|Repair of a Lateral Humeral Condyle Fracture in a Puppy|
|Written by Daniel Cardosa|
|Sunday, 27 September 2009 15:59|
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The case report in this folder is posted as a guide to what makes an acceptable case report. It is not perfect, no report ever is. The important thing is to follow the guidelines, choose a case that is appropriate and pay careful attention to grammar and syntax. Minor discrepancies are forgivable, major ones are not. The case chosen should show your ability as an orthopedic surgeon to diagnose and manage orthopedic problems appropriately and professionally.
Case reports should be written in English and include the following in the order presented here:
1. Title; the title should accurately reflect the content of the case report.
2. The identification number should be placed immediately below the title. No other information than the identification number should be included. Example:
Repair of a Lateral Humeral Condyle Fracture in a puppy
3. Introduction: The introduction should state the purpose of the report, a review of the problem including an up to date literature review. The literature review should cover history and typical presentation, differentials, diagnostic approach treatment options and prognosis for the different treatment options, and the care and management appropriate for the case. Example:
This case report will discuss the repair of a lateral humeral condylar fracture in an Olde English Sheepdog puppy. Fractures of the lateral humeral condyle occur more frequently than fracture of the medial condyle in young dogs, especially toy breeds1, but any breed can be affected. This is thought to be due to the fact that the lateral condyle is subject to more weight bearing forces and the position of the medial side of the radial head. The radial head may act as a wedge during weight bearing, especially when jumping from high surfaces, causing fracture of the lateral condyle. Secondly, the lateral condyle is located away from the weight bearing axis of the bony column placing more force on the weaker epicondylar ridge than on the lateral condyle itself. These forces are transmitted proximally to the humeral diaphysis. The weaker epicondylar ridge may then fracture during incidents of high stress such as jumping off an elevated surface and landing with the elbow extended(1,2). The forces pass between the medial and lateral condyles and cross the metaphysis. These fractures are classified as Salter-Harris IV fractures due to the involvement of a growth plate 2.
Patients with fractures of the distal humerus often present with non-weight bearing lameness of the affected limb, although some dogs may be partially weight bearing. Swelling of the affected elbow is usually evident as is crepitus and pain upon manipulation of the limb. While lateral condylar fractures of the humerus occur as Salter-Harris fractures in young dogs, there is a second group of patients that may suffer such an injury. This group is the middle-aged, medium-sized dogs such as the Cocker Spaniel and other spaniel breeds1. These breeds are at risk due to incomplete ossification of the intercondylar growth plate. There are two centers of ossification of the distal humerus. Each center is separated by a cartilaginous plate. The cartilaginous plate usually fuses at 70 days of age. If the cartilaginous plate is not replaced by bone, the two ossification centers do not fuse and a mechanically weak a rea exists between the medial and lateral condyles1. All intercondylar fractures are considered intra-articular fractures and repair must be performed with precise anatomic reduction and alignment1. Rigid fixation and early return to function are imperative to encourage a normal range of motion in the elbow joint.
|Last Updated on Saturday, 03 October 2009 18:06|