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Humerus: fracture

icanis

Introduction

  • Cause: fractures of the canine humerus occur for 2 distinct reasons:  
    1. Major trauma, usually a road traffic accident or fall from a height, or less commonly due to gunshot injury.   
    2. Humeral condylar fractures that occur without trauma and during normal activity, ie whilst walking, running or jumping. These occur secondary to Humeral IntraCondylar Fissure (HIF or HCF) previously called Incomplete Ossification of the Humeral Condyle (IOHC).
  • Signs: acute onset, severe to non-weight bearing forelimb lameness.  
  • Fractures can be divided into four main regions:   
    • Fractures of the proximal physis.  
    • Diaphyseal fractures.  
    • Supracondylar fractures.  
    • Condylar fractures. Condylar fractures can be subdivided into: 
      • Lateral condyle fractures.  
      • Medial condylar fracture.  
      • Bi (medial and lateral) condylar fractures, also called Y or T fractures.  
  • Treatment: surgical treatment is recommended; there are few alternatives bar amputation (which is often not possible because of contralateral elbow pathology) or euthanasia.   
  • Prognosis:  
    • Diaphyseal fractures: when managed appropriately and promptly the prognosis for humeral fractures is generally good.  
    • Condylar fractures: these are articular fractures hence perfect fracture reconstruction is essential, and the bone segments are very small making accurate reduction and stabilization very challenging. Bicondylar / Y/T fractures are the most challenging fractures, particularly when comminuted. When managed appropriately and promptly the prognosis for humeral condylar fractures is good but the margin for error; otherwise resulting in a poorer prognosis.

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed Papers

  • Recent references from PubMed and VetMedResource
  • Cinti F, Pisani G, Vezzoni L, Peirone B, Vezzoni A (2017) Kirschner wire fixation of Salter-Harris type IV fracture of the lateral aspect of the humeral condyle in growing dogs. A retrospective study of 35 fractures. Vet Comp Orthop Traumatol 30(1), 62-68 PubMed.   
  • Guiot L P, Guillou R P, Déjardin L M (2019) Minimally invasive percutaneous medial plate rod osteosynthesis for treatment of bicondylar humeral fractures in dogs: Surgical technique and case report. Vet Surg 48(S1), O34-O40 PubMed
  • Longley M, Chase D, Calvo I, Hall J, Langley-Hobbs SJ, Farrell M (2018) A comparison of fixation methods for supracondylar and distal humeral shaft fractures of the dog and cat. Can Vet J 59(12), 1299-1304 PubMed.
  • McKee W M, Macias C, Innes J F (2005) Bilateral fixation of Y-T humeral condyle fractures via medial and lateral approaches in 29 dogs. J Small Anim Pract 46(5), 217-226 PubMed.
  • Moores A P, Tivers M S, Grierson J (2014) Clinical assessment of a shaft screw for stabilization of the humeral condyle in dogs. Vet Comp Orthop Traumatol 27(3), 179-85 PubMed.
  • Moores A P (2021) Humeral Intracondylar Fissure in Dogs. Vet Clin North Am Small Anim Pract 51(2), 421-437 PubMed.
  • Perry K L, Bruce M, Woods S, Davies C, Heaps L A, Arthurs G I (2015) Effect of fixation method on postoperative complication rates after surgical stabilization of lateral humeral condylar fractures in dogs. Vet Surg 44(2), 246-55 PubMed.
  • Sanchez Villamil C, Phillips A S J, Pegram C L, O'Neill D G, Meeson R L (2020) Impact of breed on canine humeral condylar fracture configuration, surgical management, and outcome. Vet Surg 49(4), 639-647 PubMed.
  • Smith M A J, Jenkins G, Dean B L, O'Neill T M, Macdonald N J (2020) Effect of breed as a risk factor for humeral condylar fracture in skeletally immature dogs. J Small Anim Pract 61(6), 374-380 PubMed.
  • Walton M B, Crystal E, Morrison S, Onyett J, McClement J, Allan R, Straw M &  Innes J F (2020), A humeral intracondylar repair system for the management of humeral intracondylar fissure and humeral condylar fracture. J Small Anim Pract 61, 757-765 PubMed.

Other sources of information

  • Clarke S (2016) The humerus. In: BSAVA Manual of Canine and Feline Fracture Repair and Management. Eds Gemmill T & Clements D, BSAVA publishing. Chapter 20. ISBN: 978-1-905-31968-8 
  • DeCamp C E (2016) Fractures of the humerus. In: Brinker, Piermattei and Flo’s Handbook of Small Animal Othopedics and Fracture Repair, 5th edn, Chapter 11. Eds DeCamp C E, Johnston S A, Dejardin L M, Schaefer S L, Elsevier Inc. ISBN: 978-1-4377-2364-9 

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