCF (39/39 LCF and 14/14 ICF). At final reexamination, 20/28 dogs with LCF and 5/13 dogs with ICF were not lame and the remaining dogs demonstrated mild lameness. According to the owner questionnaire, 17/17 dogs with LCF and 8/10 dogs with ICF returned to full limb use and median Liverpool Osteoarthritis in Dogs scores were 2/52 for LCF and 6.5/52 for ICF.

Conclusion The Lateral Epicondylar Anatomical Plate can be used successfully for the surgical stabilization of HCF in dogs.

Authors' contribution

R.L.J. and M.B.W. contributed to the conception, study design. All authors contributed to acquisition of data, data analysis and interpretation, and drafted, revised, and approved the submitted manuscript and are publicly responsible for the relevant content.


Supplementary Material



Publication History

Received: 15 May 2023

Accepted: 14 March 2024

Article published online:
26 April 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
  • References

  • 1 Bardet JF. et al. Fractures of the humerus in dogs and cats: a retrospective study of 130 cases. Vet Surg 1983; 12 (02) 73-77
  • 2 Smith MAJ, Jenkins G, Dean BL, O'Neill TM, Macdonald NJ. Effect of breed as a risk factor for humeral condylar fracture in skeletally immature dogs. J Small Anim Pract 2020; 61 (06) 374-380
  • 3 Denny HR. Condylar fractures of the humerus in the dog; a review of 133 cases. J Small Anim Pract 1983; 24 (04) 185-197
  • 4 Gordon WJ. et al. Frequency of post-traumatic osteoarthritis in dogs after repair of a humeral condylar fracture. Vet Comp Orthop Traumatol 2003; 16 (01) 1-5
  • 5 Nortje J, Bruce WJ, Worth AJ. Surgical repair of humeral condylar fractures in New Zealand working farm dogs - long-term outcome and owner satisfaction. N Z Vet J 2015; 63 (02) 110-116
  • 6 Rorvik AM. Risk factors for humeral condylar fractures in the dog: a retrospective study. J Small Anim Pract 1993; 34 (06) 277-282
  • 7 Sanchez Villamil C, Phillips ASJ, Pegram CL, O'Neill DG, Meeson RL. Impact of breed on canine humeral condylar fracture configuration, surgical management, and outcome. Vet Surg 2020; 49 (04) 639-647
  • 8 Moores AP. Humeral condylar fractures and incomplete ossification of the humeral condyle in dogs. In Pract 2006; 28 (07) 391-397
  • 9 Böhme B, d'Otreppe V, Ponthot JP, Balligand M. Intraosseous stress distribution and bone interaction during load application across the canine elbow joint: a preliminary finite element analysis for determination of condylar fracture pathogenesis in immature and mature dogs. Res Vet Sci 2016; 106: 143-148
  • 10 Lefebvre JB, Robertson TR, Baines SJ, Jeffery ND, Langley-Hobbs SJ. Assessment of humeral length in dogs after repair of Salter-Harris type IV fracture of the lateral part of the humeral condyle. Vet Surg 2008; 37 (06) 545-551
  • 11 Anderson TJ, Carmichael S, Miller A. Intercondylar humeral fracture in the dog: a review of 20 cases. J Small Anim Pract 1990; 31 (09) 437-442
  • 12 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 (05) 217-226
  • 13 Marcellin-Little DJ, DeYoung DJ, Ferris KK, Berry CM. Incomplete ossification of the humeral condyle in spaniels. Vet Surg 1994; 23 (06) 475-487
  • 14 Moores AP, Tivers MS, Grierson J. Clinical assessment of a shaft screw for stabilization of the humeral condyle in dogs. Vet Comp Orthop Traumatol 2014; 27 (03) 179-185
  • 15 Witte PG, Bush MA, Scott HW. Propagation of a partial incomplete ossification of the humeral condyle in an American cocker spaniel. J Small Anim Pract 2010; 51 (11) 591-593
  • 16 Farrell M, Trevail T, Marshall W, Yeadon R, Carmichael S. Computed tomographic documentation of the natural progression of humeral intracondylar fissure in a cocker spaniel. Vet Surg 2011; 40 (08) 966-971
  • 17 Scheuermann LM, Conzemius MG. Effect of induced incomplete ossification of the humeral condyle on ex vivo humeral condylar biomechanics. Vet Comp Orthop Traumatol 2021; 34 (03) 178-182
  • 18 Coggeshall JD, Lewis DD, Fitzpatrick N. et al. Biomechanical comparison of two implants for the stabilization of incomplete ossification of the humeral condyle lesions in dogs. Vet Surg 2014; 43 (01) 58-65
