Subscribe to RSS
Correlation between the Insertion Side of a Transcondylar Screw for the Surgical Management of Humeral Intracondylar Fissures in Dogs and the Incidence of Postoperative Surgical Site Infection
Objective An increased rate of surgical site infection (SSI) following treatment of canine humeral intracondylar fissure (HIF) with a lateromedially (LM) placed transcondylar screw (TCS) compared with a mediolateral (ML) TCS has been previously postulated. We hypothesized that the direction of insertion of the TCS would not affect the incidence of postoperative SSI.
Study Design It was single-centre retrospective study. Dogs with HIF confirmed by computerized tomography, treated by TCS placement (between 2008 and 2019) and with a minimum follow-up of 12 weeks, were included. The following data were recorded: signalment, presenting clinical signs, direction of placement and size of the utilized TCS, surgical and anaesthetic times, concurrent surgical procedures, presence of concomitant elbow pathology, perioperative and postoperative antibiotic usage and postoperative complications. Recorded data were analysed with a multinomial logistic regression model with a p-value less than or equal to 0.05.
Results Thirty-five dogs (46 elbows) met the inclusion criteria. Median clinical follow-up interval was 52 weeks. Seven of thirty-one elbows with a ML TCS, and 4/15 elbows with a LM TCS developed SSI. Four of nine dogs that underwent bilateral single-surgery TCS placement developed SSI unilaterally.
Conclusion No significant difference was shown in short-term SSI occurrence between the ML and the LM direction of placement of the TCS.
Keywordsdog - humeral intracondylar fissure - transcondylar screw - transcondylar screw direction - surgical site infection
All authors contributed equally in drafting and approval of manuscript.
Received: 17 January 2022
Accepted: 24 March 2023
Article published online:
09 May 2023
© 2023. Thieme. All rights reserved.
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
- 1 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
- 2 Moores AP, Tivers MS, Grierson J. Clinical assessment of a shaft screw for stabilization of the humeral condyle in dogs. Vet Comp Orthop Traumatol 2014; 27 (03) 179-185
- 3 Chase D, Sul R, Solano M, Calvo I, Joslyn S, Farrell M. Short- and long-term outcome after transcondylar screw placement to treat humeral intracondylar fissure in dogs. Vet Surg 2019; 48 (03) 299-308
- 4 McCarthy J, Woods S, Mosley JR. Long-term outcome following management of canine humeral intracondylar fissure using a medial approach and a cannulated drill system. Vet Rec 2020; 186 (15) 490-490
- 5 Walton MB, Crystal E, Morrison S. et al. A humeral intracondylar repair system for the management of humeral intracondylar fissure and humeral condylar fracture. J Small Anim Pract 2020; 61 (12) 757-765
Perioperative morbidity associated with mediolateral positional screw placement for humeral intracondylar fissure. Abstract presented at: Annual Meeting of the British Veterinary Orthopaedic Association; April 12, 2012; Birmingham
- 7 Butterworth SJ, Innes JF. Incomplete humeral condylar fractures in the dog. J Small Anim Pract 2001; 42 (08) 394-398
- 8 Meyer-Lindenberg A, Heinen V, Fehr M, Nolte I. Incomplete ossification of the humeral condyle as the cause of lameness in dogs. Vet Comp Orthop Traumatol 2002; 15 (03) 187-194
- 9 Fitzpatrick N, Smith TJ, O'Riordan J, Yeadon R. Treatment of incomplete ossification of the humeral condyle with autogenous bone grafting techniques. Vet Surg 2009; 38 (02) 173-184
- 10 Jenkins G, Moores AP. Medial epicondylar fissure fracture as a complication of transcondylar screw placement for the treatment of humeral intracondylar fissure. Vet Surg 2022; 51 (04) 600-610
