Fusion Implants

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Advanced Veterinary Devices Fusion Implants is a newly established company created as a spin-out from the University of Liverpool and backed by venture capital.

The purpose of the company is to specialise in the manufacture of veterinary implants and associated instruments. The company consists of engineers, scientists, and orthopaedic veterinary surgeons, all with extensive research experience, and associated staff, to implement the running of the company and to drive the ideas into products. The core manufacturing capability is based on additive layer manufacture which permits an intuitive approach to design and development. Products are manufactured based on a technology which is patent protected, and already used to produce hip and knee components for human use. Our aim is to bring this most up-to-date technology into the veterinary market to produce advanced products.

$Successful surgical management of humeral condylar fractures requires more than simply stabilising the fracture. Accurat...$

30/10/2026

Successful surgical management of humeral condylar fractures requires more than simply stabilising the fracture.

Accurate anatomical reduction, stable fixation and preservation of the surrounding tissues are essential to achieving a favourable functional outcome.

However, the complex anatomy of the distal humerus, limited bone stock and challenges associated with screw placement can make fixation particularly demanding.

A 2026 review by Walton and Clark, explores the surgical management of humeral condylar fractures, including the role of locking plates and pre-contoured anatomical implants.

Several fixation options are available, including pins, screws and bone plates.

The choice depends on factors such as fracture configuration, patient size, age and bone quality.

The authors highlight that, in most humeral condylar fractures, fixation of the epicondylar component with a bone plate is advised. The distal humerus presents several anatomical challenges. Screws must engage with the metaphyseal bone, where achieving reliable bicortical fixation can be difficult. Locking plate technology provides a fixed-angle construct, allowing greater stability without relying solely on compression between the plate and bone. This can be particularly advantageous when working with limited distal bone stock. Conventional bone plates often require intraoperative contouring to accommodate the complex three-dimensional anatomy of the distal humerus.

The 2026 review highlights the availability of pre-contoured anatomical locking plates, designed to correspond with the anatomy of the humeral condyle.

These systems aim to:

-Improve anatomical conformity between the plate and bone.
-Optimise screw hole positioning and screw trajectories.
-Facilitate fixation within the available bone stock.
-Reduce the need for extensive intraoperative plate contouring.

This is particularly relevant to the development of anatomical implant systems such as Fusion Implants LEAP and MAP. The Lateral Epicondylar Anatomic Plate (LEAP) and Medial Anatomic Plate (MAP) systems have been developed to accommodate the complex anatomy of the distal humerus and provide dedicated fixation options for humeral condylar fractures.

The review also illustrates the use of medial and lateral anatomical plates together in the management of a dicondylar fracture in a cockapoo. This demonstrates how anatomic implants can be incorporated into surgical strategies for more complex fracture configurations. However, no matter what you choose to use, Implant selection remains only one component of successful fracture management. Accurate reduction, appropriate screw placement, surgical technique and understanding of the individual fracture configuration remain essential.

Reference: Walton B, Clark R. (2026). Humeral intracondylar fissure and condylar fractures in dogs. In Practice. www.fusionimplants.com/publications/

27/10/2026

For years, humeral intracondylar fissure (HIF) was commonly referred to as incomplete ossification of the humeral condyle (IOHC).

The assumption was that the two centres of ossification within the humeral condyle had failed to fuse during development.

But our understanding of this condition has changed considerably.

A September 2026 review by Walton and Clark, published in In Practice, explores the evolving evidence surrounding HIF and humeral condylar fractures.

The current thinking is that most HIFs in adult dogs are a form of stress fracture, rather than simply a developmental failure of ossification.

Research has demonstrated that:

-Partial fissures can progress to complete fissures.
-HIF can develop in previously normal humeral condyles.
-Differences in humeral condylar and radius/ulna morphology have been identified between spaniels with and without HIF.
-Reduced vascular density has been identified in the humeral condyles of American cocker spaniels compared with crossbreeds.

