IOHC predominantly affects male Cocker, English Springer and Brittany Spaniels, although other medium and large breed dogs may be affected. It is an important cause of persistent forelimb lameness and subsequent atraumatic (not caused directly by damage or trauma) elbow fracture in the dog. A high bilateral (both elbows) incidence has been reported and early detection is important with prophylactic (to protect against infection & disease) surgical management currently the treatment of choice. The surgical management of atraumatic fractures of the elbow joint in skeletally mature dogs carries a high complication rate when compared with traumatic cases.

The cartilaginous (relating to the cartilage) plates of the humeral condyle (the knuckle end of the humerus, which is the long bone in the foreleg which runs from the shoulder to the elbow) fail to ossify (become inflexible, solidify or harden) completely i.e. incomplete ossification - at the vertical physis (part of the long bone where growth bone occurs from) leaving a fissure (fracture, split or crack) through the humeral condyle. This is a line of weakness.

IOHC can produce clinical signs of forelimb lameness and elbow pain. Lameness may be intermittent and can range from mild to severe.

Some dogs with IOHC do not show any clinical signs until a fracture occurs in the weak spot in the humeral condyle (intracondylar fracture). Fractures tend to separate the condyle (knuckle joint) in two fragments and extend upwards in one of four ways; lateral intracondylar, medial intracondylar, “T” fracture and “Y” fracture.

Since these fractures affect the elbow joint, accurate surgical repair to restore a smooth weight-bearing surface is important. Surgery usually requires fixation with metal plates and screws as well as a long screw placed across the condyle.
The technique employed depends upon the number and site of fractures.

Surgical repair of intracondylar fractures can have good results. Much depends on meticulous surgical technique and appropriate post operative care. Unfortunately, osteoarthritis is inevitable in elbow joints following surgical repair, and will progress throughout the dog’s life.

Patients need to stay in hospital for 24-48 hours post operatively, with pain relief provided whilst in hospital and for the days or weeks following surgery. Exercise restriction is vital in the first 4 – 6 weeks to protect the implants and it is very important to stick to a strict regime for exercise to aid recovery.
The patient initially needs to be strictly confined (in a crate/cage or in a room with no furniture) for the first 2 – 3 weeks, as jumping could result in implant failure or re-fracture.

Walks in the garden are permitted 4 – 6 times daily on the lead to allow the patient to relieve him/herself.
The incision site needs to be checked daily for abnormal discharge and the dog should be checked by your own Vet 3 – 5 days after returning home. Stitches and staples can be removed (by your Vet) 10 – 14 days after surgery.

Physiotherapy and hydrotherapy are highly recommended during convalescence and your Vet will able to direct you to a facility for this purpose as near to you as possible, if he/she does not have his/her own facility on the premises.

Until further conclusive results from several research programmes being carried out into this condition is received by the Breed Clubs, ESS owners and breeders are being advised that, if they (or their Vets) would like to know more about this condition, have an ESS that has been diagnosed with IOHC, or would like to contribute information for a research initiative, they should please contact Stephen K Joslyn, BSc BVMS MRCVS,Veterinary Intern in Small Animal Orthopaedics, Southern Counties Veterinary Specialists, Unit 6, Forest Corner Farm, Hangersley, Ringwood, Hampshire, BH24 3JW – Tel No. 01425 485615 Fax: 01425 480849 or
Email: or click on  for further information.

If any ESS owner and/or breeder wishes to contact the Health Co-ordinators with information relating to their ESS being diagnosed with IOHC, they would be happy to hear from them to offer what assistance and guidance they are able to at this time.

It is anticipated that any conclusions that are reached with the veterinary research world on this – or any other ESS health related topic(s) – will be posted on our websites.

ESS Breed Clubs Health Co-ordinators:

Lesley Bloomfield (Tel: 01923 823579
Louise Scott (Tel: 020 8427 3396

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