Vet Comp Orthop Traumatol 2019; 32(05): 401-407
DOI: 10.1055/s-0039-1691825
Clinical Communication
Georg Thieme Verlag KG Stuttgart · New York

Repair of Y-T Humeral Condyle Fractures with Locking Compression Plate Fixation

Felicity Moffatt
1   Department of Clinical Sciences and Services, Queen Mother Hospital for Animals, Royal Veterinary College, North Mymms, United Kingdom
,
Elvin Kulendra
1   Department of Clinical Sciences and Services, Queen Mother Hospital for Animals, Royal Veterinary College, North Mymms, United Kingdom
2   North Downs Specialist Referrals, Bletchingley, United Kingdom
,
1   Department of Clinical Sciences and Services, Queen Mother Hospital for Animals, Royal Veterinary College, North Mymms, United Kingdom
› Author Affiliations
Funding No funding was provided for this manuscript
Further Information

Publication History

24 September 2018

10 April 2019

Publication Date:
19 June 2019 (online)

Abstract

Objectives The aim of this study was to describe the use of locking compression plates (LCP) in Y-T humeral condyle fractures and to evaluate their clinical outcome.

Methods This study involved a retrospective review, including clinical, radiographical and canine brief pain inventory outcome evaluation.

Results Eighteen consecutive dogs met the inclusion criteria, and 15/18 were considered to have humeral intracondylar fissure. Twelve of 18 dogs had simple fractures, and the remaining six had comminuted fractures. Postoperative radiographs revealed accurate intracondylar reconstruction (articular step defect [ASD] < 1 mm) in 17/18 of patients. Short-term outcome was considered fully functional in 9/13 and acceptable in 3/13 patients. Complications were diagnosed in 2/13; infection in one with resolution after antibiotic treatment, and one case of implant failure. Nine of 18 owners provided postoperative questionnaire responses (median 25; range: 14–52 months) and 8/9 clients perceived the treatment to have resulted in an excellent overall outcome.

Clinical significance Repair of Y-T humeral fractures with LCP allowed for hybrid fixation and monocortical screw placement in distal fracture fragments. There was no significant ASD at the intracondylar fracture line in most cases. ASD using combined medial and lateral approaches depends upon the accuracy of supracondylar reduction, particularly on the side that is reduced and stabilized first, and the use of locking screws may have been influential in minimizing primary loss of reduction, potentially maintaining the initial fragment reduction.

Author Contribution

Felicity Moffatt contributed to acquisition of data and data analysis and interpretation. Elvin Kulendra contributed to data analysis and interpretation. Richard L. Meeson contributed to conception of study, study design and data analysis and interpretation. All authors drafted, revised and approved the submitted manuscript.


Supplementary Material

 
  • References

  • 1 McKee WM, Macias C, Innes JF. Bilateral fixation of Y-T humeral condyle fractures via medial and lateral approaches in 29 dogs. J Small Anim Pract 2005; 46 (05) 217-226
  • 2 Ness MG. Repair of Y-T humeral fractures in the dog using paired ‘String of Pearls’ locking plates. Vet Comp OrthopTraumatol 2009; 22 (06) 492-497
  • 3 Anderson TJ, Carmichael S, Miller A. Intercondylar humeral fractures in the dog: a review of 20 cases. J Small Anim Pract 1990; 31: 437-442
  • 4 Bardet JF, Hohn RB, Rudy RL. Fractures of the humerus in dogs and cats. A retrospective study of 130 cases. Vet Surg 1983; 12: 73-77
  • 5 Macias C, McKee WM. Articular and periarticular fractures in the dog and cat. In Pract 2003; 25: 446-465
  • 6 Vannini R, Smeak DD, Olmstead ML. Evaluation of surgical repair of 135 distal humeral fractures in dogs and cats. J Am Anim Hosp Assoc 1998; (b) 24: 537-545
  • 7 DeTora M, Kraus K. Mechanical testing of 3.5 mm locking and non-locking bone plates. Vet Comp OrthopTraumatol 2008; 21 (04) 318-322
  • 8 Frigg R. Locking compression plate (LCP). An osteosynthesis devise based on the dynamic compression plate and the point contact fixator (PC Fix). Injury 2001; 32 (Suppl. 02) 63-66
  • 9 Schütz M, Südkamp NP. Revolution in plate osteosynthesis: new internal fixator systems. J Orthop Sci 2003; 8 (02) 252-258
  • 10 Wagner M. General principles for the clinical use of the LCP. Injury 2003; 34 (Suppl. 02) B31-B42
  • 11 Johnson KA. Locking plates - the ultimate implant? “Nothing holds up the progress of science so much as the right idea at the wrong time.” Vincent de Vigneaud, Canada (1978). Vet Comp OrthopTraumatol 2009; 22 (02) I-II
  • 12 Moores AP, Moores AL. The natural history of humeral intracondylar fissure: an observational study of 30 dogs. J Small Anim Pract 2017; 58 (06) 337-341
  • 13 Piermattei DL. The Forelimb. In: Piermattei DL, Johnson KA. , eds. An Atlas of Surgical Approaches to the Bones and Joints of the Dog and Cat. 4th ed. Philadelphia, PA: Saunders; 2004: 149-275
  • 14 Sumner-Smith G. Gait analysis and orthopaedic examination. In: Slatter D, ed. Textbook of Small Animal Surgery. 2nd ed. Philadelphia, PA: WB Saunders; 1993: 1577-1586
  • 15 Cook JL, Evans R, Conzemius MG. , et al. Proposed definitions and criteria for reporting time frame, outcome, and complications for clinical orthopedic studies in veterinary medicine. Vet Surg 2010; 39 (08) 905-908
  • 16 Bennett D, Taylor DJ. Bacterial infective arthritis in the dog. J Small Anim Pract 1988; 29: 207-230
  • 17 Brown DC. Wound infections and antimicrobial use. In: Tobias KM, Johnston SA. , eds. Veterinary Surgery Small Animal Vol 1. Missouri: Elsevier Saunders; 2012: 135-139
  • 18 Brown DC, Boston RC, Coyne JC, Farrar JT. Development and psychometric testing of an instrument designed to measure chronic pain in dogs with osteoarthritis. Am J Vet Res 2007; 68 (06) 631-637
  • 19 Moores A. Humeral condylar fractures and incomplete ossification of the humeral condyle in dogs. In Pract 2006; 28: 391-397
  • 20 Conzemius MG, Evans RB. Caregiver placebo effect for dogs with lameness from osteoarthritis. J Am Vet Med Assoc 2012; 241 (10) 1314-1319
  • 21 Filipowicz D, Lanz O, McLaughlin R, Elder S, were S. A biomechanical comparison of 3.5 locking compression plate fixation to 3.5 limited contact dynamic compression plate fixation in a canine cadaveric distal humeral metaphyseal gap model. Vet Comp OrthopTraumatol 2009; 22 (04) 270-277
  • 22 Egol KA, Kubiak EN, Fulkerson E, Kummer FJ, Koval KJ. Biomechanics of locked plates and screws. J Orthop Trauma 2004; 18 (08) 488-493
  • 23 Hertel R, Eijer H, Meisser A, Hauke C, Perren SM. Biomechanical and biological considerations relating to the clinical use of the Point Contact-Fixator–evaluation of the device handling test in the treatment of diaphyseal fractures of the radius and/or ulna. Injury 2001; 32 (02) (Suppl. 02) B10-B14
  • 24 Gautier E, Sommer C. Guidelines for the clinical application of the LCP. Injury 2003; 34 (02) (Suppl. 02) B63-B76