These findings raise important questions about the role of repetitive loading, joint anatomy, vascular supply and bone biology.

Stress fractures can develop through two different mechanisms:

-Fatigue fractures: Abnormal repetitive forces acting on otherwise normal bone.
-Insufficiency fractures: Normal forces acting on structurally compromised bone.

Both mechanisms are being considered in the development of HIF. However, the authors emphasise that there is still no universally accepted explanation for the condition. Because understanding HIF as a potentially progressive stress-related condition changes how we think about diagnosis, fracture risk, implant selection and long-term management. It also reminds us that terminology can persist long after our understanding of a disease has evolved.

Reference: Walton B, Clark R. (2026). Humeral intracondylar fissure and condylar fractures in dogs. In Practice.

www.fusionimplants.com/publications/

22/10/2026

IF A DOG HAS HIF BUT NO LAMENESS, SHOULD WE OPERATE?

This is one of the more challenging questions in veterinary orthopaedics.

A dog has a humeral intracondylar fissure (HIF), but is clinically comfortable.

Do we recommend prophylactic surgical stabilisation to reduce the risk of fracture?

Or do we monitor, accepting that some dogs will never develop clinically significant problems?

A September 2026 review by Walton and Clark examines this question using the available evidence and an interesting statistical approach.

What happens if we don't operate?

One study followed 34 elbows with subclinical HIF in 30 English springer spaniels.

Of those 34 elbows:

-18% (6/34) subsequently fractured.
-A further 6% (2/34) became painful and required transcondylar screw placement.
-Overall, approximately 24% required surgical intervention during follow-up.

This means that most elbows in this cohort did not require surgery during the study period. But a proportion experienced a potentially serious fracture.

What about the risks of prophylactic surgery?

Surgery itself carries risks, including infection, implant complications and the potential need for further intervention.

The authors use two statistical concepts to explore this balance:

-Number Needed to Treat (NNT):

How many patients need treatment for one to benefit? Using the available estimates, the authors calculate an NNT of approximately 5.In other words, around five dogs would need prophylactic treatment to prevent one adverse outcome, based on the assumptions used.

-Number Needed to Harm (NNH):

How many patients need treatment before one experiences a significant treatment-related complication? Using a 6% major complication rate, the estimated NNH is approximately 17. However, if the major complication rate rises to 20%, the NNH falls to just 5.

These figures are illustrative estimates, not definitive predictions. They depend on the populations, implants, surgical techniques and complication rates being compared. While surgical stabilisation is generally recommended due to the potential risk of progression to a complete humeral condylar fracture, the decision still requires careful consideration. The risks associated with surgery must be balanced against the potential consequences of leaving an intracondylar fissure untreated, even in an animal that currently has no clinical signs.

Reference: Walton B, Clark R. (2026). In Practice.

www.fusionimplants.com/publications/

$Humeral condylar fractures are a well-recognised orthopaedic injury in dogs.A September 2026 review by Walton and Clark,...$

20/10/2026

Humeral condylar fractures are a well-recognised orthopaedic injury in dogs.

A September 2026 review by Walton and Clark, published in In Practice, highlights some important epidemiological findings. Age is a significant factor.

In the UK, approximately 60–67% of humeral condylar fractures occur in dogs younger than 12 months, with most affected puppies being around four months old or younger.

A strong breed predisposition is also recognised, with English springer spaniels and French bulldogs particularly represented among puppies presenting with these fractures.

In older dogs, humeral condylar fractures are frequently associated with pre-existing humeral intracondylar fissures (HIF).

Although HIF has been identified in numerous breeds, including Labrador retrievers, pointers, rottweilers and French bulldogs, spaniels, particularly English springer spaniels, account for the majority of adult humeral condylar fracture cases.

Perhaps one of the most interesting findings concerns dogs without clinical signs. Research by Moores and colleagues (2014) identified HIF in 14% of English springer spaniels with no evidence of forelimb lameness or elbow pain.

