Presumed concurrent medial coronoid process fracture is a frequent radiographic finding in dogs and cats with humeral condylar fractures.

OBJECTIVE: To report the prevalence of presumed concurrent medial coronoid process fractures in a series of cases of humeral condylar fractures and evaluate factors influencing the presence of a suspected fracture of the medial coronoid process. ANIMALS: 48 dogs and 7 cats, with a total of 57 humeral fractures. METHODS: Medical records of dogs and cats diagnosed with a humeral condylar fracture with radiographs were reviewed between October 2013 and March 2022. Species, sex, neutered status, age, weight, and the nature of the trauma were noted. Radiographs were assessed for the configuration of humeral condylar fracture, the presence of a suspected fractured medial coronoid process (MCP), number of MCP fragments, nature of fracture, degree of radioulnar incongruity, soft tissue swelling, and elbow luxation/subluxation. RESULTS: A presumed fracture of the MCP was seen in 26 of 57 cases. Comminution of the condylar fracture was the only parameter that had a positive effect on the presence of a possible fractured MCP. Body weight was significantly associated with size of the suspected fractured MCP. The presence of this fracture was not associated with the type of humeral condylar fracture. The size of the presumed fractured MCP fragment was positively correlated with body weight. CLINICAL RELEVANCE: There was a high prevalence of presumed fractured MCPs in dogs with humeral condylar fractures (almost 50%) and even more so in animals with comminuted fractures. The consequences of suspected fractured MCP associated with humeral condylar fractures and whether dogs and cats would benefit from removal of the fragment remain unknown.

Acute limb shortening and modified pantarsal arthrodesis for the treatment of a highly comminuted distal tibial articular fracture in a dog.

A three-year-old female spayed Lurcher was referred for the treatment of a highly comminuted distal tibial articular fracture. Resection of the area of comminution with a transverse osteotomy of the tibial diaphysis and talar ridges was performed, followed by modified pantarsal arthrodesis and a calcaneotibial screw. The treatment resulted in 7 cm of tibial shortening, equating to a 28% reduction in the total tibial length. Radiographic union of the arthrodesis was successful. Fair use of the pelvic limb was documented long-term. Combined acute limb shortening and modified pantarsal arthrodesis resulted in an acceptable outcome and could be considered in cases of highly comminuted distal tibial fractures.

Delayed union, non-union and mal-union in 442 dogs.

OBJECTIVES: (1) To estimate the prevalence of delayed union, non-union and mal-union in canine fractures; (2) to describe fracture, demographic, and treatment characteristics for these outcomes; (3) to identify risk factors for delayed or non-union. STUDY DESIGN: Retrospective study. SAMPLE POPULATION: Four hundred and forty two dogs (461 fractures). METHODS: A review was conducted of clinical records and radiographs from 2 teaching hospitals. "Union," "delayed union," "non-union" and "mal-union" were defined, and fracture, demographic, treatment, and outcome variables described. Differences in proportions or medians between "union," "delayed union" and "non-union" were tested using χ2 and Mann-Whitney U-tests for categorical and continuous variables respectively. Potential explanatory variables for "delayed or non-union" were tested using logistic regression to identify risk factors. RESULTS: Median radiographic follow up was 53 days (14-282). Delayed union occurred in 13.9% of fractures (64/461), non-union in 4.6% (21/461), and mal-union in 0.7% (3/461). Risk factors for delayed or non-union were age (OR 1.21, 95% CI 1.12-1.31); comminuted fracture (OR 4.24, 95% CI 2.4-7.5); treatment with bone graft (all types) (OR 3.32, 95% CI 1.3-8.5); surgical site infection (OR 3.24, 95% CI 1.17-8.97), and major implant failure (OR 12.94, 95% CI 5.06-33.1). CONCLUSION: Older dogs, dogs with comminuted fractures, surgical site infection, or major implant failure were at increased odds of delayed or non-union. Radius and ulna fractures in toy breed dogs were not at increased odds of delayed or non-union. CLINICAL SIGNIFICANCE: The identified risk factors should inform fracture planning and prognosticating. The prognosis for radial fractures in toy breeds appears better than historically believed.

Mechanical evaluation of a novel angle-stable interlocking nail in a gap fracture model.

