Proximal interphalangeal joint arthrodesis in 34 horses using two parallel 5.5-mm cortical bone screws.
Authors: MacLellan K N, Crawford W H, MacDonald D G
Journal: Veterinary surgery : VS
Summary
# Proximal Interphalangeal Joint Arthrodesis: Two-Screw Technique Review Pastern joint arthrodesis remains a critical surgical option for horses with severe proximal interphalangeal joint disease, yet the optimal fixation method continues to evolve; this retrospective analysis evaluated the clinical outcomes of a specific two-screw lag technique across 39 procedures in 34 horses treated between 1991 and 1997. Using two parallel 5.5-mm ASIF cortical bone screws placed in lag fashion with a combined aiming device, the surgeons achieved successful outcomes—defined as return to previous function or intended athletic use—in 85% of front limbs and 89% of hind limbs, with only five joints experiencing failure (one directly related to surgery, four to unrelated lameness). Notably, patient age, breed, and the underlying initial diagnosis did not significantly influence success rates, suggesting this technique's broad applicability across diverse presentations. The key advantage of this approach appears to be shortened postoperative immobilisation periods whilst maintaining high fusion reliability, making it a practical option for practitioners seeking to minimise recovery time without compromising long-term soundness in athletic horses and those with severe degenerative joint disease.
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Practical Takeaways
- •Two parallel 5.5-mm cortical screws in lag fashion is a reliable technique for PIP arthrodesis with >85% success rate and faster recovery than previous methods
- •Aiming device use improves screw placement accuracy and likely contributes to high success rates—worth the investment in your surgical setup
- •Patient age, breed, and initial diagnosis shouldn't influence your decision to recommend arthrodesis; prognosis is predictable across these variables
Key Findings
- •Arthrodesis success rate was 85% in front limbs and 89% in hind limbs using two parallel 5.5-mm cortical bone screws
- •Age, breed, and initial disease diagnosis did not significantly affect surgical outcome
- •Postoperative coaptation time was shortened compared to traditional arthrodesis techniques
- •Five joints experienced failure, with only one directly attributable to surgical technique