This is clinically important because HIF may remain asymptomatic, cause intermittent lameness or predispose the humeral condyle to fracture. It also raises questions about identifying and managing subclinical disease in predisposed breeds.

While humeral condylar fractures are particularly common in young dogs, HIF should remain an important differential diagnosis in adult spaniels presenting with forelimb lameness, even when clinical signs are subtle or intermittent.

And importantly, the absence of lameness does not necessarily mean the absence of an intracondylar fissure.

Reference:Walton B, Clark R. (2026). Humeral intracondylar fissure and condylar fractures in dogs. In Practice.

www.fusionimplants.com/publications/

16/10/2026

THANK YOU FOR JOINING OUR FIRST FREE FUSION IMPLANTS WEBINAR!

A huge thank you to everyone who joined us on 14th October for our webinar exploring Humeral Condyle Fractures (HCF) and Humeral Intracondylar Fissures (HIF).

We were delighted to welcome Dr Brian Beale and Ben Walton, who shared their expertise on the surgical management of these challenging conditions.

The session explored clinical decision-making, surgical techniques and the application of our LEAP, MAP, HIRS and HISS systems, followed by an excellent Q&A.

Thank you to our speakers and everyone who attended and contributed to the discussion!

MISSED THE WEBINAR?

You can catch up with the recording, message [email protected] to request the link.

SAVE THE DATE – 23RD NOVEMBER 2026!

Our next FREE Fusion Implants webinar will focus on Feline Pelvic Trauma!

We'll be exploring the challenges of managing pelvic injuries in cats, including surgical considerations, fixation techniques and the role of anatomical implants in fracture repair.

Save the date – we hope you'll join us!

14/10/2026

Feline Lateral Iliac Plate

The Feline Lateral Iliac Plate (FLIP) was designed based on dozens of CT scans of various cat breeds. There and left and right versions in two size variations that will accommodate the vast majority of cats.

We designed the FLIP to accomodate a flexible screw configuration to maximise screw density on both sides of a fracture. The screws round the acetabulum are angled to minimise the risk of joint pe*******on while maximising screw length.

Each Fusion FLIP is crafted from medical-grade titanium alloy (Ti6Al4V) in a multi-step manufacturing process starting with 3D printing and including heat treatment, CNC machining, and anodisation.

The final products have undergone a rigorous quality control process giving you confidence that you are using a product of cutting edge innovation and premium quality.

https://www.fusionimplants.com/product-information/pelvis/flip-overview-page/

13/10/2026

Atlantoaxial (AA) Joint Instability

Bite-Size CPD

Estimated reading time: Full chapter: approximately 30 minutes | Summary: 5–10 minutes

Reference:
Platt SR, da Costa RC. Cervical Spine. Veterinary Surgery: Small Animal, Vol. 1 (2012).

Overview

Atlantoaxial (AA) instability is characterised by abnormal movement or subluxation of the atlas (C1) relative to the axis (C2), which can result in compression and concussive injury of the cervical spinal cord.

Instability may arise from ligamentous and/or osseous abnormalities affecting the atlantoaxial articulation.

Aetiology

Atlantoaxial instability is most commonly associated with congenital or developmental abnormalities, particularly in young, small-breed dogs. However, traumatic atlantoaxial subluxation can occur in dogs of any age or breed.

Documented congenital and developmental abnormalities include:

-Dens dysplasia – approximately 34%
-Hypoplasia or aplasia of the dens – approximately 46%
-Dorsal angulation of the dens
-Absence or abnormality of the transverse ligament
Absence or abnormality of the transverse ligament
-Incomplete ossification of the atlas
-Block vertebrae

Importantly, abnormalities of the dens are not identified in every affected dog, with approximately 24% of dogs with atlantoaxial subluxation reported to have a normal dens.

Traumatic atlantoaxial subluxation may follow significant trauma. However, an underlying congenital or developmental abnormality may also be present in dogs presenting following apparently traumatic events.

