These are not fun fractures to repair. For this patient (a 5 month old M Tibetan Mastiff), I placed 2 lag screws and bilateral neutralisation plates.
Tips:
-I often approach the epicondylar ridge first then stay near the bone with my subsequent muscle splitting approaches bilaterally. This way I know my landmarks and can more easily identify the neurovascular bundles.
-A bilateral approach prior to fracture reduction can help with alignment and double checking the reduction on both sides.
-There are larger biomechanical forces on the humerus - it is important not to under-engineer these repairs.
