Humeral condylar fractures

 

These are the most common fracture we see. In the past, spaniels were over represented due to a developmental defect where the humeral condyles fail to permanently unite. This creates a weakness leading to a fracture on the outside aspect (lateral) of the elbow joint. Sole medial (inside) fractures were relatively rare as this side is anatomically much stronger. In fact many medial fractures involved both condyles and become y or t fractures- this causes complete collapse of the elbow joint. These are amongst some of the most technically challenging fractures we repair.

 

With the greatly increased popularity of Frenchies, some of the rules have changed. 80% of the condylar fractures we now see are in this breed. They often also occur in young puppies at around 4 months of age. Also for reasons currently unknown, a large proportion are sole medial condylar fractures (30-40%) The underlying cause is not failure of the condyles to unite as these are very young active bones and the condyles will only unite once growth ceases. We also see fractures in adults.

These are all serious fractures as they involve a joint.

 

To regain a functional limb, these cases require fairly urgent surgery and patients will often weigh as little as 3kg. Fortunately the outcome in the majority of cases is very good to excellent with normal limb function, though long term there will be an increased risk of arthritis.

 

Surgery involves accurately reducing the fracture then placing a lag (compression) screw across the condyles. To stabilise against rotation, either a k wire or a plate is applied to the condylar ridge. The k wire is the simple and cheaper option. This is the traditional technique, and in many cases still quite suitable. With medial condylar fractures, we would always recommend plating. On this side, the condylar ridge is far more structural. The plates we always use are locking PAX plates, these are expensive but we believe they are the most suited. We carry the complete range from the smallest at 2.0 to 3.5 covering virtually all condylar fractures patients.