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Israel Journal of Veterinary Medicine  Vol. 70 (2)  June 2015 Hodik, V. 54
What Is Your Diagnosis?
Hodik, V.,
1
Aizenberg, I.
2
and Ranen, E.
2
1
17 Henrietta Szold Street, Petach-Tikva, Israel.
2
Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, Israel.
*
Corresponding Author: Dr. Vyacheslav Hodik, 17 Henrieta Szold Street., Petach-Tikva, Israel, 49532. Telephone number: +972-50-7968392.
E-mail: hodikvet@netvision.net.il
CLINICAL HISTORY
A six month old mixed breed female dog, weighing 15 kg
was presented to the clinic two days after being hit by a car.
Te dog was unable to stand without assistance but was alert
with normal vital signs. Chest radiographs and abdominal
ultrasonography did not reveal any abnormalities. Te dog
had a painful and swollen left elbow and pain on manipula-
tion of the left hip. Pelvic radiographs revealed craniodorsal
luxation of the left femur associated with avulsion fracture of
the femoral head. Te left elbow radiographs are presented
Figure 1. Make your diagnosis from Figure 1 and then turn
the page.
WHAT IS YOUR DIAGNOSIS?
Figure 1: Left elbow. A: Mediolateral projections in a normal standing position; B: In fexion; C: Cranial-caudal projection.
Israel Journal of Veterinary Medicine  Vol. 70 (2)  June 2015 55 What Is Your Diagnosis?
RADIOGRAPHIC FINDINGS AND
INTERPRETATION
On the lateral projection, the proximal part of the olecra-
non is displaced slightly cranially and mostly superimposed
on the non-displaced part of the olecranon (Figure 1A).
Flexion of the elbow increased the cranial displacement
of the fractured part relatively to the rest of the olecranon
body and decreased its superimposition (Figure 1B). It is
possible to see that the fractured portion of the olecranon
consists of two bone fragments partially superimposed
on each other and on the main portion of the olecranon
(Figure 2A, B).
On craniocaudal projection of the left elbow, the
proximal part of the olecranon appears shorter and more
radiolucent than normal (Figure 1C). Two bone frag-
ments superimposed on the lateral and medial humeral
epicondyles are seen laterally and medially to the olecranon
(Figure 2C).
RADIOLOGICAL DIAGNOSIS
Comminuted extrarticular fracture of the proximal olecranon.
Te transverse fracture line was distal to the physis at least
in one bone fragment and the fractured portion of bone was
essentially split into two parts in a sagittal plane.
TREATMENT AND OUTCOME
At surgery, two bone fragments belonging to the fractured tu-
ber olecrani were identifed laterally and medially to the main
body of the olecranon. Each fragment was attached to the
body of the olecranon by two Kirschner wires. Compression
of the fracture lines between the fragments and the main
body of olecranon was achieved by two separate tension band
wires (Figure 3).
Figure 2: A and B: Mediolateral; C: Craniocaudal projections of the left elbow. Fractured bone fragments are outlined by arrows
and arrows heads.
Figure 3: Mediolateral and craniocaudal projections of the left elbow
four weeks after fracture repair.
What Is Your Diagnosis?
Israel Journal of Veterinary Medicine  Vol. 70 (2)  June 2015 Hodik, V. 56
Te fractures healed uneventfully within four weeks and
all implants were removed. Te physis of the proximal ulna
was however closed. Nevertheless, the dog had no functional
problem during 6 months follow-up.
DISCUSSION
Fractures of the proximal ulna are not uncommon in dogs. In
a survey of 284 canine fractures, fve afected the olecranon
(1). Because fractures of the proximal ulna may be either
intra-articular or may disrupt the insertion of the triceps
tendon, their treatment requires precise anatomical reduction
and rigid internal fxation.
In skeletally immature animals fractures of the proximal
ulna may also involve growth plate. However, proximal ulnar
physis contributes only to olecranon length and is usually not
signifcant relative to premature physeal closure anomalies (2).
It is important for surgeons to be familiar with various
fractures of this area and the diferent methods of fxation.
Most reported fractures of the proximal ulna are intra-
articular with a signifcant portion of them comminuted and
sometimes accompanied by radial head luxation (3, 4). To
the best knowledge of the authors extra-articular fractures
of the proximal ulna reported so far were simple olecranon
fractures (3, 5). Tis report describes a rare comminuted
extra-articular proximal ulna fracture and its radiographic
features. Familiarity with this kind of fracture will assist
surgeons in their preoperative preparation and planning.
REFERENCES
1. Phillips, I.R.: A survey of bone fractures in the dog and cat. J.
Small Anim. Pract. 20: 661-674, 1979.
2. Piermattei, D.L., Flo, G.L. and DeCamp, C.E.: Correction of
abnormal bone growth and healing. In: Handbook of small animal
orthopedics and fracture repair. 4th ed., Saunders-Elsevier, St.
Louis, pp. 747-775, 2006.
3. Muir, P. and Johnson, K.A.: Fractures of the proximal ulna in dogs.
Vet. Comp. Orthoped. Trauma. 9: 88-94, 1996.
4. Clark, D.M.: Treatment of open comminuted intraarticular frac-
tures of the proximal ulna in dogs. J. Am. Anim. Hosp. Assoc. 23:
331-336, 1987.
5. Morgan, J.P. and Wolvekamp, P.: An Atlas of Radiology of the
Traumatized Dog and Cat. Manson Publishing. Te Veterinary
Press Ltd., London, UK, p. 176, 1994.
What Is Your Diagnosis?