Department of Veterinary Clinical Sciences, Small Animal Clinic - Surgical Department, Justus Liebig University, Giessen, Germany.
Unit for Biomathematics and Data Processing, Faculty of Veterinary Medicine, Justus Liebig University, Giessen, Germany.
N Z Vet J. 2022 Nov;70(6):349-356. doi: 10.1080/00480169.2022.2114557. Epub 2022 Sep 7.
Medical records from a single veterinary teaching hospital in Giessen, Germany were retrospectively reviewed for dogs presenting with medial or lateral humeral condylar fractures (HCF) between 2007 and 2019. Data regarding surgical technique and complications were collected from the medical records. These were supplemented through information obtained from telephone interviews with referral veterinarians and from an owner questionnaire completed ≥12 months after surgical repair, which also provided data regarding the outcome.
Eighty dogs with 85 HCF were identified: 13 (15.3%) HCF were medial (bilateral in two dogs) and 72 (84.7%) were lateral (bilateral in three dogs). French Bulldogs (n = 19/80; 23.8%) were most commonly affected. Patients were predominantly skeletally immature and light-weight, with a median age at the time of presentation of 3 (min 2, max 118) months and with a median body weight of 6.4 (min 1, max 46) kg. There were 38 female (47.5%) and 42 male (52.5%) dogs. Fractures developed most frequently secondary to minor trauma (67/77; 87.0%). Dogs were presented in 35/84 (41.7%) cases more than 24 hours after fracture occurrence.
Surgical treatment was performed in 80/85 (94.1%) HCF. An open reduction and internal fixation approach was chosen in all cases. A transcondylar screw (TS) combined with a supracondylar (SC) K-wire (67/80; 83.8%) was the most frequently used fixation technique. Considering all fracture fixation methods, complications (26/80; 32.5%) were classed as minor in 10 (12.5%), major in 14 (17.5%) and catastrophic in two (2.5%) of the 80 surgically treated HCF. Long-term outcome was excellent in 68.6% (24/35 HCF) and very good in 22.9% (8/35 HCF) of the cases for which follow-up information was obtained. Additionally, owner information revealed that 85.7% of dogs (30/35 HCF) were free of lameness in the long-term.
This case series demonstrates that surgical repair of lateral and medial HCF with a TS and SC K-wire is a viable option to consider in skeletally immature and light-weight patients. Complications occur frequently after surgical fixation of HCF, but owners can expect a very good to excellent long-term outcome in the majority of cases.
对 2007 年至 2019 年间在德国吉森的一家兽医教学医院就诊的患有肱骨内/外侧髁骨折(HCF)的犬进行了回顾性研究。从病历中收集了有关手术技术和并发症的数据。通过与转诊兽医的电话访谈和手术后 12 个月以上完成的主人调查问卷获得了补充信息,该问卷还提供了有关手术结果的信息。
共确定了 80 只患有 85 处 HCF 的犬:13 处(15.3%)为肱骨内髁(2 只为双侧),72 处(84.7%)为肱骨外髁(3 只为双侧)。法国斗牛犬(19/80;23.8%)最常受累。患者主要为未成熟和低体重,就诊时的中位年龄为 3(最小 2,最大 118)个月,中位体重为 6.4(最小 1,最大 46)kg。其中 38 只为雌性(47.5%),42 只为雄性(52.5%)。77 例(87.0%)骨折继发于轻微创伤。84 例中有 35 例(41.7%)在骨折发生后超过 24 小时就诊。
85 处 HCF 中有 80 处(94.1%)接受了手术治疗。所有病例均采用切开复位内固定术。最常使用的固定技术是经髁螺钉(TS)联合髁上(SC)克氏针(67/80;83.8%)。考虑所有骨折固定方法,并发症(26/80;32.5%)被分类为轻微(10/80;12.5%)、严重(14/80;17.5%)和灾难性(2/80;2.5%)。获得随访信息的 35 例中有 68.6%(24/35)的长期结果为极好,22.9%(8/35)的结果为很好。此外,主人信息显示,85.7%(30/35)的犬在长期随访中无跛行。
本病例系列研究表明,对于未成熟和低体重患者,使用 TS 和 SC 克氏针治疗肱骨内/外侧髁骨折是一种可行的选择。肱骨髁骨折手术后并发症发生率较高,但大多数病例的主人可期待非常好至极好的长期结果。