Humeral condylar fractures and incomplete ossification of the humeral condyle in dogs

Abstract

HUMERAL condylar fractures are among the most common fractures seen in dogs and account for approximately 20 per cent of the author's canine fracture caseload, although this is a referral population and probably does not represent the true incidence of these injuries. It has long been recognised that spaniels are predisposed to humeral condylar fractures. It is now recognised that many of these dogs have a condition known as incomplete ossification of the humeral condyle (IOHC) that predisposes them to condylar fractures, often occurring during normal activity or associated with only minor trauma. This article discusses the management of humeral condylar fractures and IOHC.

Effect of Fixation Method on Postoperative Complication Rates After Surgical Stabilization of Lateral Humeral Condylar Fractures in Dogs

“…Fractures of the humeral condyle are common and are divided into lateral condylar, medial condylar, and intercondylar fractures . Lateral humeral condylar fractures (LHCF) are most common, accounting for 34–56% of humeral condylar fractures .…”

“…LHCF have been reported in many breeds, with Spaniels, Yorkshire Terriers, English and French Bulldogs, Miniature Schnauzers, and Gordon Setters being variably overrepresented in different studies. Most LHCF occur in skeletally immature animals, with a peak incidence at 4 months, but adult dogs can also be affected . No consistent gender predisposition has been reported …”

“…LHCF is commonly traumatic in origin . A history of condylar fracture occurring during relatively normal activity should arouse suspicion of incomplete ossification of the humeral condyle (IOHC), particularly if the dog is a Spaniel . LHCF usually result from upward stress transmitted through the radius on to the humeral capitulum, which is relatively weakly supported by the thin lateral supracondylar crest .…”

“…LHCF have been treated using various methods including transcondylar screws inserted in lag fashion, pins or wire, Rush pins, various applications of Kirschner wires (K‐wires), self‐compressing Orthofix pins, cannulated screws, and closed reduction with subsequent internal fixation . Arguably, treatment using a transcondylar screw in lag fashion is most commonly performed and this has been well described . A second point of fixation, in addition to the lag screw, has been recommended to prevent rotation of the lateral fragment around the axis of the screw .…”

“…With early stabilization and anatomic reduction, the prognosis for LHCF is generally good, although more guarded for cases secondary to IOHC . However, previous humeral condylar fracture outcomes in the literature have reported that 28–57% of dogs have long‐term pain or lameness upon subjective evaluation …”