A 4 year-old, male, neutered, springer spaniel dog became acutely lame on both forelimbs. Limited response was observed after conservative management. Orthopaedic examination showed marked bilateral forelimb stiffness and pain on manipulation of the elbows. No crepitus or instability were found. Radiographs and CT showed severe bilateral propagating humeral intracondylar fissures with associated periosteal reaction in the lateral epicondylar crests.
Given the severity of the fissure and its proximal propagation, it was elected to place a transcondylar positional screw and an LCP plate in the lateral epicondylar crest. Surgery was initially performed on the left elbow as the condition appeared more severe in this elbow. The patient recovered well from surgery and was discharged with analgesics and strict cage rest. Two weeks after surgery, mild lameness deterioration in the right forelimb was noticed by the owner, but this resolved with meloxicam. Six weeks later good clinical progression was observed. Radiographs of both elbows showed stable implants in the left, and instability of the condyle and progression of the fissure in the right elbow. Surgery of the right elbow was performed similarly to the left elbow. 6 weeks after the second surgery, recheck radiographs showed a stable plate but transcondylar screw migration, and surgery to replace the screw and fix a nut was carried out. The dog had made good recovery and was making good progress 6 weeks after the third surgery. Consideration should be given to bilateral simultaneous surgery or shortening the surgical interval between limbs for severe bilateral disease.