Use of a new aiming compression device and technique for the repair of navicular bone fractures in horses: A cadaveric study.
Authors: Pudert Tanja, Fries Giuletta Felicia, Lotz Hannah, Röcken Michael, Cruz Antonio M
Journal: Veterinary surgery : VS
Summary
# Editorial Summary Navicular bone fractures in horses present a significant surgical challenge, particularly regarding achieving secure screw fixation whilst preserving critical articular and flexor cortex surfaces. Researchers from the Universities of Zurich and Ghent developed and tested a novel aiming compression device (ACD) designed to stabilise the navicular bone and guide drilling during screw insertion, evaluating its efficacy in ten cadaveric equine forelimbs using a standardised 3.5 mm cortical screw placement protocol under radiographic guidance. The technique demonstrated impressive clinical utility: median operative time was just 33.5 minutes (range 25–62 minutes), requiring a median of 18.5 radiographic images per procedure, with nine of ten bones achieving excellent screw positioning on gross examination—notably without articular surface disruption, flexor cortex violation, or screw head/tip protrusion. The lateral-to-medial compression approach proved effective enough that advanced imaging such as CBCT was unnecessary for intraoperative guidance, though the authors noted that post-operative CBCT assessment proved unreliable for validating placement. For equine practitioners managing navicular fractures, this technique offers a pragmatic, time-efficient alternative that prioritises precise screw positioning and anatomical integrity without requiring expensive imaging infrastructure, potentially improving outcomes and expanding surgical options in field and clinic settings.
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Practical Takeaways
- •This new aiming compression device offers a practical technique for navicular bone fracture repair using standard radiography without requiring advanced imaging like CT, potentially reducing costs and procedure complexity
- •The technique achieves reliable anatomically correct screw placement in under 35 minutes median time, which could translate to better clinical outcomes if validated in live horses
- •Surgeons should recognize this as a promising alternative approach to navicular fracture repair, though clinical validation in living animals is still needed before widespread adoption
Key Findings
- •The aiming compression device achieved excellent screw placement in 9 of 10 cadaveric navicular bones (90% success rate)
- •Median procedure time was 33.5 minutes with a range of 25-62 minutes
- •Median of 18.5 radiographic images were required per procedure (range 11-21)
- •No disruption of articular or flexural surfaces occurred, and no screw protrusion was observed in 9 of 10 cases