Vet Comp Orthop Traumatol 2003; 16(04): 204-210
DOI: 10.1055/s-0038-1632780
Clinical Communication
Schattauer GmbH

Arthrotomy versus arthroscopy in the treatment of the fragmented medial coronoid process of the ulna (FCP) in 421 dogs

A. Meyer-Lindenberg
1   The Clinic of Small Animals, School of Veterinary Medicine Hannover, Hannover, Germany
,
A. Langhann
1   The Clinic of Small Animals, School of Veterinary Medicine Hannover, Hannover, Germany
,
M. Fehr
1   The Clinic of Small Animals, School of Veterinary Medicine Hannover, Hannover, Germany
,
I. Nolte
1   The Clinic of Small Animals, School of Veterinary Medicine Hannover, Hannover, Germany
› Author Affiliations
Further Information

Publication History

Received 20 December 2002

Accepted 31 March 2003

Publication Date:
22 February 2018 (online)

Summary

In a retrospective trial over eight years 518 joints from 421 dogs with fragmented medial coronoid process of the ulna (FCP) were included. Seventy-five joints had an additional osteochondrosis dissecans of the medial aspect of the humeral condyle. Forty-six point eight percent of the dogs (197/421) were younger than one year. Two hundred and forty-seven joints were treated by conventional arthrotomy and 271 joints were treated by arthroscopy. Two hundred and thirty-eight cases (103 treated by arthrotomy and 135 by arthroscopy) were re-evaluated clinically and radiographically and 191 cases (88 treated by arthrotomy and 103 by arthroscopy) by means of a questionnaire at an average of 23 and 21 months after the operations, respectively. Forty-two point four percent (81/191) of the cases treated by arthrotomy did not show any lameness, 29.3% (56/191) showed temporary lameness after rest or heavy exercise, and 28.3% (54/191) showed constant lameness. The signs of which had, however, been reduced by surgery in 14 of these cases. Sixty point one percent (143/238) of the cases treated by arthroscopy did not show any lameness, 29.4% (70/238) showed temporary lameness after rest or heavy exercise and 10.5% (25/238) showed constant lameness, out of which four cases had improved after surgery. In the cases treated by arthroscopy, the period of convalescence was shorter. Differences between these methods were not observed with respect to the development of subsequent arthrosis. The results of the study show that arthroscopy, with its minimal invasive character, gives better functional results than conventional arthrotomy. However, the development of secondary arthrosis cannot be avoided by either method.

