Traumatic craniolateral shoulder luxation and fracture of the lesser tubercle of the humerus in a dog

Summary

A five-year old, spayed female, Bearded Collie was presented with a 24-hour history of non-weight-bearing lameness of the right thoracic limb after sustaining vehicular trauma. Radio-graphs revealed a craniolateral scapulohumeral luxation and a distally and medially displaced fracture of the lesser tubercle of the humerus. Open reduction and internal fixation of the fracture was achieved with lag screw fixation and an anti-rotational Kirsch-ner wire. Surgical repair resulted in compression across the fracture line, anatomic reduction of the articular surface, and a stable scapulohumeral joint following reduction of the humeral head in the glenoid. Six weeks postoperatively, the patient exhibited no evidence of pain or lameness on the right thoracic limb and radiographs revealed complete healing of the fracture and normal articulation of the scapulohumeral joint. This is the first report of a lesser tubercle fracture associated with a craniolateral shoulder luxation. Surgical intervention resulted in the return of full shoulder joint function in this dog.

Keywords

Scapulohumeral luxation - lesser tubercle fracture - Spica splint

• References

• 1 Talcott KW, Vasseur PB. Luxation of the scapulohumeral joint. In: Slatter D, editor. Handbook of Small Animal Surgery. 3^rd Edition. Philadelphia: WB Saunders; 2003: 1897-1904.
• 2 Hohn RB, Rosen H, Bohning RH. et al Surgical stabilization of recurrent shoulder luxation. Vet Clin North Am 1971; 1: 537-548.
• 3 Piermattei DL, Flo GL, DeCamp CE. The Shoulder Joint. In: Brinker, Piermattei and Flo’s Handbook of Small Animal Orthopedics and Fracture Repair. 4^th ed. Philadelphia: WB Saunders; 2006: 262-296.
• 4 Laflamme D. Development and validation of a body condition scoring system for dogs. Canine Pract 1997; 22: 10-15.
• 5 Piermattei DL. An Atlas of Surgical Approaches to the Bones and Joints of the Dog and Cat. 3^rd ed. Philadelphia: WB Saunders; 1993
• 6 Vasseur PB, Moore D, Brown SA. Stability of the canine shoulder joint: an in vitro analysis. Am J Vet Res 1982; 43: 352-255.
• 7 Sideway BK, McLaughlin RM, Elder SH. et al Role of the tendons of the biceps brachii and infraspinatus muscles and the medial glenohumeral ligament in the maintenance of passive shoulder joint stability in dogs. Am J Vet Res 2004; 65: 1216-1222.
• 8 Vasseur PB. Clinical results of surgical correction of shoulder luxations in dogs. J Am Vet Med Assoc 1983; 182: 503-505.
• 9 Puglisi TA. Canine humeral joint instability-Part I. Comp Contin Educ 1986; 8: 593-601.
• 10 Earwaker J. Isolated avulsion fracture of the lesser tuberosity of the humerus. Skel Radiol 1990; 19: 121-125.
• 11 Klasson SC, Vander Schilden JL, Park JP. Late effect of isolated avulsion fractures of the lesser tubercle of the humerus in children. Report of two cases. J Bone Joint Surg Am 1993; 75: 1691-1694.
• 12 Piermattei DL, Flo GL, DeCamp CE. Principles of Joint Surgery. In: Brinker, Piermattei and Flo’s Handbook of Small Animal Orthopedics and Fracture Repair. 4^th ed. Philadelphia: WB Saunders; 2006: 216-232.