Short and long-term outcome after transcondylar screw placement to treat humeral intracondylar fissure in dogs

Authors: 
Chase D, Sul R, Solano M, Calvo I, Joslyn S, Farrell M.
Vet Surg. 2019 Jan 21. doi: 10.1111/vsu.13155. [Epub ahead of print]

OBJECTIVE: To describe the postoperative complications and long-term functional outcome after surgical management of humeral intracondylar fissure (HIF) by transcondylar screw (TCS) placement.

STUDY DESIGN: Retrospective study.

SAMPLE POPULATION: Nineteen dogs (26 elbows) METHODS: Medical records (2000-2009) were reviewed for dogs with a diagnosis of HIF according to results of computed tomography and treated by TCS placement at a single referral institution. Collected data included signalment, surgical technique, surgical duration, surgeon experience, use of antibiotics, and the presence and nature of any complications. Owner questionnaire, orthopedic examination, and pressure platform analysis were used to assess long-term outcome. The relationship between these variables was statistically analyzed.

RESULTS: In total, 18 of 26 surgically managed elbows were diagnosed with a postoperative complication; 11 of these consisted of a surgical site infection (SSI). No risk factors for short-term complications or long-term outcome were identified. Dogs with an SSI (n = 11) were 28 times more likely to have an unsatisfactory long-term outcome than dogs without an SSI (n = 8). Symmetry indices (SI) between thoracic and pelvic limbs did not return to published normal values. There was no difference in the SI of dogs with HIF and a surgically repaired contralateral humeral condylar fracture.

CONCLUSION: Placement of a TCS was commonly associated with short-term complications, affecting long-term outcome.

CLINICAL SIGNIFICANCE: The high complication rate after placement of lateromedial TCS provides evidence to justify the development of alternative strategies to manage HIF.

Small animal: