Developmental Diseases—Fractured Coronoid Process (FCP)

X-ray appearance of a normal elbow, AP view: Click to enlarge

Who is usually affected?
-Young dogs of large to giant breeds
-Most frequently affected breeds include Labrador retrievers, Golden retrievers, Rottweilers, and Bernese mountain dogs

What is happening?
-The 3 bones of the elbow joint fit poorly, causing abnormal pressure on the ulna
-A small piece of bone associated with the ulna in the front of the joint (coronoid process) breaks off
-Swelling and pain result from the altered joint mechanics and cartilage destruction
-Arthritis develops

X-ray appearance of a normal elbow, lateral view: Click to enlarge Elbow arthroscopy: Click to enlarge

Clinical signs you might notice in your pet
-Limping on a front leg after rest or exercise
-Tiring easily with play
-Resting more than other dogs of similar age and breed, "mellow" puppy
-Head bobbing during walking or running
-Sitting or standing crookedly with a front leg turned outward

Diagnosis
-Careful orthopedic examination to determine which joint(s) are affected
-X-rays are used to evaluate the condition of joint surfaces
-CT scanning may be useful in select cases to evaluate joint surfaces

Surgical treatment
-Removal of the bone fragment and any damaged cartilage (curettage)
-Surgery through small portals (arthroscopy) or a larger incision (arthrotomy) may be indicated
-Surgery on both elbows may be recommended, as the disease is frequently present on both sides

Special postoperative care
-Patient activity is generally limited for 4-6 weeks following surgery, allowing time for joint swelling to subside

Expected results after surgery
-Much initial improvement in the degree of pain and limping
-Ultimate outcome depends on the amount of joint damage present prior to surgery and the degree of elbow misfit ( incongruity )
-Moderate exercise, weight control and medication may be recommended for the long term management of optimal joint health