Fixation of humeral intercondylar fractures using a lateral plate in 14 dogs supported by finite element analysis of repair

Abstract

Fourteen Spaniels that presented with an intercondylar fracture of the distal humerus were managed using a lateral plate and an additional pin in twelve cases. Fixation of the fracture was achieved using a plate applied laterally which incorporated the transcondylar lag screw in the most distal hole. Of the 14 cases, two had poor results, one of which was a bilateral case, whilst the remaining 12 cases had good or very good results with only occasional stiffness or lameness. Finite element (FE) modelling of a distal humerus was generated, and loading of fracture repairs using a lateral plate and caudal plate was completed in a comparative study to determine which fixation method resisted micro-motion most effectively. Finite element analysis revealed that the lateral plate fixation provided significantly more resistance to micro movement at the fracture site that the caudal plate fixation, with 40% more micro-motion in the latter.

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

“…As expected following an articular fracture, up to 100% of dogs develop osteoarthritis 4 and 29 to 57% experience long-term pain or lameness. 3,24,31 Despite this, the majority of owners report acceptable functional outcomes. 5,7 Advantages of anatomical plates include reduced time required for plate contouring and site-specific screw hole distribution.…”

Lateral Approach for Distal Articular Fractures of Humerus in Canines-A Review of 4 Cases

“…They require immediate surgical stabilization which in turn led to medial elbow subluxation and joint deformity (Denny and Butterworth, 2000). In addition to these, the most commonly encountered complications of elbow affections are elbow arthrosis, nonunion, fixation failure, seroma formation and infections (McCartney et al, 2007). Various surgical techniques have been recommended to address these fractures which includes transcondylar lag screws, K-wire fixation, bone plates and screws (Perry et al, 2015).…”

Humeral condylar fractures and fissures in the French bulldog

“…The majority of distal humeral fractures in dogs involve the humeral condyle. 1 A number of breeds have been found to be predisposed to humeral condylar fractures (HCF) including spaniels, 1 , 2 , 3 , 4 Yorkshire terriers, 5 , 6 Miniature schnauzers, Gordon setters, 6 Cavalier King Charles spaniels 7 and the French bulldog. 6 , 8 HCF are most commonly diagnosed in young, skeletally immature dogs, with the most common age being around 4 months when ossification of the humeral condyle is not yet complete, 1 , 5 , 7 , 9 or in older dogs with an underlying humeral intracondylar fissures (HIF).…”

“… 8 , 24 Reported complications include persistent lameness, reduced range of motion, elbow arthrosis, nonunion, fixation failure, seroma formation and infection. 1 , 3 , 4 , 7 , 17 , 24 , 26 Other negative outcomes associated with HCF can include long‐term pain and lameness, with these signs reported in 28%–57% of dogs post‐surgery. 1 , 3 , 7 With early reduction and stabilization, the prognosis for both medial and lateral condylar fractures is generally good.…”