Transcript Ununited Anconeal Process

Veterinary Specialists of South
Florida Presents
Ununited Anconeal Process
Tyler Foreman, DVM
VETERINARY SPECIALISTS OF
SOUTH FLORIDA
Tebow
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1 yr. MI American Bulldog
R Front Lameness began October 2010
Worsened over time
No improvement with medical
management
• Dx with UAP by rDVM
• PPHx: Pyoderma
Physical Exam
• Grade 3/5 lame R front limb
• Severe joint effusion R cubital joint
between olecranon and humerus
• Subluxation of the R hip
Normal Anatomy
Ununited Anconeal Process
• Anconeal process fails to unite with proximal
ulnar metaphysis
• Cannot make diagnosis until after 5 months
• Occurs mostly in giant breed dogs age 6-12
months (GSD)
• Ununited process allows for secondary DJD
• Bilateral disease occurs in 20-35% of cases
Etiology
• OCD as a result of timely endochondral
ossification
• Joint incongruity
– Lack of equal lengths between radius and
ulna
– Trochlear notch malformation
• Usually connected to ulna via connective
tissue
Treatment Options
• Medical: NSAID’s, cage rest, PT
– Recommended for older animals or young
prior to physeal closure
– Removal of fragment will not repair DJD
already present
• Surgery: Standard treatment
Surgical Options
• Removal of the fragment
– Lateral vs. medial approach
• Ulnar Osteotomy
– A cut is made in the ulna taking pressure off
the anconeus
• Surgical reduction and fixation
– Fallen out of favor due to failure rate
Surgical Approach
• Incision started just proximal to the lateral
humeral epicondyle
• Lateral head of the triceps retracted
caudally
• Anconeus muscle incised as well as joint
capsule
• Fragment removed
Tebow
• Elbow Arthroscopy
– Confirmed UAP, evidence of mild DJD, no
FCP
• Lateral approach made to remove the
fragment
Outcome
• Recovered well from surgery
• Still lame on the right front leg but
improved
• Very fractious patient
References
• http://www.gsdhelp.info/ortho/elbow.html
• Slatter. Textbook of Small Animal Surgery. 3rd edition. Vol 2. Pg.
1931-1935
• Fossum. Small Animal Surgery. 2nd edition. Pg. 1075-1078
• http://www.vetsurgerycentral.com/elbow_arthroscopy.htm
• http://www.demotivationalposters.org/view.php?id=87833
• http://www.advancedvetcare.com.au/all-about-us/clients/surgery1/orthopaedic-surgery/minimally-invasive-surgery
We would like to thank you for your
continued support and referrals