Moores A P, Tivers M S, Grierson J
Andy Moores, BVSc DSAS(Orth) Dip ECVS MRCVS, Anderson Moores Veterinary Specialists, Bunstead Barns, Poles Lane, Hursley, Winchester, Hampshire, United Kingdom, Phone: + 44 1962 767920, Fax: + 44 1962 775909, E-mail:
Vet Comp Orthop Traumatol. 2014;27(3):179-85. doi: 10.3415/VCOT-13-05-0063. Epub 2014 Feb 26.
To report the use of a 4.5 mm shaft screw for the management of humeral condylar fractures (HCF) and incomplete ossification of the humeral condyle (IOHC) in dogs, and to assess risk factors for complications.
Dogs with HCF or IOHC that were managed with a 4.5 mm shaft screw with a minimum follow-up of six months from surgery were included. Data from the case records were used to identify risk factors for complications. Long-term follow-up was provided by an owner questionnaire and veterinary re-examination.
Forty-three elbows were treated in 40 dogs (14 IOHC, 29 HCF). Minor complications were seen in four cases (9%) and major complications in 10 cases (23%). There were no statistically significant risk factors for major complication. Infection resulted in shaft screw removal from three IOHC cases. Four of eight IOHC cases that had a lateral approach had a major complication compared with zero out of six dogs that had a medial approach, but this difference was not significant (p = 0.085). Nine of 12 IOHC cases and 20/23 HCF cases had excellent or good limb use at the time of long-term follow-up (median of 106 weeks, range 26-227 weeks). All fractures healed but IOHC fissure healing was inconsistent. Fatigue failure of shaft screws was not seen.
The use of shaft screws for the management of IOHC and HCF is associated with a relatively low rate of complications (compared to previous reports) and a good long-term outcome.
报告使用4.5毫米骨干螺钉治疗犬肱骨髁上骨折(HCF)和肱骨髁不完全骨化(IOHC)的情况,并评估并发症的危险因素。
纳入使用4.5毫米骨干螺钉治疗HCF或IOHC且术后至少随访6个月的犬。利用病例记录数据确定并发症的危险因素。通过主人问卷调查和兽医复查进行长期随访。
40只犬的43个肘部接受了治疗(14例IOHC,29例HCF)。4例(9%)出现轻微并发症,10例(23%)出现严重并发症。严重并发症无统计学意义上的危险因素。感染导致3例IOHC病例的骨干螺钉被取出。8例采用外侧入路的IOHC病例中有4例出现严重并发症,而6例采用内侧入路的犬中无一例出现严重并发症,但差异无统计学意义(p = 0.085)。12例IOHC病例中的9例以及23例HCF病例中的20例在长期随访时(中位时间为106周,范围26 - 227周)肢体使用情况为优或良。所有骨折均愈合,但IOHC的裂隙愈合情况不一致。未观察到骨干螺钉的疲劳失效。
使用骨干螺钉治疗IOHC和HCF的并发症发生率相对较低(与既往报道相比),且长期预后良好。