Medial versus lateral transcondylar screw placement for canine humeral intracondylar fissures
Objective: To determine the influence of screw direction on complications following transcondylar screw placement for the treatment of canine humeral intracondylar fissures (HIFs).
Study design: Equivalence, parallel group, randomized clinical trial.
Sample population: 52 client-owned dogs (73 elbows).
Methods: Transcondylar screw placement was randomized to either a medial or lateral approach. The primary outcome was the incidence of postoperative complications.
Results: There were 37 cases in the lateral approach group and 36 cases in the medial approach group. There was a significantly greater proportion of postoperative complications following the placement of transcondylar screws from a lateral to medial direction (p = .001). There were seven cases with complications (19%) in the medial approach group versus 23 cases with complications (62%) in the lateral approach group. Most complications were seromas (n = 13) and surgical site infections (n = 16) with 4 complications requiring further surgery. Implant area moment of inertia (AMI), normalized to body weight, was lower in dogs with a major complication (p = .037).
Conclusion: Transcondylar screws placed from lateral to medial for canine HIFs had a greater proportion of postoperative complications in this randomized clinical trial design. Implants with a lower AMI, relative to body weight, were more likely to lead to major complications.
Clinical significance: We recommend placing transcondylar screws from medial to lateral for canine HIFs to reduce the risk of postoperative complications. Relatively small-diameter implants had an increased risk of major complications.
Darren Carwardine et al. "Medial versus lateral transcondylar screw placement for canine humeral intracondylar fissures: A randomized clinical trial." Veterinary Surgery. 12 July 2023. https://doi.org/10.1111/vsu.13993
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