OBJECTIVE: To describe the mechanical characteristics of a novel angle-stable interlocking nail (NAS-ILN) and compare them to those of a locking compression plate (LCP) by using a gap-fracture model. STUDY DESIGN: Experimental study. SAMPLE POPULATION: Synthetic bone models. METHODS: Synthetic bone models simulating a 50 mm diaphyseal comminuted canine tibial fracture were treated with either a novel angle-stable interlocking nail (NAS-ILN) or a locking compression plate (LCP). Maximal axial deformation and load to failure in compression and 4-point bending, as well as maximal angular deformation, slack, and torque to failure in torsion, were statistically compared (P < .05). RESULTS: In compression, the maximal axial deformation was lower for NAS-ILN (0.11 mm ± 0.03) than for LCP (1.10 mm ± 0.22) (P < .0001). The ultimate load to failure was higher for NAS-ILN (803.58 N ± 29.52) than for LCP (328.40 N ± 11.01) (P < .0001). In torsion, the maximal angular deformation did not differ between NAS-ILN (22.79° ± 1.48) and LCP (24.36° ± 1.45) (P = .09). The ultimate torque to failure was higher for NAS-ILN (22.45 Nm ± 0.24) than for LCP (19.10 Nm ± 1.36) (P = .001). No slack was observed with NAS-ILN. In 4-point bending, the maximal axial deformation was lower for NAS-ILN (3.19 mm ± 0.49) than for LCP (4.17 mm ± 0.34) (P = .003). The ultimate bending moment was higher for NAS-ILN (25.73 Nm, IQR [23.54-26.86] Nm) than for LCP (16.29 Nm, IQR [15.66-16.47] Nm) (P = .002). CONCLUSION: The NAS-ILN showed greater stiffness in compression and 4-point bending, and a greater resistance to failure in compression, torsion, and 4-point bending, than LCP. CLINICAL IMPACT: Based on these results, NAS-ILNs could be considered as alternative implants for the stabilization of comminuted fractures.

Application of a bilateral temporal fascia free graft in a dog with multifragmented frontal sinus and nasal bone fracture.

OBJECTIVE: To describe the use of temporal fascia free grafts to treat dorsal open comminuted frontal sinus and nasal fractures. ANIMAL: One Belgian shepherd dog. STUDY DESIGN: Case report METHODS: A 5-year-old spayed female Belgian shepherd was admitted with severe facial deformation due to trauma. A deep, 3 cm wide wound was present between the nose and the frontal sinus. No abnormalities were detected on neurological examination. On computed tomographic examination, comminuted open fractures of the frontal and nasal bones were associated with a severe depression of the dorsal wall and presence of bone fragments in the sinus cavities. Bone fragments were apposed with polydioxanone monofilament suture. Bilateral temporal fascia grafts were placed over the bone fragments. RESULTS: The integrity of the frontal and nasal cavities, and the facial profile of the dog were restored. No short-term or long-term complications were observed after 4 months follow up. CONCLUSION: The innovative combination of suture apposition of bone fragments and a temporal fascia free graft resulted in very satisfying long-term outcomes in a dog with open sinus and nasal bone fractures.

Use of a bone-to-tendon plate to stabilize a comminuted calcaneus fracture in a dog.

OBJECTIVE: To report the use of an ancillary plate spanning from the calcaneus to the common calcaneal tendon to stabilize a comminuted fracture in a dog. STUDY DESIGN: Case report ANIMALS: Two year old male neutered mix-breed dog. METHODS: The dog presented for a grade IIIa open highly comminuted fracture of the shaft and tuber of the left calcaneus from a suspected gunshot wound. Plantar and lateral locking plates were applied to the calcaneus, with the lateral plate extending proximally and sutured directly to the common calcaneal tendon. Autogenous cancellous and allogenic corticocancellous bone grafts were placed into the fracture site, and a human placental matrix was injected after closure. A lateral tarsal splint was applied for 17 weeks postoperatively. The lateral bone-to-tendon plate was replaced with a smaller lateral plate spanning only the calcaneus 9 weeks after the initial surgery. RESULTS: Radiographic union was documented at 17 weeks. At 25 weeks, both plates were removed due to suspected implant associated infection. At the final follow-up assessment, 36 weeks after initial surgery, the dog had returned to normal function with no observable lameness. CONCLUSION: Incorporation of the common calcaneal tendon as a proximal segment for plate fixation led to successful union of a highly comminuted calcaneal fracture.

Fixation of a scapular body fracture in a 5 month old foal using three 4.5/5.0 mm locking compression plates.

