Incomplete ossification of the humeral condyle - IOHC

Question 1

What are the ossification centres of the humeral condyle?

Answer 1

1) medial ossification center
2) lateral ossification centre
3) smaller ossification centre that forms the medial epicondyle

Question 2

When should the ossification centre close?

Answer 2

between 8-12 weeks

Question 3

Which breeds?

Answer 3

Spaniel breeds
Labradors
Rottweilers

Question 4

Mode of inheritance?

Answer 4

Analysis suggests: Recessive mode of inheritance (am. cocker spaniel)

Question 5

Three ways of presentation with IOHC?

Answer 5

1) With lameness
2) With humeral condylar fractures secondary to IOHC
3) without clinical signs

Question 6

Clinical examination?

Answer 6

Pain on etention and pronation/supination, and palpation lateral epicondular ridge

Question 7

Image modality?

Answer 7

XR - can miss fissure
CT, MRI - golden standard
Arthroscopy

Question 8

Treatment?

Answer 8

Transcondylar lag or positional screw
Lateral plate

Question 9

Screw choice?

Answer 9

Large diameter (3,5 - 4,5mm) as IOCH often not close -> screw holds, increase area moment of inertia

Question 10

What type of fractures are seen in IOHC? Percentage?

Answer 10

Majority: lateral condylar (60%)
Y or T-fractures (30%)

Question 11

Unsymptomatic IOHC?

Answer 11

may be seen as screening elbows

Question 12

Treatment of unsymptomatic IOHC?

Answer 12

Transcondylar screw - must weight risk of potential fracture if not treated against risk of surgery