Hazewinkel H A, Voorhout G
Tijdschr Diergeneeskd. 1986 Dec 15;111(24):1234-45.
An ununited medial coronoid process (MCP) is the most common developmental disturbance in the elbow joint of young dogs of large and medium-sized breeds. The clinical and radiological symptoms of ununited medial coronoid processes in thirty-nine dogs are reported, the presence of an ununited medial coronoid process being established by arthrotomy in these cases. Lameness was observed for the first time in these dogs, mainly Rottweilers, Retrievers and Berner Sennenhunde, and more often male dogs than bitches, when they were from four to six months of age. They showed lameness ranging from slight to severe, and the leg was frequently held in a position of abduction and outward rotation. The elbow joints involved often showed abnormal accumulations of fluid, hyperflexion and/or hyperextension being painful. Osteophytes, only occurring along the proximal border of the anconeal process, could be well assessed on the mediolateral radiographs. The appearance of the MCP, varying from normal to ununited, could best be evaluated in the mediolateral and anteroposterior medial oblique radiographs. These two radiographs were also of value in diagnosing an ununited anconeal process which was present at the same time as osteochondrosis of the medial condyle of the humerus in two dogs. The clinical symptoms were not associated with radiologically perceptible changes in some cases. Arthrotomy of the elbows showed that the entire apex or otherwise one or several fragments of the MCP, which are often wedged between the radius and ulna in these cases, may break off. Rapid post-operative improvement of locomotion is frequently reported. Preventive and diagnostic procedures carried out to make possible early institution of surgical treatment are discussed.
未愈合的内侧冠状突(MCP)是大中型犬种幼犬肘关节最常见的发育障碍。本文报告了39只犬未愈合内侧冠状突的临床和放射学症状,这些病例通过关节切开术确诊存在未愈合的内侧冠状突。这些犬首次出现跛行时,主要是罗威纳犬、寻回犬和伯恩山犬,公犬比母犬更常见,年龄在4至6个月。它们表现出从轻微到严重程度不等的跛行,患肢常保持外展和外旋姿势。受累的肘关节常出现异常积液,过度屈曲和/或过度伸展时疼痛。骨赘仅出现在尺骨鹰嘴突的近端边缘,在内外侧位X线片上可清晰显示。内侧冠状突的形态从正常到未愈合各不相同,在内外侧位和前后内侧斜位X线片上能得到最佳评估。这两种X线片对于诊断同时存在的未愈合尺骨鹰嘴突也有价值,在两只犬中,未愈合尺骨鹰嘴突与肱骨内侧髁骨软骨病同时出现。在某些情况下,临床症状与放射学可见的变化无关。肘关节切开术显示,内侧冠状突的整个尖端或部分碎片,在这些病例中常楔入桡骨和尺骨之间,可能会断裂。术后运动能力通常能迅速改善。本文还讨论了为尽早进行手术治疗而采取的预防和诊断措施。