- 11 Carwardine D, Burton NJ, Knowles TG, Barthelemy N, Parsons KJ. Outcomes, complications and risk factors following fluoroscopically guided transcondylar screw placement for humeral intracondylar fissure. J Small Anim Pract 2021; 62 (10) 895-902
- 12 Moores AP, Moores AL. The natural history of humeral intracondylar fissure: an observational study of 30 dogs. J Small Anim Pract 2017; 58 (06) 337-341
- 13 Välkki KJ, Thomson KH, Grönthal TSC. et al. Antimicrobial prophylaxis is considered sufficient to preserve an acceptable surgical site infection rate in clean orthopaedic and neurosurgeries in dogs. Acta Vet Scand 2020; 62 (01) 53
- 14 Fitzpatrick N, Solano MA. Predictive variables for complications after TPLO with stifle inspection by arthrotomy in 1000 consecutive dogs. Vet Surg 2010; 39 (04) 460-474
- 15 Hagen CRM, Singh A, Weese JS, Marshall Q, Linden AZ, Gibson TWG. Contributing factors to surgical site infection after tibial plateau leveling osteotomy: a follow-up retrospective study. Vet Surg 2020; 49 (05) 930-939
- 16 Moores AP. Humeral intracondylar fissure in dogs. Vet Clin North Am Small Anim Pract 2021; 51 (02) 421-437
- 17 Morgan ODE, Reetz JA, Brown DC, Tucker SM, Mayhew PD. Complication rate, outcome, and risk factors associated with surgical repair of fractures of the lateral aspect of the humeral condyle in dogs. Vet Comp Orthop Traumatol 2008; 21 (05) 400-405
- 18 Perry KL, Bruce M, Woods S, Davies C, Heaps LA, Arthurs GI. Effect of fixation method on postoperative complication rates after surgical stabilization of lateral humeral condylar fractures in dogs. Vet Surg 2015; 44 (02) 246-255
- 19 Barnes DM, Morris AP, Anderson AA. Defining a safe corridor for transcondylar screw insertion across the canine humeral condyle: a comparison of medial and lateral surgical approaches. Vet Surg 2014; 43 (08) 1020-1031
- 20 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
World Health Organization.
WHO guidelines for safe surgery: 2009: safe surgery saves lives. Accessed April 4, 2023 at: http://apps.who.int/iris/bitstream/handle/10665/277399/9789241550475-eng.pdf?sequence=1&isAllowed=y
Centers for Disease Control and Prevention.
Healthcare-associated Infections- Accessed April 4, 2023 at: https://www.cdc.gov/hai/ssi/ssi.html
R Core Team.
‘R: a language and environment for statistical computing’. R foundation for Statistical Computing, Vienna, Austria. 2021 Accessed April 4, 2023 at: https://www.r-project.org
- 24 Witte PG, Bush MA, Scott HW. Propagation of a partial incomplete ossification of the humeral condyle in an American cocker spaniel. J Small Anim Pract 2010; 51 (11) 591-593
- 25 von Pfeil DJF, DeCamp CE, Agnello C, Steficek BA. Deformity secondary to bilateral incomplete ossification of the humeral condyle in a German Shorthaired Pointer dog. A case report with ten-year follow-up. Vet Comp Orthop Traumatol 2010; 23 (06) 468-471
- 26 Robin D, Marcellin-Little DJ. Incomplete ossification of the humeral condyle in two Labrador retrievers. J Small Anim Pract 2001; 42 (05) 231-234
- 27 Grand JG. Percutaneous screw fixation of incomplete ossification of the humeral condyle in three dogs (four elbows). J Am Anim Hosp Assoc 2017; 53 (01) 45-51
- 28 Gnudi G, Martini FM, Zanichelli S. et al. Incomplete humeral condylar fracture in two English Pointer dogs. Vet Comp Orthop Traumatol 2005; 18 (04) 243-245
- 29 Clark AC, Greco JJ, Bergman PJ. Influence of administration of antimicrobial medications after tibial plateau leveling osteotomy on surgical site infections: a retrospective study of 308 dogs. Vet Surg 2020; 49 (01) 106-113
- 30 Frey TN, Hoelzler MG, Scavelli TD, Fulcher RP, Bastian RP. Risk factors for surgical site infection-inflammation in dogs undergoing surgery for rupture of the cranial cruciate ligament: 902 cases (2005-2006). J Am Vet Med Assoc 2010; 236 (01) 88-94
- 31 Garcia Stickney DN, Thieman Mankin KM. The impact of postdischarge surveillance on surgical site infection diagnosis. Vet Surg 2018; 47 (01) 66-73