OBJECTIVE: To report a surgical technique and an outcome for the repair of a displaced, transverse scapular body fracture with locking compression plates (LCPs) in a colt. ANIMALS: One 5 month old Thoroughbred colt. STUDY DESIGN: Case report. METHODS: A colt sustained an unstable, comminuted, transverse fracture of the scapular body. Three 4.5/5.0 mm LCPs were used with 6.5 mm cancellous screws, 4.5 mm cortex screws, and 5.0 mm locking head screws. Implants were removed 2 months after surgery. RESULTS: Surgical site infection was identified by purulent discharge at the distal aspect of the suture line 3 days after surgery. The surgical site infection resolved with daily lavage within 15 days after surgery. Three months after internal fixation of the scapular body fracture, the colt was sound and was turned out to pasture. One year later, the colt was sound and in training to be a flat racehorse. CONCLUSION: Repair of a scapular body fracture using LCP provided a good outcome with an early return to soundness. The LCP system can therefore be considered for the repair of scapular body fractures in small equids.

Titanium mesh osteosynthesis for the treatment of severely comminuted maxillofacial fractures in four dogs.

INTRODUCTION: Major goals in maxillofacial fracture treatment include to restore the dental occlusion, stabilise the major skeletal supports, restore the contour of the face and achieve proper function and appearance of the face. Titanium is considered an optimal material for maxillofacial reconstruction due to its biocompatibility, high strength, minimal inflammatory reaction and minimal imaging artefact. OBJECTIVES: To describe the clinical details, surgical technique, pre- and postoperative imaging and short- and long-term follow-up of severely comminuted maxillofacial fractures treated with titanium mesh and titanium screws in dogs. MATERIALS AND METHODS: Retrospective short case series included four client-owned dogs with maxillofacial fractures. After appropriate medical stabilisation, preoperative CT examination of the head was obtained in all patients for evaluation of fracture configuration and surgical planning. The maxillofacial fractures were stabilised by titanium mesh osteosynthesis. Short- and long-term clinical and radiographic follow-ups were available for all dogs. RESULTS: Proper dental occlusion and reconstruction of the anatomic buttresses was achieved in all cases. All dogs recovered uneventfully from the surgery and no complications were recorded on the long-term follow-up up to 43 months. Occlusion was maintained in all dogs, as well as excellent cosmesis of the midface. CLINICAL SIGNIFICANCE: Titanium mesh osteosynthesis can achieve sufficient rigidity and lead to uncomplicated healing of severely comminuted maxillofacial fractures. This internal fixation method can be considered a valuable option to treat maxillofacial fractures in particular in cases of large bone defect and midface reconstruction.

Clinical application of the small I-Loc interlocking nail in 30 feline fractures: A prospective study.

OBJECTIVE: To describe medium-term functional outcome after nail osteosynthesis in feline traumatology and report clinically relevant recommendations for I-Loc angle-stable interlocking nail use in cats. STUDY DESIGN: Prospective clinical study. SAMPLE POPULATION: Client-owned cats (n = 29). METHODS: Consecutive cases with femoral, tibial, or humeral fractures were included. Outcome measures included fracture and surgical procedure description, limb alignment, nail size vs body weight (BW), percentage of nail medullary canal (MC) fill, time to limb function at clinical union (CU), and complications. Descriptive statistics were reported and compared with historical data. RESULTS: Bone distribution was 53.3% femora, 30% tibiae, and 16.7% humeri. There were six epimetaphyseal and 24 diaphyseal fractures. Overall, 67% of fractures were comminuted. Open reduction and minimally invasive techniques were used in 73% and 27% of cases, respectively. Seventeen I-Loc 3 (cat mean BW 4.4 ± 2.2 kg) and 13 I-Loc 4 (cat mean BW 5.2 ± 1.2 kg) nails were placed with mean MC fill of ≤50%. Average time to CU was 7.2 weeks. At CU, lameness had resolved or was mild in every cat, and all cats ultimately regained full limb function. No major complications were encountered. CONCLUSION: Because of improved CU times, excellent functional outcomes, and low complication rate, our results provide evidence that I-Loc nails are safe and effective for feline traumatology. CLINICAL SIGNIFICANCE: The I-Loc may be advantageous for fixation of epimetaphyseal fractures. Because of feline bone specific dimensional constraints, I-Loc 3 is likely appropriate for all feline humeri and most tibiae, while I-Loc 4 is well sized for feline femora.

Stiffness of a type II external skeletal fixator and locking compression plate in a fracture gap model.

