33rd Annual Scientific Meeting proceedings

Introduction: Articular fractures are commonly encountered in dogs and frequently in the elbow. Repair of articular fracture requires anatomic reduction, rigid fixation and early return to mobility. Minimally invasive approaches aim to reduce surgical morbidity, allow rapid return to function and can be used for minimally displaced, simple and acute articular fractures. Arthroscope-assisted management offers superior visualization of joint surfaces with less invasiveness compared with arthrotomy. 

Case description: A 3-month-old female Beagle dog was presented with acute onset of non-weightbearing lameness of the left forelimb. On radiographs, fracture of the lateral part of the distal humeral condylar with minimal displacement was diagnosed. First, lateral elbow arthroscopy, using a 2.4 mm, 30° oblique arthroscope (Arthrex, Munich, Germany) was performed showing fracture hematoma at the fracture line. The fracture was reduced using digital pressure under arthroscopic control, then maintained by forceps. A transcondylar 3.5-mm cannulated screw was placed with an anti-rotational pin across the epicondylar fracture in percutaneous fashion. Compression of the fracture line was arthroscopically seen while tightening the screw. Finally, medial arthroscopy confirmed accurate fracture reduction.

Results: Follow-up radiographs 8 weeks postoperatively showed complete fracture healing. There was no evidence of lameness. Five months postoperatively, the dog showed normal activity with no lameness.

Discussion/conclusions: Arthroscopic evaluation of the joint surface in this case ensures anatomic reduction and visualization of possible step defects while repairing the fracture line. It also permits percutaneous fixation with a minimal approach to the lateral part of the distal humeral condyle.