Proximal interphalangeal joint arthrodesis using a combination plate-screw technique in 53 horses (1994-2003).
Authors: Knox P M, Watkins J P
Journal: Equine veterinary journal
Summary
# Editorial Summary: PIP Joint Arthrodesis Using Combined Plate-Screw Fixation Knox and Watkins' retrospective review of 53 horses undergoing proximal interphalangeal joint arthrodesis between 1994 and 2003 evaluated the clinical efficacy of a dorsally placed dynamic compression plate combined with transarticular cortex screws placed in lag fashion—a technique designed to provide rigid fixation whilst minimising post-operative cast dependency. Over a mean follow-up period of 3 years, 87% of horses (40 of 46) returned to their intended use, with notably superior outcomes in hindlimbs (95% success rate) compared to forelimbs (81%), and 85% of horses treated for performance work achieving successful returns. The technique offered a marked advantage in recovery management, with only 14 days of cast application required post-operatively, whilst complications such as implant infection and cast sores remained relatively minor. For equine practitioners managing chronic pastern joint pathology—including osteoarthritis, middle phalanx fractures, subluxation and subchondral cystic lesions—this combined fixation approach represents a robust surgical option, particularly for hindlimb cases where prognosis for athletic return appears excellent; forelimb arthrodeses, whilst showing good outcomes, warrant more conservative prognostication.
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Practical Takeaways
- •This combination plate-screw fixation technique offers a reliable surgical option for pastern joint arthrodesis with excellent return-to-work rates, particularly for hindlimb cases
- •The short 14-day casting period reduces complications and recovery time compared to traditional methods, improving owner compliance and reducing care burden
- •Expect 81-95% success rates depending on limb, with hindlimb cases having substantially better prognosis for return to performance
Key Findings
- •87% of 46 horses with long-term follow-up (mean 3 years) could be used as intended after PIP joint arthrodesis
- •Hindlimb arthrodeses had 95% success rate compared to 81% for forelimb procedures
- •23 of 27 horses (85%) used for performance had successful outcomes
- •Post-operative casting period of only 14 days was sufficient with the combined DCP and transarticular cortex screw technique