Elbow Dysplasia Flashcards
What possible issues can cause developmental elbow disease?
Ununited anconeal process of ulna
OCD of medial humeral condyle
Fragmented medial coronoid process of ulna
Asynchronous growth of radius and ulna leading to joint incongruity
When do patients typically present with elbow dysplasia, and what signs are shown?
6 months +
Low grade mild lameness, bilateral
What can we see on physical examination of a patient with elbow dysplasia?
Elbow effusion
Decreased ROM, pain on extremes of flexion/extension
What radiograph views should be taken to differentiate between causes of elbow issues?
Craniocaudal
Mediolateral
Flexed lateral
Ununited anconeal process, fragmented coronoid process, osteochondrosis dissecans (OCD)
What do we see on flexed mediolateral radiograph views?
Dorsal anconeal process and radial head
Sclerosis of ulna notch
Flattened/blurred FCP
Increased humeroradial joint space
Looking for primary lesion/secondary DJD
What can we see with neutral lateral radiograph views?
Joint incongruity
What can we see on fully flexed mediolateral radiograph views?
Dorsal osteophytes
Ununited anconeal process
What can we see with cranio-caudal (orthogonal) radiograph views?
Osteophytes/OCD on medial lateral condyle
How can we treat ununited anconeal process?
Conservative
Surgical - removal of anconeal process, proximal dynamic ulna osteotomy, lag screw fixation
How can we treat elbow incongruity/short radius?
Dynamic partial ulnar ostectomy
+/- intramedullary pin
Describe a dynamic partial ulnar ostectomy.
Small portion of ulna excised, allowing improved humeroradial contact
Ulna not rigidly stabilised to allow it to shift to ‘best fit’ position
OR small intramedullary pin placed to decrease pain/prevent excessive caudal translation of proximal ulna
What is OCD?
Osteochondritis dissecans
Affects medial humeral condyle
Usually appears on humeral trochlea as thickened flap of cartilage overlying relatively deep (1-2mm) subchondral bone defect
How can we treat OCD?
Conservative - restricted exercise 4-6 weeks, NSAIDs
Surgical if no improvement - arthrotomy and debridement / arthroscopy and debridement (flap removal and abrasion arthroplasty/microfracture of subchondral bone)
Where does fragmented coronoid process most commonly occur?
Craniolateral aspect of medial coronoid adjacent to radial head
How can we treat FCP?
Arthroscopic debridement
Medical management of OA