OBJECTIVE: To compare the stiffness of constructs fixed with a type II external skeletal fixator (ESF) or a 3.5-mm locking compression plate (LCP) in axial compression and bending with a fracture gap model. STUDY DESIGN: Quasi-static four-point bending and axial compression tests. SAMPLE POPULATION: Ten LCP and 10 ESF immobilizing epoxy cylinders with a 40-mm fracture gap. METHODS: Five constructs of each type were tested in nondestructive mediolateral (ML) four-point bending and then rotated and tested in nondestructive craniocaudal (CC) four-point bending. Five additional constructs of each type were tested in nondestructive axial compression. Stiffness was compared between loading modes by construct type and between construct types by loading mode. RESULTS: Type II ESF were stiffer than LCP in ML bending (difference, 1474 N/mm, P < .0001) and in axial compression (difference, 458 N/mm, P = .008) but not in CC bending (P = .1673). Type II ESF were stiffer in ML bending than in CC bending (difference, 999 N/m, P < .0001), while LCP were stiffer in CC bending than in ML bending (difference, 634 N/mm, P < .0001). CONCLUSION: Type II ESF generated stiffer constructs compared with LCP in ML bending and in axial compression without a difference in CC bending. External skeletal fixator and LCP bending stiffness varied by loading direction. CLINICAL SIGNIFICANCE: A type II ESF should be considered in a comminuted fracture requiring increased stability in ML and axial directions.

Human placenta-derived matrix with cancellous autograft and demineralized bone matrix for large segmental long-bone defects in two dogs with septic nonunion.

OBJECTIVE: To report the successful treatment of septic nonunion in two dogs with large segmental defects secondary to long-bone fractures by using a novel human placenta-derived matrix (hPM) as adjunct to fixation. ANIMALS: One 3-kg 9-year-old neutered male Yorkshire terrier with a distal antebrachial fracture and one 6-kg 4-year-old spayed female miniature pinscher with a distal humeral fracture. STUDY DESIGN: Short case series. METHODS: Both dogs presented for septic nonunion after internal fixation of Gustilo type II open diaphyseal fractures from dog bite injuries. During revision, debridement of nonviable bone resulted in segmental defects of 32% and 20% of the bone length for the antebrachial and humeral fractures, respectively. The antebrachial fracture was stabilized with a circular external fixator, and the humeral fracture was stabilized with biaxial bone plating. The fracture sites were not collapsed, and full length was maintained with the fixation. Autogenous cancellous bone graft and canine demineralized bone allograft were packed into the defects, and hPM was injected into the graft sites after closure. RESULTS: Radiographic union was documented at 8 weeks and 6 weeks for the antebrachial and humeral fractures, respectively. Both dogs became fully weight bearing on the affected limbs and returned to full activity. CONCLUSION: Augmenting fixation with grafts and hPM led to a relatively rapid union in both dogs reported here.

The Use of Bone Marrow-Derived Stem Cells in the Treatment of a Comminuted Tibiotarsal Fracture in a Juvenile Red-legged Seriema (Cariama cristata).

An adult red-legged seriema (Cariama cristata) presented with a comminuted fracture of the tibiotarsus and fibula. Surgery was performed, and a type II external fixator, with 2 distal and 2 proximal pins, was used to stabilize the fracture. After a 10-day stabilization period, the bird developed a second fracture on the same bone, proximal to the first fracture site. Another surgery was performed on the seriema similar to the first one. However, in this second surgical procedure a single pin, instead of 2 perpendicular pins, was placed proximally to the fracture site. After the second surgical procedure, bone marrow stem cells (BMSCs) from the seriema's left ulna were collected. Twenty-seven days after the second surgery, the BMSCs were transplanted, into the fracture sites. Twenty-four days after the stem cells were injected into the fractures (51 days after the second surgical procedure), radiographic images revealed healing bone calluses at the fracture sites. The fracture healing was relatively long for this case (a total of 75 days). The addition of bone marrow stem cell therapy to the use of external fixation may have contributed to the healing observed radiographically 24 days after administration; therefore, bone marrow stem cell therapy, in addition to traditional surgical fracture reduction and stabilization, may be a promising therapeutic approach for avian cases with similar injuries and bone anatomy. However, as this is a single case, this therapeutic modality deserves further application and study. Moreover, we suggest modifications in the bone marrow stem cell collection and therapy, which may be useful for future studies and application involving birds.

