Impact of breed on canine humeral condylar fracture configuration, surgical management, and outcome.

Carlos Sanchez Villamil,Dan G. O'Neill,Andrew S. J. Phillips,Camilla L. Pegram,Richard L. Meeson

doi:10.1111/vsu.13432

Carlos Sanchez Villamil, Dan G. O'Neill + Show 3 more

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https://doi.org/10.1111/vsu.13432

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Abstract

To report the prevalence, configuration, risk factors, fixation methods and outcomes after repair of humeral condylar fractures (HCF) in dogs. Retrospective nested cohort study. One hundred twelve dogs. Medical records of dogs referred between January 2010 and August 2018 were searched for HCF. Demographics, fracture configuration, repair, and complications were obtained from medical records. Radiographs were assessed for fracture reduction, implant positioning, and bone healing. Short-term radiographic and clinical outcomes, and long-term owner-assessed outcome was determined. Associations between these variables were statistically analyzed. Dogs with HCF represented 112 of 43 325 (0.26%, 95% CI 0.22-0.31) referrals. French bulldogs and spaniel breeds were predisposed to HCF (P < .02). French bulldogs were 6.58 times (95% CI 1.62-26.7) more likely than other breeds to have a medial HCF (P = .008). Epicondylar plate fixation was associated with reduced complications compared with lag screws and Kirschner wires (P = .009). Lameness was scored as 1 of 5 (median) in the 85 dogs with initial follow-up (median 6 weeks) after HCF repair. Outcome was considered excellent in 26 of 31 dogs with long-term follow-up (median 36 months). French bulldogs and spaniels were predisposed to HCF, and medial HCF were more common in French bulldogs. Epicondylar plate fixation was associated with reduced complications. French bulldogs are predisposed to HCF, including medial HCF. Epicondylar plate fixation is recommended over other epicondylar fixation methods to reduce complications.

Highlights

Humeral condylar fractures (HCF) account for nearly 50% of all humeral fractures in dogs[1] and are classified into lateral, medial, or intercondylar/bicondylar configurations.[2]
The hypotheses were that (1) French bulldogs have an increased odds of HCF compared with non-spaniel breeds, (2) French bulldogs are predisposed to medial HCF compared with other breeds, (3) HCF epicondylar repair with plates has a lower complication risk than other methods of repair, and (4) breed and fracture morphology are not associated with a difference in clinical outcome
Breed predisposition was confirmed for spaniel breeds and detected for French bulldogs

Summary

| INTRODUCTION

Humeral condylar fractures (HCF) account for nearly 50% of all humeral fractures in dogs[1] and are classified into lateral, medial, or intercondylar/bicondylar configurations.[2]. Most clinical studies in which HCF has been investigated were conducted pre1995.1,4-6,8 Since to the best of the authors' knowledge, no epidemiological studies have been conducted to accurately determine the risk of HCF, nor have the predisposing factors, fracture morphology, or repair method been assessed for impact on complications and outcome. The objectives of this study were (1) to report the prevalence, fracture configuration and risk factors for HCFs within a contemporary referral population of dogs; and (2) to describe methods of repair and outcome, and to identify risk factors for complications. The hypotheses were that (1) French bulldogs have an increased odds of HCF compared with non-spaniel breeds, (2) French bulldogs are predisposed to medial HCF compared with other breeds, (3) HCF epicondylar repair with plates has a lower complication risk than other methods of repair, and (4) breed and fracture morphology are not associated with a difference in clinical outcome

| MATERIALS AND METHODS

| RESULTS

Findings

| DISCUSSION