Abstract
The aim of this study was to describe the use of locking compression plates (LCP) in Y-T humeral condyle fractures and to evaluate their clinical outcome. This study involved a retrospective review, including clinical, radiographical and canine brief pain inventory outcome evaluation. Eighteen consecutive dogs met the inclusion criteria, and 15/18 were considered to have humeral intracondylar fissure. Twelve of 18 dogs had simple fractures, and the remaining six had comminuted fractures. Postoperative radiographs revealed accurate intracondylar reconstruction (articular step defect [ASD] < 1 mm) in 17/18 of patients. Short-term outcome was considered fully functional in 9/13 and acceptable in 3/13 patients. Complications were diagnosed in 2/13; infection in one with resolution after antibiotic treatment, and one case of implant failure. Nine of 18 owners provided postoperative questionnaire responses (median 25; range: 14-52 months) and 8/9 clients perceived the treatment to have resulted in an excellent overall outcome. Repair of Y-T humeral fractures with LCP allowed for hybrid fixation and monocortical screw placement in distal fracture fragments. There was no significant ASD at the intracondylar fracture line in most cases. ASD using combined medial and lateral approaches depends upon the accuracy of supracondylar reduction, particularly on the side that is reduced and stabilized first, and the use of locking screws may have been influential in minimizing primary loss of reduction, potentially maintaining the initial fragment reduction.
Highlights
Distal humeral condylar fractures, often described as Y-T fractures, are common in dogs and involve an intra-articular fracture of the humeral condyle with concurrent separation from the diaphysis.[1,2,3,4] Rigid fracture fragment fixation and precise reconstruction of the articular surface are paramount to optimize functional outcome and limit development of osteoarthritis.[1,5] Typically, the fragments are reduced via Richard L
The aim of this study was to describe the use of locking compression plates (LCP) in Y-T humeral condyle fractures and to evaluate their clinical outcome
Clinical significance Repair of Y-T humeral fractures with LCP allowed for hybrid fixation and monocortical screw placement in distal fracture fragments
Summary
Often described as Y-T fractures, are common in dogs and involve an intra-articular fracture of the humeral condyle with concurrent separation from the diaphysis.[1,2,3,4] Rigid fracture fragment fixation and precise reconstruction of the articular surface are paramount to optimize functional outcome and limit development of osteoarthritis.[1,5] Typically, the fragments are reduced via Richard L. Olecranon osteotomy or combined medial and lateral approaches, followed by rigid internal fixation.[1,2] To date, their functional outcome has been assessed subjectively and results have been variable.[1,3,6]. There has been considerable interest in locking plate technology for fracture repair, with results demonstrating advantages under certain circumstances.[7,8,9] Cortical plating produces compression between the implant and the bone, relying on the generation of friction between plate and bone and between screw head and plate,[10,11] whereas in locking plates, the screw is mechanically coupled to the plate.[10] This received September 24, 2018 accepted after revision April 10, 2019
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