SUCCESSFUL REPAIR OF ANTEBRACHIAL FRACTURES WITH EXTERNAL SKELETAL FIXATION IN THREE MACROPODS.

Three captive macropods comprising three different species sustained unilateral antebrachial fractures. All fractures were assumed to be trauma related, although the specific circumstances surrounding each case was unknown. Each fracture was surgically repaired with type Ia (unilateral, monoplanar) external skeletal fixators, which were all removed approximately 3 mo postoperatively. Although each animal experienced at least one complication, all animals showed adequate bridging and remodeling at the fracture sites and had good-to-excellent return to normal function after fixator removal. This case series is the first to describe the successful repair of antebrachial fractures using external skeletal fixation in captive macropods and details some of the complications that can occur with postoperative management of captive animals.

Intrasinus bolstering of traumatic maxillary sinus fractures by using Foley catheter balloons in two foals.

OBJECTIVE: To describe the repair of unstable facial fractures by using Foley catheter balloons as intrasinus bolsters. STUDY DESIGN: Case report ANIMALS: Two weanling foals with unilateral fractures of the sinus and orbit secondary to kick injuries. Preoperative imaging that included positive contrast dacrocystorhinography and computed tomography confirmed severe comminution of facial fractures and nasolacrimal duct disruption in both foals. METHODS: Small bone fragments were surgically removed, and large fragments were retained even when denuded of periosteum. Repair procedures included nasolacrimal canaliculosinusotomy and suturing fracture fragments together with polydioxanone sutures. After fixation, the fracture fragments could be depressed into the sinus with manual pressure, so two intrasinus Foley catheters were placed to bolster the sinus wall, with the tubing exiting through a frontal sinus trephine. The skin was completely closed over the fractures. Catheters and nasolacrimal stenting were maintained in place during fracture healing. RESULTS: One foal prematurely dislodged catheters and nasolacrimal stent 11 days after fixation. The catheters and stenting were removed as planned 4 weeks after surgery in the second foal. Wound, fracture healing, and overall cosmesis was good in both foals, and epiphora resolved. Surgical site infection, sinusitis, and sequestration did not occur. Both foals became high-level performance horses with acceptable cosmetic outcome and good bilateral nasal airflow. CONCLUSION: Foley catheter balloons supported sinus fracture repair and maintained stability of the surgical reconstruction during convalescence. CLINICAL SIGNIFICANCE: Suture repair of comminuted sinus fractures can be supported by using Foley catheters, which are readily available.

A month in a horse's life: healing process of a fractured third metatarsal bone from medieval Viljandi, Estonia.

The remains of a horse's hind foot - a third metatarsal bone and three phalanges - were found in a presumed waste pit of a prosperous medieval household in Viljandi, Estonia, dated from the second half of the 13th to the beginning of the 15th century. The metatarsal bone had been broken during the horse's lifetime and showed evidence of partial healing. Using archaeological, zooarchaeological, morphological, microscopic, densitometric and radiographic analyses, we investigated the bones and the healing process in order to understand animal treatment in a medieval urban context. Our results show that the fracture was a complete comminuted fracture that appears to have been closed and stable, caused most probably by a trauma from a strong impact. Based on callus formation and the worn edges of the separated diaphysis, the horse had survived for at least a month and used the injured foot to some extent. We suggest that the horse was treated by splinting the foot and keeping the animal in a standing position during the healing process. Eventually the horse died because of a wound infection, or was killed. The relatively long period of careful treatment indicates the animal's economic or emotional value.

Surgical management of long bone fractures in cats using cortical bone allografts preserved in honey.

This report describes comminuted fractures in 2 cats repaired by stabilization with cortical bone allografts that had been preserved in honey. Both cats exhibited appropriate post-operative weight-bearing. Preservation of bone in honey is a simple and widely available alternative for bone banking. This is the first report of a bone defect in cats repaired with bone preserved in honey.

Gestion chirurgicale de fractures osseuses longues chez les chats à l'aide d'une allogreffe de la corticale préservée dans du miel. Ce rapport décrit deux fractures comminutives réparées par la stabilisation à l'aide de l'allogreffe de la corticale qui avait été préservée dans du miel. Les deux chats ont manifesté une mise en charge postopératoire appropriée. La préservation de l'os dans du miel est une méthode de remplacement simple et facilement disponible comme ostéothèque. Il s'agit du premier rapport d'un défaut osseux chez des chats qui a été réparé à l'aide d'un os préservé dans du miel.(Traduit par Isabelle Vallières).