Pathophysiology and Clinical Signs

The presence of atlantoaxial instability does not necessarily correlate directly with the severity of clinical signs. Clinical presentation is largely determined by the degree of spinal cord compression and injury associated with subluxation.

Neck pain is a common presenting complaint. It has been reported in:

-Most dogs with traumatic lesions
-Approximately 30–60% of dogs with congenital lesions

Neurological abnormalities can vary considerably and may include:

-Gait abnormalities – reported in up to 94% of cases
-Postural reaction deficits – reported in approximately 56%
-Tetraplegia – reported in approximately 10%

Neurological deficits may be asymmetric, and the severity of dysfunction can differ between the thoracic and pelvic limbs.

Surgical Considerations

Surgical stabilisation of the atlantoaxial joint requires implant placement within small and anatomically demanding cervical vertebrae, where accurate trajectory and depth are particularly important.

Fusion Implants patient-specific vertebral drilling guides are designed to support accurate pre-planned screw placement in this challenging anatomy.

The guides allow the surgical plan to define:

-Screw entry points
-Screw trajectory and angulation
-Planned screw depth
-Bicortical placement where appropriate
-Implant positioning to optimise available bone purchase while respecting surrounding anatomy

Each patient-specific case is planned by Fusion Implants' biomedical engineering team and reviewed as part of the preoperative planning process.

The surgeon receives:

-In silico planning images
-A sterilisable patient-specific bone model
-Duplicate patient-specific surgical guides, allowing preoperative assessment and rehearsal

In the surgical management of atlantoaxial instability, patient-specific guides can therefore provide a means of translating the preoperative plan to the patient, supporting controlled implant positioning in an anatomically complex and high-risk region.

Key Takeaway

Atlantoaxial instability is most commonly associated with congenital or developmental abnormalities in young, small-breed dogs, although traumatic presentations also occur. Clinical signs result from the associated cervical spinal cord injury and can range from neck pain and mild neurological deficits to tetraplegia.

Where surgical stabilisation is indicated, careful preoperative planning and accurate implant placement are particularly important because of the small osseous corridors and adjacent critical structures of the upper cervical spine.

https://www.fusionimplants.com/product/spine/

08/10/2026

Bitesize CPD

French Bulldogs, HIF and Humeral Condylar Fractures

We recently revisited an interesting study by Anderson, Langley-Hobbs and Parsons examining humeral condylar fractures and humeral intracondylar fissures (HIF) in French Bulldogs.

The retrospective study reviewed 44 French Bulldogs presenting with humeral condylar fractures between 2012 and 2021 and found:

➡️ 63.6% had lateral humeral condylar fractures.

➡️ Dogs treated with a transcondylar screw (TCS) and K-wires had 7.62 times the odds of experiencing a major complication compared with other fixation methods.

➡️ All reported cases of screw migration (7/7) occurred in the TCS + K-wire group.

➡️ Of the dogs that underwent CT examination of the contralateral elbow, 58.1% had evidence of HIF.

➡️ Increasing age was not significantly associated with a reduced likelihood of HIF.

Why is this clinically important?

The Anderson study also identified a higher risk of major complications with TCS + K-wire fixation compared with other fixation methods used within the study, with screw migration occurring exclusively in this group.

There is, however, positive evidence for alternative fixation constructs. Eayrs et al. reported good perioperative, mid-term and long-term outcomes following repair of lateral humeral condylar fractures in skeletally mature dogs using a transcondylar screw combined with an epicondylar plate.

The French Bulldog Lateral Epicondylar Anatomic Plate (LEAP)

The Fusion FBD LEAP was designed using CT data from French Bulldogs (although can be used on any breed of puppies and dogs of that size and weight bracket, for suitable cases) to provide a plate that closely matches the anatomy of the lateral humeral condyle, helping to minimise the need for intraoperative contouring.

