Elbow Ununited Anconeal Process (UAP)
What is UAP?
When a small fragment of bone is detached from the ulna due to prolonged fusion time of the growth plate, the growth plate never attaching to the ulna, or the humoral condyle doesn’t fit correctly in the socket which causes the anconeal process to break off in the elbow joint. Once this happens, it causes significant pain within the joint. It is most common in puppies, but more common in the German Shepherd and Bassett Hound breeds.
You, your primary veterinarian, and our veterinary surgeons will use multiple layers of diagnostics to confirm UAP in your pet. Severe lameness and pain will guide our diagnostic plan. Your primary care veterinarian may perform a physical exam with possible radiographs of the elbow joint. He or she may then suggest further review/diagnostics by a referred specialty veterinarian. Dr. Jha will perform a thorough physical exam as well as additional radiographs depending on the diagnostic quality and time frame of the radiographs taken previously. However, if none of these can give him a clear image of the bone fragment or if the fragment seems to appear loosely attached to ulna, then a Computed Tomography (CT) scan might be used in addition to the original radiographs.
Dogs with UAP have the best chance to achieve the long-term resolution of clinical signs is to reattach the loose bone fragment with a screw if the fragment has not changed its shape. During the surgery Dr. Jha will inspect the joint with an arthroscope to decide the viability of the bone fragment. A screw will be placed from the ulna to the anconeal process to attach the fragment. He may or may not do an ulnar osteotomy (cut the ulna) to release the pressure in the ulnar joint. The other option is to remove the fragment if it has changed its shape or is no longer viable bone.
Since puppies are known for having a faster healing time, recovery takes about 4-6 weeks. Your pet will go home from the hospital with a splint bandage that will be removed after the first week of recovery. After 4 weeks of healing time with restricted activity, you will need to bring your pet back for recheck radiographs to make sure everything is healing properly. Continuing activity restrictions, you will wait another 4 weeks to then come back and do a final recheck radiograph. If all has healed properly, your pet will be able to have no activity restrictions and be a normal dog again. However, physical therapy may be required after 8 weeks to help the range of motion of the limb come back to normal.