Rostral mandibular fracture repair in a pet bearded dragon (Pogona vitticeps).

CASE DESCRIPTION A 2-year-old male bearded dragon (Pogona vitticeps) was evaluated because of a traumatic mandibular fracture. CLINICAL FINDINGS An open comminuted fracture of the rostral aspect of the right mandible was evident, with a fragment of bone exposed and dorsally displaced. Whole-body radiography revealed no evidence of additional injury. Other findings were unremarkable, except for moderate anemia (PCV, 19%). TREATMENT AND OUTCOME The fracture fragments were stabilized with 2 crossed 36-gauge interfragmentary wire loops. An external fixator device was fashioned from four 25-gauge needles inserted at alternating angles through the fracture fragments; plastic IV fluid line tubing filled with dental acrylic was used as a connecting bar. One day after surgery, the lizard had regained its typical activity level and appetite. Body weight was measured and the external fixator was inspected 1 week after surgery and monthly thereafter. Three months after initial injury, the fracture was stable, radiography revealed bony callus formation at the fracture site, and the external fixator was removed. Recheck radiography performed 5.5 months after initial injury revealed complete osseous union of the fracture fragments, and the interfragmentary wires were removed. CLINICAL RELEVANCE Surgical management of the traumatic comminuted mandibular fracture in this bearded dragon by means of a combination of internal and external fixation resulted in complete healing of the mandible and restoration of function. Management of this complicated fracture was achieved with the aid of readily available and inexpensive supplies in a clinical setting, which may be useful to other clinicians in the management of similar cases.

A 3-dimensional-printed patient-specific guide system for minimally invasive plate osteosynthesis of a comminuted mid-diaphyseal humeral fracture in a cat.

OBJECTIVE: To report the use of a 3-dimensional (3D)-printed patient-specific reduction guide system to facilitate minimally invasive plate osteosynthesis (MIPO) of a humeral fracture in a cat. STUDY DESIGN: Case report. ANIMALS: A 9-year-old male neutered domestic short hair cat weighing 4.4 kg. METHODS: A 9-year-old male domestic short hair cat was presented with a comminuted, mid-diaphyseal left humeral fracture. Computed tomographic data were processed to yield 3D mesh representations of both humeri and subsequently manipulated in computer-aided design software. The mirrored, intact humerus was used as a template for appropriate spatial orientation of the major proximal and distal fracture fragments. Patient-specific Ellis pin orientation guides and a reduction guide were designed and 3D printed. The guide system was used intraoperatively to align the major fracture fragments before application of locking internal fixation via standard MIPO surgical portals. RESULTS: Internal fixation of the fracture resulted in appropriate bone alignment. Recovery was uncomplicated, with early return to normal limb function and radiographic evidence of advanced fracture healing after 4 months. CONCLUSION: A 3D-printed patient-specific reduction guide system facilitated accurate alignment of a comminuted humeral fracture during MIPO without intraoperative imaging.

Adjunct fixation with a Kirschner wire or a plate for lateral unicondylar humeral fracture stabilization.

OBJECTIVE: To compare the biomechanical properties of using an interfragmentary 1.6 mm Kirschner wire or a 2.7 mm reconstruction plate as adjunctive epicondylar stabilization in simulated comminuted lateral unicondylar humeral fractures stabilized with a transcondylar 4.5 mm cortical screw. STUDY DESIGN: Cadaveric biomechanical assessment. SAMPLE POPULATION: Paired humeri harvested from 9 young, skeletally mature dogs. METHODS: Simulated comminuted lateral unicondylar humeral fractures were stabilized with a transcondylar 4.5 mm cortical screw placed in lag fashion. Adjunct fixations consisting of a 1.6 mm Kirschner wire on one side, and a 2.7 mm reconstruction plate on the contralateral side, were tested within paired humeri. Repaired humeri were axially loaded to failure and construct stiffness, yield load, and load to failure were obtained from the load-deformation curves. RESULTS: Stiffness (mean ± SD: 577 ± 245 vs 310 ± 71 N/mm; P = .01), yield load (mean ± SD: 2389 ± 572 vs 1017 N ± 292; P = .0002), and load at failure (mean ± SD: 3351 ± 358 vs 1693 ± 363 N; P = .009) were greater in constructs incorporating a reconstruction plate rather than a Kirschner wire. CONCLUSION: Our results support the recommendation for adjunct fixation of comminuted lateral unicondylar humeral fractures with an epicondylar plate.