French Bulldogs are an important breed to consider when managing humeral condylar fractures, particularly in younger dogs. A breed-specific anatomical plate provides surgeons with a fixation option designed around the anatomy encountered in these patients.

Clinical evaluation of the Lateral Epicondylar Anatomic Plate (LEAP) has also demonstrated encouraging outcomes in dogs with humeral condylar fractures. In a study population predominantly comprising spaniels, 17/17 dogs with lateral condylar fractures returned to full limb use according to owner questionnaires (which we acknowledge has its own limitations and biases). Median Liverpool Osteoarthritis in Dogs (LOAD) scores were 2/52 for dogs who presented with lateral condylar fractures.

The authors concluded that the Lateral Epicondylar Anatomical Plate can be used successfully for the surgical stabilisation of humeral condylar fractures in dogs.

Anderson OJ, Langley-Hobbs SJ, Parsons KJ. Humeral condylar fractures and fissures in the French bulldog. Vet Surg. 2023;52(1):134–145. doi:10.1111/vsu.13907.

Eayrs MK, Guerin V, Grierson J, Moores AP. Repair of Fractures of the Lateral Aspect of the Humeral Condyle in Skeletally Mature Dogs with Locking and Non-Locking Plates. Vet Comp Orthop Traumatol. 2021;34(6):419–426. doi:10.1055/s-0041-1735552.

Clinical Assessment of a Lateral Epicondylar Anatomical Plate for the Stabilization of Humeral Condylar Fractures in Dogs.

https://www.fusionimplants.com/courses/

06/10/2026

US Veterinary Teams - we now have a base near you!

We are excited to see you all at American College of Veterinary Surgeons - ACVS Congress.

Every year we enjoy ACVS, so much so that we started running some courses in Park City, UT, and it soon because obvious we needed to expand, so here we are!

Contact Details

9615 Yupondale Dr,
Houston, TX 77080

Email: [email protected]

Check out our website here:

https://www.fusionimplants.vet/

$ObjectiveTo report the use of a Lateral Epicondylar Anatomical Plate for the management of humeral condylar fractures (H...$

05/10/2026

Objective

To report the use of a Lateral Epicondylar Anatomical Plate for the management of humeral condylar fractures (HCF) in dogs.

Study Design

Medical records of dogs with HCF stabilized using the Lateral Epicondylar Anatomical Plate at six UK veterinary referral centres between April 2018 and February 2021 were reviewed. Long-term follow-up (>6 months) was obtained via owner questionnaire, which incorporated the Liverpool Osteoarthritis in Dogs clinical metrology instrument.

Results

Sixty-two HCF were treated in 61 dogs (44 lateral condylar fractures [LCF] and 18 intracondylar (T/Y) fractures [ICF]). Fifty-one dogs were Spaniels or Spaniel crossbreeds. Intraoperative contouring of the plate was required for one dog—a French Bulldog. Postoperative complications occurred in 14/42 LCF and 6/18 ICF; overall there were 14 minor, 8 major, and 2 catastrophic complications. On final follow-up imaging, there was evidence of partial or complete osseous continuity of the condylar part of the fracture 32/53 HCF (24/39 LCF and 8/14 ICF) and lateral epicondylar part of the fracture in 53/53 HCF (39/39 LCF and 14/14 ICF). At final reexamination, 20/28 dogs with LCF and 5/13 dogs with ICF were not lame and the remaining dogs demonstrated mild lameness. According to the owner questionnaire, 17/17 dogs with LCF and 8/10 dogs with ICF returned to full limb use and median Liverpool Osteoarthritis in Dogs scores were 2/52 for LCF and 6.5/52 for ICF.

Conclusion

The Lateral Epicondylar Anatomical Plate can be used successfully for the surgical stabilization of HCF in dogs.

https://www.fusionimplants.vet/publications/

Address

181 Harrison Hughes Building
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Telephone

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Website

http://www.fusionimplants.com/

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