Medial versus lateral transcondylar screw placement for canine humeral intracondylar fissures: A randomized clinical trial

• Published in: Veterinary surgery 2024-02, Vol.53 (2), p.264-276
• Main Authors: Carwardine, Darren, Mather, Alastair, Schofield, Imogen, Langley‐Hobbs, Sorrel, Carbonell‐Buj, Elena, Belch, Alex, Barthelemy, Nicolas, Parsons, Kevin
• Format: Article
• Language: English
• Subjects: Animals; Bone Screws - veterinary; Clinical trials; Complications; Dog Diseases - surgery; Dogs; Fracture Fixation, Internal - veterinary; Humans; Humerus; Humerus - surgery; Implants; Moments of inertia; Postoperative; Retrospective Studies; Screws; Surgical site infections; Surgical Wound Infection - veterinary; Transplants & implants
• ISSN: 0161-3499; 1532-950X
• DOI: 10.1111/vsu.13993

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 Fifty‐two 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 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. The majority of 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 bodyweight, 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 bodyweight, 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.