Intraoperative Distraction Device for Open Reduction of Nascent Lateral Humeral Condylar Fractures in Five Dogs

Abstract

Lateral humeral condylar (LHC) nascent malunion fractures are challenging to treat because of extensive callus formation, scar tissue and contracture of surrounding tissues. The objective of this retrospective case series is to describe the novel procedural use of an intraoperative distraction device to aid in the reduction and anatomical alignment of nascent malunion LHC fractures along with long-term functional outcomes in these cases. Medical records of five consecutive cases of dogs with seven nascent malunion LHC fractures that were treated between 2015 and 2018 with the aid of an intraoperative distraction device were reviewed. Relevant clinical and radiographic data, forelimb circumference, elbow goniometry and clinical outcome were evaluated. Anatomic reduction and fixation with complete healing were achieved in all seven cases. Implants were removed in four cases to resolve persisting lameness. Three dogs (4 cases) were available for long-term follow-up: mean circumference and range of motion were decreased in the operated limbs as compared with the contralateral normal limbs. One dog (with bilateral fractures) was euthanized due to poor outcome. In the other five elbows, outcome was acceptable. Based on the results of this case series, use of an intraoperative distraction device to aid in anatomical reduction and fixation of nascent malunion LHC fractures should be considered.

Keywords

humeral condylar fractures - malunion - intraoperative distraction - dog

Publikationsverlauf

Eingereicht: 25. Mai 2023

Angenommen: 12. Juni 2023

Artikel online veröffentlicht:
11. August 2023

• References

• 1 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
• 2 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
• 3 Moores A. Humeral condylar fractures and incomplete ossification of the humeral condyle in dogs. In Pract 2006; 28: 391-397
• 4 Durall I, Diaz MC, Morales I. Interlocking nail stabilization of humeral fractures: initial experience in seven clinical cases. Vet Comp Orthop Traumatol 1994; 7: 3-8
• 5 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
• 6 Elmi A, Tabrizi A, Rouhani A, Mirzatolouei F. Treatment of neglected malunion of the distal radius: a cases series study. Med J Islam Repub Iran 2014; 28: 7
• 7 Knight GC. Internal fixation of the fractured lateral humeral condyle. Can J Comp Med Vet Sci 1960; 24 (04) 131-133
• 8 McCarthy J, Comerford EJ, Innes JF, Pettitt RA. Elbow arthrodesis using a medially positioned plate in 6 dogs. Vet Comp Orthop Traumatol 2020; 33 (01) 51-58
• 9 Olivencia-Morell PJ, Frederick SW, Forbes JN, Cross AR. Evaluation of the clinical value of routine radiographic examination during convalescence for tibial plateau-leveling osteotomy. Vet Surg 2021; 50 (08) 1644-1649
• 10 Hazewinkel HAW. Elbow dysplasia, definition and known aetiologies. Paper presented at: The 22nd Annual Meeting of the International Elbow Working Group; September 8, 2007; Munich, Germany. Accessed July 11, 2023 at: http://www.vet-iewg.org/wp-content/uploads/2017/02/proceedings2007iewg.pdf
• 11 Berríos-Torres SI, Umscheid CA, Bratzler DW. et al. Healthcare Infection Control Practices Advisory Committee. Centers for Disease Control and Prevention Guideline for the Prevention of Surgical Site Infection, 2017. JAMA Surg 2017; 152 (08) 784-791
• 12 Formenton MR, de Lima LG, Vassalo FG, Joaquim JGF, Rosseto LP, Fantoni DT. Goniometric assessment in French bulldogs. Front Vet Sci 2019; 6: 424
• 13 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
• 14 Gordon WJ, Besancon MF, Conzemius MG. et al. Frequency of post-traumatic osteoarthritis in dogs after repair of a humeral condylar fracture. Vet Comp Orthop Traumatol 2003; 16: 1-5
• 15 Shubert MP, Filliquist B, Chou PY. et al. Results of using multiplanar reconstructed CT images for assessing elbow joint osteoarthritis in dogs are consistent with results of radiographic assessment. Am J Vet Res 2022; 83 (10) x