Monday 18th Feb, 2019

Be on your guard for easily overlooked lateral humeral condylar fractures (LHCFs) in French Bulldogs

It is well recognised that French Bulldogs have breed-related problems, specifically Brachycephalic Obstructive Airway Syndrome (BOAS), yet they remain one of the most popular dog breeds of the moment.

Through the work we do with French Bulldog charities and the large number of BOAS procedures we undertake, we encounter many of this breed and recognise the frequency and challenges in diagnosing lateral condylar fractures (LHCFs) in French Bulldogs.

So here are out top tips, and ‘red-flags’ for vets faced with French Bulldog forelimb lameness, and hope these will assist vets in diagnosing these common fractures:

  1. Age: most lateral humeral condylar fractures occur between 3-4months of age.
  2. Trauma: in 90% of cases the trauma is minor; a fall from the arms, or tumble off the bed.
  3. Non-weight bearing: a French Bulldog presents with a non-weight bearing lameness X-rays are required even if no fractures are obvious on palpation.
  4. Physical: feel for the medial and lateral epicondyles of the humerus. If they are not in line with each other there will be a fracture (in LHCFs the lateral condyle will generally move proximally).
  5. X-rays: perfect positioning for X-rays is essential to pick up these fractures. Slight rotation can ‘hide’ small, or incomplete fractures.

Remember to be mindful of LCHFs when presented with a French Bulldog with a forelimb lameness, as swift diagnosis greatly simplifies the surgery required and improves the likelihood of successful outcome.

French Bulldogs are well-muscled, stoical dogs, so these fractures are often problematic to detect on clinical examination. The key point when undertaking a medical examination of French Bulldogs is that vets feel for the medial and lateral epicondyles of the humerus to assess if they are in perfect alignment: if one is higher than the other, this suggests a fracture; even if a fracture is not readily visible on X-ray.

Great care must be taken to ensure that X-rays are positioned perfectly because if the elbow is rotated - even slightly - these fractures can easily be overlooked. They are good at hiding!

Roundhouse Referrals has recently treated several French Bulldogs with lateral humeral condylar fractures deploying various surgical techniques: usually a transcondylar lag screw along with a supracondylar K-wire, or additional supracondylar positional screw or plate.

Next Post: Patella Fracture or KaTS?

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