Proximal interphalangeal joint arthrodesis in horses: concepts, indications, and techniques (original) (raw)
Related papers
Vlaams Diergeneeskundig Tijdschrift, 2019
Two adult warmblood horses with a history of chronic hind limb lameness originating from the proximal interphalangeal joint (PIPJ) were presented at the equine hospital De Bosdreef (Belgium) between 2016 and 2017. Based on the case history and orthopedic examination, chronic osteoarthrosis (OA) of the PIPJ was diagnosed in both horses. A modified surgical arthrodesis of the PIPJ was performed using a central dorsal three-hole proximal interphalangeal locking compression plate (PIP plate) and four 5.5 mm transarticular cortical screws placed in a lag fashion (TCS-LF). The procedure resulted in an early bone bridging of the PIPJ and a return of the horses to the intended use within ten months after the surgery.
Veterinary Surgery, 1990
Arthrodesis of the proximal interphalangeal joint was used to treat lameness resulting from osteoarthrosis and for closed subluxation in 35 horses. Six horses had bilateral arthrodeses. Several conventional internal fixation techniques and a three converging screw method were used. Criteria for success included the horse performing its previous or intended athletic actiwity and the owner being satisfied with the outcome. Using these criteria, a successful outcome was obtained in 65% of the 26 animals in which adequate follow-up was available. A successful outcome was observed in four of six horses with bilateral arthrodeses. The internal fixation technique used did not influence the success rate, and the duration of postoperative casting was similar in successful and unsuccessful cases. The success rate of proximal interphalangeal arthrodeses was 46% in the fore limbs and 83% in the hind limbs. Complications included infection, cast ulcers, bone or implant failure, implant loosening, and laminitis.
Javma-journal of The American Veterinary Medical Association, 2018
P roximal interphalangeal joint arthrodesis is indicated for horses that have lameness as a result of osteoarthritis or instability of the PIPJ or P2 fracture caused by trauma. Several methods for PIPJ arthrodesis have been described in the literature, including transarticular screws placed in lag fashion, platescrew combinations, laser-facilitated ankylosis with transarticular screws placed in lag fashion, and chemically induced ankylosis. 1-8 Use of an LCP in conjunction with locking head screws for internal fracture fixation was first described in the human medical literature. 9 The LCP was introduced as an alternative to LC-DCPs and DCPs, with purported benefits in im
Journal of Equine Veterinary Science, 2020
The objective of this study was to compare the biomechanical properties in a single cycle axial loading test and the types of failures in two constructs (a 3-hole 4.5-mm dynamic compression plate (DCP) and 7-hole 5.5-mm Y locking compression plate (Y-LCP)) in equine proximal interphalangeal joint (PIJ) arthrodesis. One limb in each pair was randomly assigned to PIJ arthrodesis using a 3-hole 4.5-mm DCP combined with two transarticular 5.5-mm cortical screws, whereas the contralateral limb was submitted to PIJ arthrodesis using a 7-hole Y-shaped 5.0-mm LCP in conjunction with one transarticular 4.5-mm cortical screw inserted through the central plate hole. Cortical screws were inserted in lag fashion. Constructs were submitted to a single axial load cycle to failure. Construct stiffness, load, and deformation were analyzed. Dynamic compression plate and Y-LCP arthrodesis constructs did not differ significantly and were equally resistant to axial loading under the conditions studied (DCP and Y-LCP group stiffness, 5685.22 N/mm and 6591.10 N/mm, respectively). Arthrodesis of the PIJ using a DCP and two transarticular 5.5-mm cortical screws or a Y-LCP yielded biomechanically equivalent outcomes under the test conditions considered. However, Y-LCP provides less impact in the palmar/plantar bone. Application of Y-LCP with unicortical screws has equivalent biomechanical characteristics of DCP and may be a safe option for PIJ arthrodesis, where potential trauma secondary to applying bicortical screws in the palmar/plantar aspect of the pastern can be avoided.
