Bilateral elbow surgery tied to higher complication rates in dogs

VERSION 1 — BRIEF

A new retrospective study in the Journal of Small Animal Practice found that dogs undergoing bilateral surgery for humeral intracondylar fissures, humeral condylar fractures, or both had significantly higher postoperative complication rates than dogs treated unilaterally. The analysis included 75 dogs and reported that simultaneous bilateral procedures were associated with up to a 2.22-fold increase in complications, suggesting that operating on both elbows at once may carry added risk. The finding lands in a clinical area already known for meaningful complication rates after condylar fixation and prophylactic transcondylar screw placement. (pubmed.ncbi.nlm.nih.gov)

Why it matters: For veterinary surgeons and referral teams, the study adds evidence to an everyday decision point: whether to stabilize a contralateral fissure prophylactically during the same anesthetic event. That question is especially relevant in breeds predisposed to these lesions, including spaniels and French bulldogs, where contralateral fissures are not uncommon. In French bulldogs specifically, recent retrospective data on 43 unicondylar humeral fractures found no evidence that screw/plate fixation was superior to screw/pin fixation, with both approaches producing similar outcomes and acceptable perioperative function, suggesting the bigger planning question may be timing and case selection rather than implant construct alone. Prior literature has shown that condylar fracture and fissure repair can already carry notable risks, including infection, implant-related complications, and revision surgery, so a higher complication signal with bilateral simultaneous surgery may push more clinicians toward staged management unless the opposite limb is clinically active or unstable. (pubmed.ncbi.nlm.nih.gov)

What to watch: Whether surgeons begin favoring delayed intervention on the prophylactic limb, and whether future studies can identify which dogs with silent contralateral fissures are most likely to benefit from early versus staged repair. It will also be worth watching whether breed-specific data—especially in French bulldogs, where both plate- and pin-based epicondylar fixation appear viable for unilateral fractures—help refine how surgeons separate fixation choice from the separate question of whether both sides should be addressed in one procedure. (pmc.ncbi.nlm.nih.gov)