Proximal interphalangeal arthrodesis in 22 horses.
Authors: Schaer T P, Bramlage L R, Embertson R M, Hance S
Journal: Equine veterinary journal
Summary
# Editorial Summary: Proximal interphalangeal arthrodesis in 22 horses Chronic pastern joint osteoarthritis represents a significant cause of lameness in equine athletes, and whilst arthrodesis (surgical fusion) can restore function, traditional fixation methods have been complicated by prolonged healing times and excessive bone proliferation around the joint. Researchers at Rood and Riddle Equine Hospital compared two internal fixation techniques in 22 horses undergoing proximal interphalangeal arthrodesis: three cortical screws placed in lag fashion alone, versus this screw technique combined with a dorsally-applied dynamic compression plate, with all cases supported by fibreglass casting. Horses treated with the combination technique spent significantly less time in cast and achieved soundness more rapidly than those with screw fixation alone, though both approaches resulted in similar numbers returning to intended use (seven of eight hindlimbs and three of six front limbs with combination technique; four of five hindlimbs and one of two front limbs with screws alone). The superiority of hybrid fixation appears to derive from increased construct stability that minimises micromotion at the arthrodesis site, thereby promoting more efficient bone remodelling and faster fusion. For practitioners managing chronic pastern arthritis cases, these findings suggest that combining parallel lag screws with plate fixation justifies the additional operative time and cost through substantially reduced recovery periods and faster return to work.
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Practical Takeaways
- •For pastern arthrodesis, combining parallel lag screws with a dorsally-applied dynamic compression plate provides faster healing and quicker return to soundness than screws alone
- •The combination technique may be particularly valuable for hindlimb cases, which showed higher success rates than forelimbs
- •Both fixation techniques can successfully restore function in chronic pastern osteoarthritis, but combination approach minimizes casting time
Key Findings
- •Combination technique (parallel screws with dynamic compression plate) achieved soundness in 7 of 8 hindlimbs and 3 of 6 forelimbs
- •Screw-only technique achieved return to intended use in 4 of 5 hindlimbs and 1 of 2 forelimbs
- •Combination technique reduced time in cast and time to soundness compared to screw-only technique
- •Internal fixation method did not significantly influence overall return to intended performance level