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Carwardine et al: Medial versus lateral transcondylar screw placement for canine humeral intracondylar fissures: A randomized clinical trial
Veterinary Surgery 2, 2024

🔍 Key Findings

  • 73 elbows (52 dogs) underwent randomized medial or lateral transcondylar screw placement for HIF.
  • Lateral-to-medial placement resulted in a significantly higher rate of complications (62.2%) vs medial-to-lateral (19.4%) (p = .001).
  • Odds ratio for complications: 6.11 (95% CI: 2.13–17.52).
  • Most common complications: seromas (n = 13), surgical site infections (n = 16).
  • Implants with lower AMI/bodyweight were significantly associated with major complications (p = .037).
  • Only 4 procedures (5%) required revision surgery (major type I complications), with no difference by screw direction.
  • NNT = 2.3 for medial placement to prevent one complication.

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← Articles

Carwardine et al: Medial versus lateral transcondylar screw placement for canine humeral intracondylar fissures: A randomized clinical trial
Veterinary Surgery 2, 2024

🔍 Key Findings

  • 73 elbows (52 dogs) underwent randomized medial or lateral transcondylar screw placement for HIF.
  • Lateral-to-medial placement resulted in a significantly higher rate of complications (62.2%) vs medial-to-lateral (19.4%) (p = .001).
  • Odds ratio for complications: 6.11 (95% CI: 2.13–17.52).
  • Most common complications: seromas (n = 13), surgical site infections (n = 16).
  • Implants with lower AMI/bodyweight were significantly associated with major complications (p = .037).
  • Only 4 procedures (5%) required revision surgery (major type I complications), with no difference by screw direction.
  • NNT = 2.3 for medial placement to prevent one complication.

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Multiple Choice Questions on this study

In Carwardine 2024 et al., on screw placement in HIF, which placement direction was associated with a significantly higher complication rate?

A. Medial to lateral
B. Lateral to medial
C. Craniocaudal
D. Caudocranial
E. No difference

Answer: Lateral to medial

Explanation: 62.2% of lateral-to-medial placements developed complications, compared to only 19.4% for medial-to-lateral (p = .001).
In Carwardine 2024 et al., on screw placement in HIF, what was the number needed to treat (NNT) for medial placement to prevent one complication?

A. 1.5
B. 2.3
C. 4.1
D. 5.7
E. 10.2

Answer: 2.3

Explanation: Placing 2.3 screws from medial to lateral prevented one complication compared to lateral placement.
In Carwardine 2024 et al., on screw placement in HIF, which complication type was significantly more common with lateral screw placement?

A. Screw loosening
B. Medial epicondyle fracture
C. Seroma
D. Screw head prominence
E. Elbow luxation

Answer: Seroma

Explanation: Seromas were significantly more frequent in lateral placement cases (p = .012).
In Carwardine 2024 et al., on screw placement in HIF, what percentage of elbows with screws placed from lateral to medial developed postoperative complications?

A. 19.4%
B. 28.7%
C. 41.1%
D. 50.6%
E. 62.2%

Answer: 62.2%

Explanation: 23 out of 37 elbows (62.2%) with lateral screw placement developed complications.
In Carwardine 2024 et al., on screw placement in HIF, a lower implant AMI/bodyweight ratio was associated with which outcome?

A. Shorter anesthesia time
B. Higher lameness resolution
C. Fewer infections
D. Higher risk of major complication
E. Improved radiographic union

Answer: Higher risk of major complication

Explanation: AMI/bodyweight was significantly lower in dogs with major complications (p = .037).

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