Background: Until recent years, arthroscopic subtotal coronoidectomy has been the universally accepted treatment for medial coronoid disease but has variable clinical outcomes. The aim of this study was to evaluate the completeness of arthroscopic medial coronoid debridement and to detect the most vulnerable location of failure. Methods: Eighty-three dogs with a diagnosis of medial coronoid disease were included in the study. Arthroscopic debridement was performed in 92 elbow joints, and the completeness of removal was assessed by postoperative computed tomography scans. Results: Pathological changes were confined to the coronoid apex in 92/92 (100%) of cases and combined with radial incisure lesions in 39/92 (42%). Apical lesions were completely removed in 66/92 (72%) of cases and radial incisure lesions in 2/39 (5%). Bony remnants were detected at the apex (46%) and base (24%) of the medial coronoid process, free within the elbow joint (9%), and/or within the instrument port (84%). Fissures were positively associated with the occurrence of bony remnants (p = 0.038) and a 37% higher probability of incomplete removal of radial incisure lesions (p = 0.001). Conclusion:In this study, incomplete removal was more likely to occur in the presence of radial incisure lesions. Thorough assessment of this region during arthroscopy is strongly recommended.

A 3‐year‐old mixed‐breed dog was presented with acute onset of non‐weight bearing right thoracic limb lameness. Radiographs revealed dislocation of the ulnar styloid and a small slab fracture of the medial cortex of the distal ulna. Moderate medial and mild lateral instability without hyperextension were detected, and carpal bone fractures were excluded on stress radiographs and computed tomography. The surgical repositioning of the ulnar bone revealed multiple torn ligaments. To reinforce primary repair, the collateral ligaments were augmented medially and laterally using screws, washers and synthetic suture material. Postoperatively, external coaptation, followed by a soft neoprene brace, was used for further rehabilitation. Seven months postoperatively, the dog exhibited pre‐traumatic function. There is no proper classification for multi‐ligamentous injuries, and little is known regarding the long‐term outcomes and limitations of primary carpal ligament repair. In this case, medial and lateral ligament prostheses provided a feasible treatment option with excellent outcomes.