A humeral intracondylar repair system for the management of humeral intracondylar fissure and humeral condylar fracture

Abstract

Objectives To report complications, clinical outcomes and CT‐imaging outcomes of a surgical system designed for the management of humeral intracondylar fissures and humeral condylar fractures. Materials and Methods Retrospective review of fracture healing from medical records, direct owner contact and an online data‐submission service. Follow‐up included CT scans and a calculated “bone‐opacity continuity index” to quantify bone healing. Results There was one major surgical complication and one major medical complication out of 34 fissure cases, and two major surgical and one major medical complication out of 14 fractures. Follow‐up times ranged from 29 to 1268 days. All cases with CT follow‐up had some continuity of bone opacity across the condyle. Clinical Significance In the cases included in this study, this repair system was associated with low complication rates and favourable healing rates, particularly for humeral intracondylar fissure.

Outcomes, complications and risk factors following fluoroscopically guided transcondylar screw placement for humeral intracondylar fissure

“…The condition has been described as an incomplete ossification of the humeral condyle (IOHC) (Marcellin-Little et al 1994) but case reports have also documented natural progression of HIF in adult dogs with the progression of partial to complete fissures (Witte et al 2010) and de novo fissure formation (Farrell et al 2011). For dogs presenting with a persistent forelimb lameness and an associated HIF, treatment has been described using a transcondylar screw or a combination of a transcondylar screw and autogenous bone graft (Butterworth & Innes 2001, Fitzpatrick et al 2009, Moores et al 2014, Easter et al 2020, Walton et al 2020. The accuracy of transcondylar screw placement can be improved with the use of an aiming device, a custom printed patient-specific drill guide or intraoperative fluoroscopy (Grand 2017, McCarthy et al 2019, Pardo et al 2019, Easter et al 2020.…”

“…2020, Walton et al . 2020). The accuracy of transcondylar screw placement can be improved with the use of an aiming device, a custom printed patient‐specific drill guide or intraoperative fluoroscopy (Grand 2017, McCarthy et al .…”

“…The accuracy of transcondylar screw placement can be improved with the use of an aiming device, a custom printed patient-specific drill guide or intraoperative fluoroscopy (Grand 2017, McCarthy et al 2019, Pardo et al 2019, Easter et al 2020. Complications associated with transcondylar screw placement for HIF are common and range from 15 to 69% with the most commonly reported complications including seroma and infection (Hattersley et al 2011, Moores et al 2014, Chase et al 2019, McCarthy et al 2019, Walton et al 2020.…”

Repair of Fractures of the Lateral Aspect of the Humeral Condyle in Skeletally Mature Dogs with Locking and Non-Locking Plates

“…5,28 Alternatively, consideration could be given to techniques which aim to improve the likelihood of intracondylar union, although presently there is no evidence to suggest improved outcomes when techniques of this sort are utilized. 29,30 A high proportion of transcondylar screws in this study were 4.5 mm shaft screws (23/32). The effect of this is unclear in the current study, but this may have contributed to the low complication rate as 4.5 mm shaft screws may be more resistant to fatigue failure in cases where intracondylar union is not achieved due to HIF.…”

“…Computed tomography may offer better assessment of intracondylar bone healing compared with orthogonal radiographs as well as documenting elbow co-morbidities. 30,34 Minor variation in surgeon technique, the retrospective nature and small sample size are further limitations of the current study. It is likely that the effect size of plate type on postoperative complications is small requiring recruitment of a larger cohort of subjects than the current study.…”