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veterinary
farriery
2023
Case Report

Modified toggle pin technique combined with prosthetic capsular reconstruction for surgical stabilization of coxofemoral luxation in a Shetland pony.

Authors: Müller Eva M T, Ehrle Anna, Pozzi Antonio, Lasarzik de Ascurra Juliane, Lischer Christoph J, Kümmerle Jan M

Journal: Veterinary surgery : VS

Summary

# Editorial Summary: Modified Toggle Pin Technique for Coxofemoral Luxation in Equine Cases Craniodorsal luxation of the hip joint is a rare but devastating injury in horses and ponies, typically requiring surgical intervention to restore function and prevent chronic degenerative changes. Müller and colleagues presented a case of a 167 kg Shetland pony treated via open reduction combined with a novel stabilisation strategy: a toggle pin anchored through the femoral head and acetabulum, supplemented by FiberWire figure-of-8 capsular reconstruction, avoiding the need for osteotomy of the greater trochanter. The technique achieved stable femoral head reduction confirmed on immediate postoperative radiographs, with the pony progressing through an 8-week sling recovery period followed by gradual mobilisation over two months. At two-year follow-up, the pony remained sound at walk and trot, demonstrating that combined intra- and extra-articular fixation can provide durable functional recovery in this challenging scenario. For equine surgical teams managing hip luxations, this hybrid approach offers a viable alternative that preserves greater trochanteric anatomy whilst providing robust multi-planar stability, potentially reducing long-term complications associated with more invasive osteotomy-based techniques.

Read the full abstract on PubMed

Practical Takeaways

  • Hip luxation can be surgically managed in ponies using a combined intra- and extra-articular stabilization approach, offering an alternative to traditional techniques requiring greater trochanter osteotomy
  • Extended sling support (8 weeks) and gradual return to activity over 2 months appears essential for successful outcome in this weight-bearing joint
  • Surgeon should consider this technique as a viable option for hip luxation cases seeking to preserve trochanteric anatomy

Key Findings

  • Modified toggle pin technique combined with prosthetic capsular reconstruction successfully stabilized coxofemoral luxation in a Shetland pony without greater trochanter osteotomy
  • Open reduction using pulley system achieved anatomical reduction of the luxated femoral head into the acetabulum
  • Two-year follow-up demonstrated successful long-term reduction with pony sound at walk and trot

Conditions Studied

coxofemoral luxationcraniodorsal hip joint luxation