Morgan O D E, Reetz J A, Brown D C, Tucker S M, Mayhew P D
Department of Clinical Studies, Matthew J. Ryan Veterinary Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Vet Comp Orthop Traumatol. 2008;21(5):400-5. doi: 10.3415/vcot-07-11-0107.
To determine outcome, report complications, and risk factors for complications associated with the surgical treatment of fractures of the lateral aspect of the humeral condyle (FLHC) in dogs.
Fifty dogs with FLHC that had been repaired surgically were included in this retrospective case series.
The medical records and radiographs from 50 dogs with FLHC from 1990--2006 were analyzed.
The complication rate was 30%. For every 30-minute increase in surgical time the odds of a complication increased by 2.00 (95% CI: 1.06, 3.77). For every 10 degrees increase in the angle between the transcondylar screw and a line between the epicondyles viewed on a craniocaudal radiograph there was a 4.82 (95% CI: 1.23, 18.86) greater odds of an intracondylar fracture gap appearing on postoperative radiographs. When an intracondylar fracture gap was present after surgery there was a 25% long-term radiographic outcome failure rate, whereas there was a 0% radiographic failure rate in the dogs in which an intracondylar fracture gap was not present. In conclusion, transcondylar screw placement parallel to the epicondylar line should be attempted for the repair of FLHC. An increase in surgical time leads to an increase in postoperative complication rate. The presence of an intracondylar fracture gap may be associated with fracture failure.
Screw angulation predisposed to postoperative intracondylar fracture gap which in turn may be associated with higher fracture fixation failure rate. The dogs that had prolonged surgical times had an increased complication rate.
确定犬肱骨髁外侧骨折（FLHC）手术治疗的结果，报告并发症及并发症的危险因素。
本回顾性病例系列纳入了50只接受FLHC手术修复的犬。
分析了1990年至2006年50只患有FLHC犬的病历和X光片。
并发症发生率为30%。手术时间每增加30分钟，发生并发症的几率增加2.00（95%可信区间：1.06，3.77）。在颅尾位X光片上，髁间螺钉与上髁间连线的夹角每增加10度，术后X光片上出现髁内骨折间隙的几率就高出4.82（95%可信区间：1.23，18.86）。术后存在髁内骨折间隙时，长期影像学结果失败率为25%，而不存在髁内骨折间隙的犬影像学失败率为0%。总之，修复FLHC时应尝试将髁间螺钉平行于上髁线放置。手术时间增加会导致术后并发症发生率增加。髁内骨折间隙的存在可能与骨折失败有关。
螺钉角度易导致术后髁内骨折间隙，进而可能与较高的骨折固定失败率相关。手术时间延长的犬并发症发生率增加。
