Whyte MacKenzie A, Murphy Sean M, Won Wade W, Weng Hsin-Yi, Malek Sarah
Kansas State University Veterinary Teaching Hospital, Manhattan, Kansas, USA.
WestVet Animal Specialty and Emergency Center, Boise, Idaho, USA.
Vet Surg. 2025 Feb;54(2):334-344. doi: 10.1111/vsu.14156. Epub 2024 Aug 21.
To describe unicondylar humeral fracture (UHF) repair using cannulated transcondylar screws, report postoperative fracture reduction, healing, and complication rates.
Retrospective.
A total of 49 client owned dogs with UHF.
Surgical technique and approach (i.e., open, limited open, or minimally invasive) were recorded. Articular step defect (ASD) and gap (Gap) at the humeral condylar articular surface were measured on pre- and postoperative images and reported as percentages. Fracture healing was graded on follow-up radiographs. Functional outcome was based on client questionnaire over the phone. General linear models were used to assess the impact of surgical approach on %ASD, %Gap, whereas Cox regression was used to assess prognostic factors of full fracture healing.
A total of 49 fractures repaired with a transcondylar screw with or without an antirotational pin(s) were included. Surgical approach did not have an impact on postoperative %ASD, %Gap or development of complications. The overall complication rate was 26% (11/42), with no revision surgery necessary. Of the dogs that encountered complications, 50% required pin and/or screw removal after fracture healing. For 29 dogs with a minimum of four-month owner telephone questionnaire follow-up, 90% reported no lameness and only three reported intermittent lameness. Achieving complete fracture healing was affected by increased postoperative %ASD (p = .033).
The UHFs repaired by transcondylar cannulated screws had acceptable outcomes and fracture reduction with complication rates being similar regardless of the surgical approach.
Cannulated screws can be implanted with varying surgical approaches to successfully repair UHFs with comparable clinical outcome to previous reports.
描述使用空心经髁螺钉修复单髁肱骨骨折（UHF）的方法，报告术后骨折复位、愈合及并发症发生率。
回顾性研究。
共49只患有UHF的客户拥有的犬。
记录手术技术和入路（即开放、有限开放或微创）。在术前和术后影像上测量肱骨髁关节面的关节台阶缺损（ASD）和间隙（Gap），并以百分比报告。根据随访X线片对骨折愈合进行分级。功能结果基于通过电话对客户进行的问卷调查。使用一般线性模型评估手术入路对ASD百分比、间隙百分比的影响，而使用Cox回归评估骨折完全愈合的预后因素。
共纳入49例使用经髁螺钉（有或无抗旋转针）修复的骨折病例。手术入路对术后ASD百分比、间隙百分比或并发症的发生没有影响。总体并发症发生率为26%（11/42），无需翻修手术。在出现并发症的犬中，50%在骨折愈合后需要取出针和/或螺钉。对29只至少随访四个月的犬进行电话问卷调查，90%报告无跛行，只有3只报告间歇性跛行。术后ASD百分比增加会影响骨折完全愈合（p = 0.033）。
经髁空心螺钉修复UHF的效果可接受，骨折复位良好，无论手术入路如何，并发症发生率相似。
可采用不同的手术入路植入空心螺钉，以成功修复UHF，临床结果与先前报告相当。
