Medial epicondylar fissure fracture as a complication of transcondylar screw placement for the treatment of humeral intracondylar fissure
Objective To report the incidence of medial epicondylar fissure fracture (MEFF) after medial‐to‐lateral transcondylar screw placement in dogs with humeral intracondylar fissure (HIF) and to identify risk factors for MEFF. Study design Retrospective study. Sample population Seventy‐four client‐owned...
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Published in | Veterinary surgery Vol. 51; no. 4; pp. 600 - 610 |
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Main Authors | , |
Format | Journal Article |
Language | English |
Published |
Hoboken, USA
John Wiley & Sons, Inc
01.05.2022
Blackwell Publishing Ltd |
Subjects | |
Online Access | Get full text |
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Summary: | Objective
To report the incidence of medial epicondylar fissure fracture (MEFF) after medial‐to‐lateral transcondylar screw placement in dogs with humeral intracondylar fissure (HIF) and to identify risk factors for MEFF.
Study design
Retrospective study.
Sample population
Seventy‐four client‐owned dogs (88 elbows).
Methods
Medical records of dogs surgically treated for HIF, and postoperative imaging studies were reviewed for demographics, fracture characteristics, and repair techniques. The width of the transcondylar screw was expressed relative to the height of the condyle. Screw angle and degree of countersinking were recorded. Information from case records and follow‐up radiographs were used to identify complications.
Results
Medial epicondylar fissure fracture was identified in 10 elbows (11.4%) following medial‐to‐lateral transcondylar screw placement: 4 cases were detected intraoperatively, 2 on immediate postoperative radiographs, 1 during routine radiographic follow up, and 3 when radiographs were reviewed for this study. A larger relative screw size was found to increase the risk of MEFF (P = .004, OR = 1.5). Fifteen additional complications were identified in 13/80 elbows at a median of 6 weeks postoperatively (range 1–56 weeks). Screw loosening was the most frequent complication (n = 9) and was the only complication in dogs with MEFF (n = 3); MEFF tended to increase the risk of perioperative screw loosening (P = .06).
Conclusion
Medial epicondylar fissure fracture occurred in 10/88 elbows treated for HIF and was more common in elbows treated with a larger screw size relative to the height of the condyle.
Clinical significance
Placing transcondylar screws with a diameter inferior to 41% of the height of the condyle is recommended to avoid MEFF. Medial epicondylar fissure fracture appears to have a low clinical significance in the perioperative period, although its effect on long‐term outcome remains unknown. |
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Bibliography: | Funding information No grant or financial support to disclose. ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 0161-3499 1532-950X |
DOI: | 10.1111/vsu.13800 |