Fluoroscopic-Assisted Olecranon Fracture Repair in Three Dogs

Stephen C Jones,Matthew D Winter,Daniel D Lewis

doi:10.1155/2015/542842

Stephen C Jones, Matthew D Winter + Show 1 more

Open Access

https://doi.org/10.1155/2015/542842

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Abstract

Olecranon fractures in dogs are often both comminuted and intra-articular. Anatomic reduction and stable internal fixation are thus paramount to achieving primary bone healing and mitigating the development of posttraumatic osteoarthritis. Intraoperative fluoroscopy can be useful to confirm accurate fracture reduction and facilitate precise implant placement, potentially reducing the surgical exposure required and additional trauma. Despite widespread use in human surgery, reports of fluoroscopic-assisted fracture repair in dogs are limited. Presented here are three dogs in which intraoperative fluoroscopy was used to facilitate accurate olecranon fracture reduction and implant positioning. The olecranon fractures appeared to heal by primary bone union, although the anconeal process failed to obtain osseous union in one dog. Despite the development of mild-to-moderate osteoarthritis in all three dogs, and the nonunion of the anconeal process in one dog, the clinical outcome was considered successful with all dogs subjectively free of lameness at long-term follow-up evaluation. Intraoperative fluoroscopy was found to be a useful modality during fracture reduction and implant placement in dogs with olecranon fractures.

Highlights

The olecranon is the most proximal segment of the ulna and is comprised of the olecranon tuber, the anconeal process, and the proximal portion of the trochlear notch [1]
Despite widespread application in human orthopedic surgery [5,6,7,8,9], and an apparent increased usage in small animal surgery [15], reports detailing the results associated with fluoroscopic-assisted fracture stabilization in dogs are limited
Intraoperative fluoroscopy has been shown to be advantageous for assessing fracture reduction and facilitating accurate implant placement in human patients [6]

Summary

Introduction

The olecranon is the most proximal segment of the ulna and is comprised of the olecranon tuber, the anconeal process, and the proximal portion of the trochlear notch [1]. The majority of antebrachial fractures in dogs involve the radial and ulnar diaphyses [2] with surgical intervention often directed towards stabilization of the radius alone [3]. Olecranon fractures are often comminuted and commonly involve the articular surface of the trochlear notch [4]. Owing to the large tensile force exerted by the triceps brachii muscles and the frequent articular involvement, anatomic reduction and stable internal fixation of olecranon fractures are required to promote primary bone healing, mitigate the development of posttraumatic osteoarthritis, and optimize the probability of a return to prefracture limb function. The use of fluoroscopy allows surgeons to accurately assess fracture reduction while facilitating and confirming proper implant placement. This report describes the use of intraoperative fluoroscopy to facilitate the anatomic reduction and stabilization of intra-articular olecranon fractures in three dogs

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