Minimally invasive plate osteosynthesis of diaphyseal humeral fractures using a lateral plate-rod application in dogs and cats: 11 cases (2007-2021)

Authors: White JF, Lewis DD, Johnson MD, Pozzi A, Kim SE
Publication: Australian Veterinary Practitioner, Volume 52, Issue 3, pp 147-158, Sep 2022
Publisher: Australian Veterinary Association

Animal type: Cat, Dog
Article class: Scientific/Clinical

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Abstract:

Objectives: To evaluate the efficacy of minimally invasive plate osteosynthesis (MIPO) performed via a lateral approach as a means of stabilising diaphyseal humeral fractures in dogs and cats.

Materials and Methods: Clinical data including surgical technique and implants utilised were recorded. Post-operative humeral length and alignment were compared to the intact contralateral humerus. Post-operative complications, time to union and functional outcomes were recorded.

Results: Fractures sustained by seven dogs and four cats were included. A plate-rod construct was used in all fractures. The mean ± SD absolute discrepancies in frontal and sagittal plane alignment were 1.9o ± 1.3o and 4.3o ± 1.5o, respectively. The mean ± SD relative discrepancy in humeral length was 2.7% ± 3.9%. Post-operative complications occurred in four animals, with three of these animals requiring revision procedures. Time to union, as assessed via serial radiographs, was available in six animals; three of these animals had uncomplicated fracture healing, with a mean ± SD time to union of 82 ± 49 days. The remaining three animals, which all underwent revision procedures, had a mean ± SD time to union of 185 ± 93 days.

Clinical significance: This case series documents that MIPO performed via a lateral approach consistently yielded acceptable post-operative reduction and alignment of diaphyseal humeral fractures, ascribed in part to the physiologic positioning of the fractured limb during surgery. Complications occurred most frequently in open fractures, suggesting that MIPO may not mitigate risks inherent to such cases.

KEYWORDS: cat, dog, humeral fracture, MIPO, minimally invasive plate osteosynthesis

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