O D E Morgan1, J A Reetz, D C Brown, S M Tucker, P D Mayhew. 1. Department of Clinical Studies, Matthew J. Ryan Veterinary Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA. odemorgan@gmail.com
Abstract
OBJECTIVE: To determine outcome, report complications, and risk factors for complications associated with the surgical treatment of fractures of the lateral aspect of the humeral condyle (FLHC) in dogs. STUDY DESIGN: Fifty dogs with FLHC that had been repaired surgically were included in this retrospective case series. METHODS: The medical records and radiographs from 50 dogs with FLHC from 1990--2006 were analyzed. RESULTS: The complication rate was 30%. For every 30-minute increase in surgical time the odds of a complication increased by 2.00 (95% CI: 1.06, 3.77). For every 10 degrees increase in the angle between the transcondylar screw and a line between the epicondyles viewed on a craniocaudal radiograph there was a 4.82 (95% CI: 1.23, 18.86) greater odds of an intracondylar fracture gap appearing on postoperative radiographs. When an intracondylar fracture gap was present after surgery there was a 25% long-term radiographic outcome failure rate, whereas there was a 0% radiographic failure rate in the dogs in which an intracondylar fracture gap was not present. In conclusion, transcondylar screw placement parallel to the epicondylar line should be attempted for the repair of FLHC. An increase in surgical time leads to an increase in postoperative complication rate. The presence of an intracondylar fracture gap may be associated with fracture failure. CLINICAL SIGNIFICANCE: Screw angulation predisposed to postoperative intracondylar fracture gap which in turn may be associated with higher fracture fixation failure rate. The dogs that had prolonged surgical times had an increased complication rate.
OBJECTIVE: To determine outcome, report complications, and risk factors for complications associated with the surgical treatment of fractures of the lateral aspect of the humeral condyle (FLHC) in dogs. STUDY DESIGN: Fifty dogs with FLHC that had been repaired surgically were included in this retrospective case series. METHODS: The medical records and radiographs from 50 dogs with FLHC from 1990--2006 were analyzed. RESULTS: The complication rate was 30%. For every 30-minute increase in surgical time the odds of a complication increased by 2.00 (95% CI: 1.06, 3.77). For every 10 degrees increase in the angle between the transcondylar screw and a line between the epicondyles viewed on a craniocaudal radiograph there was a 4.82 (95% CI: 1.23, 18.86) greater odds of an intracondylar fracture gap appearing on postoperative radiographs. When an intracondylar fracture gap was present after surgery there was a 25% long-term radiographic outcome failure rate, whereas there was a 0% radiographic failure rate in the dogs in which an intracondylar fracture gap was not present. In conclusion, transcondylar screw placement parallel to the epicondylar line should be attempted for the repair of FLHC. An increase in surgical time leads to an increase in postoperative complication rate. The presence of an intracondylar fracture gap may be associated with fracture failure. CLINICAL SIGNIFICANCE: Screw angulation predisposed to postoperative intracondylar fracture gap which in turn may be associated with higher fracture fixation failure rate. The dogs that had prolonged surgical times had an increased complication rate.