title: Techniques of application and initial clinical experience with sliding humeral osteotomy for treatment of medial compartment disease of the canine elbow.
abstract: OBJECTIVE
  To determine medium-term clinical efficacy of sliding humeral osteotomy (SHO) for treatment of lameness and elbow pain associated with clinically diagnosed elbow disease featuring cartilage eburnation of the medial elbow compartment (medial compartment disease--MCD).
  
  
  METHODS
  Case series.
  
  
  METHODS
  Dogs (n=49) with severe or persistent lameness attributable to MCD.
  
  
  METHODS
  Signalment, lameness history, and preoperative imaging findings were recorded. A custom, locking, stepped SHO plate was applied to the medial aspect of the humerus, stabilizing a mid-diaphyseal transverse osteotomy, medially translating the distal segment relative to the proximal segment. Three variants of technique of application were used and outcomes compared between respective patient groups. Outcome measures included lameness scoring, anatomic measures, VAS scoring of elbow pain, and owner assessment of function. Measures recorded preoperatively, 12, and 26 weeks postoperatively were compared.
  
  
  RESULTS
  Of 59 limbs that had SHO, 39 had preoperative focal treatment of the diseased medial aspect of the coronoid process. Mean +/- SD dog age was 45.5 +/- 37.48 months and body weight ranged from 13.6 to 46.7 kg. Mean preoperative duration of lameness was 14.7 +/- 18.50 months. Lameness improved for all limbs by 26 weeks, and resolved in 21/32 limbs. Significant improvements in postoperative elbow pain scores and most owner assessments of function were observed. Incidence of major complications requiring surgical intervention was 17.2%, 22.2%, and 4.8% for each of the 3 technique variants described. Histologic examination of 2 elbows at >12 months revealed fibrocartilage cover of medial aspect of humeral condyle.
  
  
  CONCLUSIONS
  Canine SHO with or without focal treatment of the diseased medial aspect of the coronoid process ameliorates lameness and pain associated with MCD at medium-term follow-up. Application technique is critical to minimizing morbidity.
  
  
  CONCLUSIONS
  SHO is appropriate for clinical management of pain and lameness in select cases of canine MCD.
authors.affiliation: Fitzpatrick Referrals, Eashing, UK. noelF@fitzpatrickreferrals.co.uk
authors.forename: Noel
authors.initials: N
authors.lastname: Fitzpatrick
authors.forename: Russell
authors.initials: R
authors.lastname: Yeadon
authors.forename: Thomas
authors.initials: T
authors.lastname: Smith
authors.forename: Kurt
authors.initials: K
authors.lastname: Schulz
mesh_terms: D000818:Animals; D001860:Bone Plates; D001863:Bone Screws; D004283:Dog Diseases / Q000601:surgery*; D004285:Dogs; D016267:External Fixators; D005260:Female; D005552:Forelimb / Q000601:surgery*; D005592:Fracture Fixation / Q000662:veterinary; D050723:Fractures, Bone / Q000628:therapy / Q000662:veterinary; D007592:Joint Diseases / Q000601:surgery / Q000662:veterinary*; D008297:Male; D019637:Orthopedic Procedures / Q000009:adverse effects / Q000379:methods / Q000662:veterinary*