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Impact of Postoperative Radiography on the Management of Humeral Condylar Fractures in Immature Dogs

Stavros Karydas, Ignacio Quinonero Reinaldos, Jake Chitty, Davide Malucelli, Miguel Solano, Rosario Vallefuoco, Alan Danielski

Background
Humeral condylar fractures account for a significant proportion of fractures in young dogs, requiring precise reduction and internal fixation. Standard postoperative care often includes radiographic follow-up to assess healing and detect complications. However, the necessity of routine follow-up radiographs has been questioned, as they may not impact clinical management in the absence of clinical abnormalities. This study aimed to evaluate the impact of postoperative radiographs on treatment decisions in skeletally immature dogs following humeral condylar fracture repair.

Methods
A retrospective, multicenter study was conducted using medical records of 139 dogs under 12 months of age that underwent unilateral humeral condylar fracture repair. Data collected included patient demographics, fracture type, fixation method, postoperative concerns, clinical examination findings, radiographic results, and any changes in the postoperative plan. Statistical analysis identified predictors of postoperative plan modifications.

Results
Among the 139 cases, 23 dogs (17%) required a change in their postoperative management. Factors significantly associated with a change in the postoperative plan included owner concerns (odds ratio [OR] 7.6), prolonged analgesic use (OR 7.9), presence of lameness (OR 5.9), abnormal clinical findings (OR 44.8), and radiographic abnormalities (OR 51.9). However, no cases required management changes based solely on radiographic findings in the absence of clinical abnormalities.

Limitations
The retrospective nature of the study may have introduced variability in data collection and interpretation across multiple centers. The sample size, while moderate, may limit the statistical power to detect less common associations. Additionally, the study did not assess the impact of radiographs on the duration of postoperative recovery.

Conclusions
Routine follow-up radiographs did not influence postoperative management decisions in cases where clinical examination was unremarkable, and no concerns were reported. Thorough clinical assessment, including owner-reported concerns, analgesic use, and signs of lameness, can effectively screen for complications, reducing the need for unnecessary imaging. The findings suggest that radiographs should be reserved for cases with clinical indications rather than as a routine practice.

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