Page 239 - Canine Lameness

14.10 Elbow uxation 211

(A) (C) (E) (G) (I)

(B) (D) (F) (H) (J)

Figure 14.9 Elbow luxation: (A, B) Type I congenital elbow luxation (caudolateral luxation of the radial head); (C, ELBOW REGION
D) Type II congenital elbow luxation (lateral rotation and subluxation of the ulna); (E, F) traumatic, lateral
elbow luxation (note the collateral ligament avulsion fragments, white arrow); (G, H) traumatic, lateral subluxation
of the elbow; and (I, J) clinical picture and 3D-CT reconstruction of the patient shown in images (A, B).

in large-breed dogs but is also described in Yorkshire Terriers. Type II luxations occur more often
in small-breed dogs (Rahal et al. 2000). Of the three variants of CEL, Type III luxation occurs less
frequently and is poorly described, but it is known to occur in small-breed dogs with a case study
in Cavalier King Charles Spaniel reported (McDonell 2004).

14.10.2 Physical Exam

TELs are generally associated with severe pain and non-weight-bearing lameness. Most TELs are
lateral (i.e. the radius and ulna are lateral to the humerus) because of the larger-sized and distally
sloped trochlea (medial humeral condyle; Figure 14.2) making the radial head easily palpable and
the lateral epicondyle less distinct. Patients with lateral TEL present with their limb in an abducted
and externally rotated position. Congenital luxations may cause various degrees of lameness and
degrees of pain. Depending on the severity and chronicity, limited ROM and crepitus may be pre-
sent. Palpation of the elbow (for both types) allows palpation of the abnormal/displaced anatomic
structures. In extension, the anconeal process is located within the olecranon fossa, making the
elbow inherently stable. When the elbow is flexed, Campbell’s test can be used to evaluate the
integrity of the medial and lateral collateral ligament. This is done by flexing the elbow and carpus
to 90° and evaluating the maximum angles of pronation (testing medial collateral ligament integ-
rity) and supination (testing lateral collateral ligament). Normal values for Campbell’s test have