Perry Karen L, Bruce Mieghan, Woods Samantha, Davies Clare, Heaps Laura A, Arthurs Gareth I
The Royal Veterinary College, Veterinary Clinical Sciences, Services, Hawkshead Lane, North Mymms, United Kingdom.
Vet Surg. 2015 Feb;44(2):246-55. doi: 10.1111/j.1532-950X.2014.12276.x. Epub 2014 Sep 22.
To assess the impact of stabilization method on the complication rate after lateral humeral condylar fracture (LHCF) repair.
Retrospective multicenter clinical cohort study.
Dogs (n = 151) with LHCF.
Medical records (2004-2012) were reviewed for dogs that had surgical repair of LHCF. Data retrieved included signalment, cause of fracture, evidence of incomplete ossification of the humeral condyle, occurrence of postoperative complications, presence of supracondylar comminution preoperatively, and persistence of an intracondylar fissure postoperatively. Outcome was assessed based on the most recent data available and graded as excellent, good, fair, or poor.
LHCF (n = 135) were evaluated in 132 dogs; 61 fractures were stabilized using a transcondylar screw and supracondylar K-wire, 13 using a transcondylar screw and supracondylar screw, and 61 using a transcondylar screw and lateral epicondylar plate. Major complications were significantly (P = .01) more common after stabilization using a transcondylar screw and supracondylar K-wire (28%) than in dogs where a supracondylar screw or lateral epicondylar plate were used (11%). Cases that had postoperative complications were significantly (P = .02) more likely to have a poor outcome.
LHCF stabilized using a transcondylar screw and supracondylar K-wire are more likely to have major complications resulting in a poorer outcome than cases stabilized using a supracondylar screw or lateral epicondylar plate.
评估稳定方法对肱骨外侧髁骨折(LHCF)修复术后并发症发生率的影响。
回顾性多中心临床队列研究。
患有LHCF的犬(n = 151)。
回顾2004年至2012年接受LHCF手术修复的犬的病历。检索的数据包括特征、骨折原因、肱骨髁骨化不完全的证据、术后并发症的发生情况、术前髁上粉碎的存在以及术后髁内裂隙的持续存在。根据可得的最新数据评估结果,并分为优、良、中或差。
对132只犬的135处LHCF进行了评估;61处骨折采用髁间螺钉和髁上克氏针固定,13处采用髁间螺钉和髁上螺钉固定,61处采用髁间螺钉和外侧髁钢板固定。与使用髁上螺钉或外侧髁钢板固定的犬(11%)相比,采用髁间螺钉和髁上克氏针固定后主要并发症明显更常见(P = 0.01,28%)。发生术后并发症的病例预后较差的可能性明显更高(P = 0.02)。
与使用髁上螺钉或外侧髁钢板固定的病例相比,采用髁间螺钉和髁上克氏针固定的LHCF更有可能出现主要并发症,导致预后较差。