Clinical Research and Trials
Introduction: The diseases of the equine proximal interphalangeal joint (PIJ) occur frequently and usually it is necessary to perform arthrodesis as a treatment option. A reasonable number of retrospective studies have been published referring to the outcomes of different ways to promote ankylosis of this joint, either from the point of view of indications or by the techniques employed. The aim of this study is to carry out a meta-analysis of retrospective studies of PIJ arthrodesis in horses to do a better evaluation and interpretation of the likely outcomes of different forms of intervention. Methods and analysis: A systematic review of the literature will be carried in the CAB, Scopus, Web of Science, ScienceDirect, PubMed, following the recommendations of Cochrane and PRISMA, in search of retrospective studies of proximal interphalangeal arthrodesis in horses. Information on the length of hospital stay, time of rigid external immobilization (casting), time to return to activities, survival rate, presence of lameness after the end of treatment, will have their effects measured by standardized mean difference or odds ratio. The meta-analysis will be performed using fixed and random effect.
Proximal interphalangeal arthrodesis in seven horses: A retrospective study in Brazil (2011-2019)
Ciência Rural, 2021
ABSTRACT: This study discussed several cases of proximal interphalangeal arthrodesis in horses at a veterinary hospital in Brazil. The medical records of seven horses that underwent proximal interphalangeal arthrodesis between 2011 and 2019 were analyzed for indication, technique, and complications. Short- and long-term outcomes were obtained from both the medical records and telephone interviews with the owners. A dynamic compression plate (DCP) was used in one of the seven horses that underwent surgical arthrodesis, and locking compression plates (LCP) were used in the others. Hospital discharge was recorded in 71.4% (5/7) of the horses, with an average hospital stay of 79 ± 45 days. Casting was maintained for 59 ± 26 days. Contact with owners was possible in four cases, two of which regained their prior level of function. The proximal interphalangeal arthrodesis may improve a horse’s well-being, especially when it is considered an early intervention, minimizing the chances of imm...
Veterinary Surgery, 2012
Objective: To describe regions of the thoracic and pelvic limb proximal interphalangeal (PIP) joints that are arthroscopically accessible and identify soft tissue structures that should be avoided during arthroscope and instrument placement. Study Design: Experimental ex vivo descriptive study. Animals: Horses (n = 15). Methods: Cadaver limbs (n = 36) were used for anatomic modeling, magnetic resonance imaging (MRI) with MRI-compatible needles, computed tomography with contrast arthrography, and arthroscopy of the PIP joint. Two arthroscopic approaches to the dorsal joint pouch were compared. Results: With arthroscopy, 62.4% of the joint perimeter could be observed from the dorsal and palmar/plantar joint pouches with no significant difference in the amount of joint observed when using the more proximal or distal approach to the dorsal joint pouch (P =.59). Conclusion: The dorsal and palmar/plantar joint pouches provide adequate arthroscopic visibility for the axial portions of the articular surface of the proximal and middle phalanx. The abaxial portions of the articular surface were difficult to view because of narrowing of the joint pouches abaxially. When comparing the proximal and distal approach to the dorsal joint pouch, arthroscope insertion 1.5 cm proximal to the joint allowed the easiest manipulation of the arthroscope. Palmar/plantar portals were placed dorsal to the neurovascular bundle, proximal to the epicondyle of the middle phalanx to prevent tendon and ligament injury.
Veterinary Surgery, 2010
Objective-To compare the biomechanical cyclic fatigue properties of 2 and 3 parallel transarticular 5.5 mm cortical screws used in arthrodesis of the proximal interphalangeal (PIP) joint. Study Design-Randomized block design, for horse, fixation method (2 versus three 5.5 mm cortical screws), side (right, left) and end (front, hind) in cadaveric equine limbs. Sample Population-Cadaveric adult equine fore-and hindlimbs (n ¼ 5 pairs each). Methods-Two parallel 5.5 mm cortical screws were inserted in lag fashion, transarticularly through the PIP joint in 1 limb of a pair, and in the contralateral limb, three 5.5 mm cortical screws were inserted in similar fashion. Constructs were then tested in 3-point bending in a dorsal-to-palmar (plantar) direction using a materials testing machine using a cyclic load of À500 to À3500 N at a rate of 6 Hz. Results-There was no significant difference in displacement at failure, force at failure or number of cycles between limbs. Forelimb constructs tended to fail at a greater mean displacement than hindlimb constructs but this difference was not significant (P ¼ .06). There was no statistical difference in any tested biomechanical variable between left-and right-sided limbs.