  • 19 Schettler M, Cassel N, Elliot RC, Fosgate GT, Schettler K, Biller D. A prevalence study of canine humeral condylar fractures over a ten-year period at an academic teaching hospital. Vet Comp Orthop Traumatol 2022; 35 (03) 191-197
  • 20 Au K, Mattern KL, Lewis DD. Dicondylar humeral fracture stabilisation in a dog using a transilial rod and external fixation. J Small Anim Pract 2008; 49 (03) 148-151
  • 21 Cockett PA, Clayton Jones DG. The repair of humeral condylar fractures in the dog: a review of seventy-nine cases. J Small Anim Pract 1985; 26 (09) 493-520
  • 22 Ness MG. Repair of Y-T humeral fractures in the dog using paired ‘String of Pearls’ locking plates. Vet Comp Orthop Traumatol 2009; 22 (06) 492-497
  • 23 Daubs BM, McLaughlin RM, Silverman E, Rizon J. Evaluation of compression generated by self compressing Orthofix bone pins and lag screws in simulated lateral humeral condylar fractures. Vet Comp Orthop Traumatol 2007; 20 (03) 175-179
  • 24 Guille AE, Lewis DD, Anderson TP. et al. Evaluation of surgical repair of humeral condylar fractures using self-compressing orthofix pins in 23 dogs. Vet Surg 2004; 33 (04) 314-322
  • 25 Vida JT, Pooya H, Vasseur PB, Garcia TC, Schulz K, Stover SM. Biomechanical comparison of orthofix pins and cortical bone screws in a canine humeral condylar fracture model. Vet Surg 2005; 34 (05) 491-498
  • 26 Rochereau P, Diop A, Maurel N, Bernarde A. Biomechanical comparison of 4.0-mm short-threaded cannulated screws and 4.0-mm short-threaded cancellous screws in a canine humeral condylar fracture model. Vet Surg 2012; 41 (06) 712-719
  • 27 Gonsalves MN, Jankovits DA, Huber ML, Strom AM, Garcia TC, Stover SM. Biomechanical comparison of 3.0 mm headless compression screw and 3.5 mm cortical bone screw in a canine humeral condylar fracture model. Vet Comp Orthop Traumatol 2016; 29 (05) 353-360
  • 28 Perry KL, Bruce M, Woods S, Davies C, Heaps LA, Arthurs GI. Effect of fixation method on postoperative complication rates after surgical stabilization of lateral humeral condylar fractures in dogs. Vet Surg 2015; 44 (02) 246-255
  • 29 Biedrzycki AH. Dynamic compression vs. locking plating − is one “better”? A review of biomechanical principles and in vitro testing. In: Locking Plates in Veterinary Orthopedics; 2018: 25-39
  • 30 Morgan OD, Reetz JA, Brown DC, Tucker SM, Mayhew PD. 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 (05) 400-405
  • 31 McCartney WT, Comiskey DP, Mac Donald B, Garvan CB. 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 (04) 285-290
  • 32 Cook JL, Evans R, Conzemius MG. et al. Proposed definitions and criteria for reporting time frame, outcome, and complications for clinical orthopedic studies in veterinary medicine. Vet Surg 2010; 39 (08) 905-908
  • 33 Walton MB, Cowderoy E, Lascelles D, Innes JF. Evaluation of construct and criterion validity for the ‘Liverpool Osteoarthritis in Dogs’ (LOAD) clinical metrology instrument and comparison to two other instruments. PLoS One 2013; 8 (03) e58125
  • 34 Martin RB, Crews L, Saveraid T, Conzemius MG. Prevalence of incomplete ossification of the humeral condyle in the limb opposite humeral condylar fracture: 14 dogs. Vet Comp Orthop Traumatol 2010; 23 (03) 168-172
  • 35 Stoffel K, Dieter U, Stachowiak G, Gächter A, Kuster MS. Biomechanical testing of the LCP–how can stability in locked internal fixators be controlled?. Injury 2003; 34 (Suppl. 02) B11-B19
  • 36 Walton MB, Crystal E, Morrison S. et al. A humeral intracondylar repair system for the management of humeral intracondylar fissure and humeral condylar fracture. J Small Anim Pract 2020; 61 (12) 757-765
  • 37 García J, Yeadon R, Solano MA. Bilateral locking compression plate and transcondylar screw fixation for stabilization of canine bicondylar humeral fractures. Vet Surg 2020; 49 (06) 1183-1194
  • 38 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 (02) 185-191
  • 39 Fitzpatrick N, Smith TJ, O'Riordan J, Yeadon R. Treatment of incomplete ossification of the humeral condyle with autogenous bone grafting techniques. Vet Surg 2009; 38 (02) 173-184
  • 40 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 (06) 728-733