 
  • References

  • 1 Alexander JW, Richardson DC, Selcer BA. Osteochondritis dissecans of the elbow, stifle and hock - A Review. J Am Anim Hosp Assoc 1981; 17: 51-6.
  • 2 Anderson SM, Lippincott CL, Schulman AJ. Longitudinal myotomy of the flexor carpi radialis: A new approach to the medial aspect of the elbow joint. J Am Anim Hosp Assoc 1989; 25: 499-503.
  • 3 Bardet JF. Arthroscopy of the elbow in dogs. Part two: The cranial portals in the diagnosis and treatment of the lesions of the coronoid process. Vet Comp Orthop Traumat 1997; 10: 60-5.
  • 4 Bennett B, Duff SRI, Kene RO, Lee R. Osteochondritis dissecans and fragmentation of the coronoid process in the elbow joint of the dog. Vet Rec 1981; 109: 329-36.
  • 5 Berzon JL, Quick CB. Fragmented coronoid process: anatomical, clinical and radiographic considerations with case analysis. J Am Anim Hosp Assoc 1980; 16: 241-51.
  • 6 Bouck GR, Miller CW, Taves CL. A comparison of surgical and medical treatment of fragmented coronoid process and osteochondritis dissecans of the canine elbow. Vet Comp Orthop Traumat 1995; 08: 177-83.
  • 7 Brunnberg L, Allgöwer I. Age-related results of the treatment of elbow dysplasia (FCP) in the Bernese Mountain Dog. Vet Comp Orthop Traumat 1996; 09: 65-6.
  • 8 Denny HR, Gibbs C. The surgical treatment of the osteochondritis dissecans and ununited coronoid process in the canine elbow joint. J Small Anim Pract 1980; 21: 323-31.
  • 9 Fox SM, Walker AM. Identifying and treating the primary manifestations of the osteochondrosis of the elbow. Vet Med 1993; 88: 132-46.
  • 10 Groendalen J, Groendalen T. Arthrosis in the elbow joint of young rapidly growing dogs V. Nord Vet Med 1981; 33: 1-16.
  • 11 Grondalen J. Arthrosis in the elbow joint of young rapidly growing dogs III. Nord Vet Med 1979; 31: 520-7.
  • 12 Gutbrod F, Festl D. Operative Therapie der Fraktur des Processus coronoideus ulnae und klinische Ergebnisse. Kleintier Prax 1999; 44: 405-20.
  • 13 Hazewinkel HAW, Meij BP, Theyse LFH. Surgical treatment of elbow dysplasia. Vet Quat 1998; 20 (Suppl. 01) 29-31.
  • 14 Henry WB. Radiographic diagnosis and surgical management of fragmented medial coronoid process in the dogs. J Am Vet Med Assoc 1984; 184: 799-805.
  • 15 Huibregtse BA, Johnson AL, Muhlbauer MC. et al. The effect of treatment of fragmented coronoid process on the development of osteoarthritis of the elbow. J Am Anim Hosp Assoc 1994; 30: 190-5.
  • 16 International Elbow Working Group. Guidelines for radiographic examination and interpretation of the elbow joint. Annual meeting, San Francisco: 1990
  • 17 Janthur I, Meyer-Lindenberg A, Fehr M. Arthroskopische Diagnostik von Ellbogengelenkserkrankungen des Hundes. Tierärztl Prax 2000; 28: 11-8.
  • 18 Lewis DD, Parker RB, Hager DA. Fragmented medial coronoid process of the canine elbow. Comp Cont Educ Pract Vet 1989; 11: 703-34.
  • 19 Lorenz RJ. Biometrie. 2. Aufl. Stuttgart, Germany: Verlag Gustav Fischer; 1988
  • 20 Mason TA, Lavelle RB, Skipper SC. et al. Osteochondrosis of the elbow joint in young dogs. J Small Anim Pract 1980; 21: 641-56.
  • 21 Meyer-Lindenberg A, Fehr M, Brunnberg L, Nolte I. Fragmentierter Processus coronoideus medialis der Ulna beim Hund. Monatsh Vet Med 1993; 48: 457-66.
  • 22 Meyer-Lindenberg A, Staszyk C, Gasse H, Fehr M, Nolte I. Caudomedial approach for removal of an ununited anconeal process and assessment of the medial coronoid process of the ulna. J Vet Med A 2002; 49: 277-80.
  • 23 Morgan JP, Wind A, Davidson AP. Elbow dysplasia. In: Morgan JP, Wind A, Davidson AP. (eds). Hereditary bone and joint diseases in the dog. Hannover: Schlütersche; 2000: 41-95.
  • 24 Olsson SE. The early diagnosis of fragmented coronoid process and osteochondrosis dissecans of the canine elbow joint. J Am Anim Hosp Assoc 1983; 19: 616-26.
  • 25 Probst CW, Flo GL, Mcloughlin MA, Decamps CE. A simple medial approach to the canine elbow for treatment of fragmented coronoid process and osteochondritis dissecans. J Am Anim Hosp Assoc 1989; 25: 331-4.
  • 26 Probst CW. Fragmented medial coronoid process and osteochondritis dissecans of the elbow. Comp Anim Pract 1988; 02: 27-33.
  • 27 Read RA, Armstrong SJ, O’Keefe JD. et al. Fragmentation of the medial coronoid process of the ulna in dogs:A study of 109 cases. J Small Anim Pract 1990; 31: 330-4.
  • 28 Smith CW. Osteochondrosis in the dog - diagnosis, treatment, and prognosis. Canine Pract 1991; 16: 15-21.
  • 29 Tobias TA, Miyabayashi T, Olmstead ML. et al. Surgical removal of fragmented medial coronoid process in the dog: Comparative effects of surgical approach and age at time of surgery. J Am Anim Hosp Assoc 1994; 30: 360-8.
  • 30 Van Bree H, Van Ryssen B. Diagnostic and surgical arthroscopy in osteochondrosis lesions. Vet Clin North Am Small Anim Pract 1998; 28: 161-89.
  • 31 Van Bree H, Van Ryssen B. Imaging the canine elbow: radiography, computed tomography and arthroscopy. Vet Ann 1995; 35: 118-29.
  • 32 Van Ryssen B, Van Bree H, Simoens P. Elbow arthroscopy in clinical normal dogs. Am J Vet Res 1993; 54: 191-8.
  • 33 Van Ryssen B, Van Bree H. Arthroscopic findings in 100 dogs with elbow lameness. Vet Rec 1997; 126: 3602.
  • 34 Wind AP, Packard ME. Elbow incongruity and developmental elbow disease in the dog: Part. J Am Anim Hosp Assoc 1986; 22: 725-30.
  • 35 Winhart S. Zur Fraktur des Processus coronoideus medialis ulnae beim Hund. Dissertation. Ludwig-Maximilians-Universität München; Germany: 1991