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Jenkins et al: Medial epicondylar fissure fracture as a complication of transcondylar screw placement for the treatment of humeral intracondylar fissure
Veterinary Surgery 4, 2022

🔍 Key Findings

  • MEFF occurred in 11.4% (10/88 elbows) following medial-to-lateral transcondylar screw placement in dogs with HIF.
  • Screw size to condylar height ratio >41% significantly increased MEFF risk (P = .004, OR 1.52).
  • MEFF was not recognized intraoperatively in 60% of cases and was only seen on follow-up or retrospective imaging review.
  • Screw loosening was the most common complication (11.2%), observed both with and without MEFF.
  • MEFF tended to increase the risk of screw loosening (P = .06), but was not statistically significant.
  • Most MEFFs did not require treatment and healed radiographically by 14–17 weeks in monitored cases.
  • Shaft screws were used in all MEFF cases, but shaft vs cortical design was not significantly associated with MEFF.
  • The clinical impact of MEFF was minor in most cases, although long-term significance is unknown.

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← Articles

Jenkins et al: Medial epicondylar fissure fracture as a complication of transcondylar screw placement for the treatment of humeral intracondylar fissure
Veterinary Surgery 4, 2022

🔍 Key Findings

  • MEFF occurred in 11.4% (10/88 elbows) following medial-to-lateral transcondylar screw placement in dogs with HIF.
  • Screw size to condylar height ratio >41% significantly increased MEFF risk (P = .004, OR 1.52).
  • MEFF was not recognized intraoperatively in 60% of cases and was only seen on follow-up or retrospective imaging review.
  • Screw loosening was the most common complication (11.2%), observed both with and without MEFF.
  • MEFF tended to increase the risk of screw loosening (P = .06), but was not statistically significant.
  • Most MEFFs did not require treatment and healed radiographically by 14–17 weeks in monitored cases.
  • Shaft screws were used in all MEFF cases, but shaft vs cortical design was not significantly associated with MEFF.
  • The clinical impact of MEFF was minor in most cases, although long-term significance is unknown.

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Multiple Choice Questions on this study

In Jenkins 2022 et al., on medial epicondylar fissure fracture, which of the following is true regarding MEFF identification?

A. It was always identified intraoperatively
B. Only cases with screw loosening showed MEFF
C. Most cases were recognized via postoperative CT
D. Many cases were only detected on follow-up or retrospective radiograph review
E. All cases showed radiographic healing by 6 weeks

Answer: Many cases were only detected on follow-up or retrospective radiograph review

Explanation: 60% of MEFF cases were not recognized intraoperatively and were only identified on follow-up or retrospective review.
In Jenkins 2022 et al., on medial epicondylar fissure fracture, what was the most common postoperative complication reported?

A. Screw loosening
B. Deep surgical site infection
C. Fracture propagation
D. Screw breakage
E. Implant migration

Answer: Screw loosening

Explanation: Screw loosening was the most common complication (11.2%), both with and without MEFF.
In Jenkins 2022 et al., on medial epicondylar fissure fracture, what was the most significant risk factor for developing MEFF?

A. Using cortical screws over shaft screws
B. Placing screws from a lateral approach
C. Using screws with a size-to-condylar height ratio >41%
D. Performing arthroscopy prior to screw placement
E. Using screws with >50% countersinking

Answer: Using screws with a size-to-condylar height ratio >41%

Explanation: Larger screw size relative to condylar height (>41%) significantly increased MEFF risk (P = .004, OR 1.52).
In Jenkins 2022 et al., on medial epicondylar fissure fracture, what was the general clinical outcome for cases with MEFF during the perioperative period?

A. Required implant removal in all cases
B. Progressed to complete fracture in most dogs
C. Required antibiotic therapy in most cases
D. Were treated conservatively and healed in most cases
E. Were associated with non-union in all dogs

Answer: Were treated conservatively and healed in most cases

Explanation: MEFF was usually minor, and most cases healed uneventfully with conservative management.
In Jenkins 2022 et al., on medial epicondylar fissure fracture, what proportion of elbows developed MEFF after transcondylar screw placement?

A. 3.2%
B. 7.9%
C. 11.4%
D. 18.6%
E. 22.7%

Answer: 11.4%

Explanation: MEFF was documented in 10 out of 88 elbows, or 11.4%.

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