Minimally invasive plate fixation of lower limb injury in horses: 32 cases (1999-2003)

Abstract

Summary Reasons for performing study: Complications of osteosynthesis including superficial and deep infections continue to affect adversely outcome in equine surgery of the lower limb. Objective: To describe a technique for minimally invasive plate fixation in horses and evaluate clinical results of the technique. Hypothesis: Lower complication rates would occur in horses treated with a minimally invasive approach compared with conventional techniques. Methods: Cases of minimally invasive plate fixation from January 1999 to December 2003 were evaluated. Case records, radiographs and race records for horses that sustained distal third metacarpal/metatarsal (Mc/tIII) condylar fractures were assessed. Follow‐up information was obtained and results analysed. In addition, results for horses that received arthrodesis by a conventional, open approach during the same period were evaluated and statistical analysis was performed. Results: Thirty‐two cases of minimally invasive plate fixation were identified (22 incomplete distal Mc/tIII condylar fractures with a spiralling or diaphyseal component, 10 metacar pophalange al arthrodes es and 4 pastern arthrodeses). For both types of arthrodesis, surgery times and infection rates were lower and survival rates higher in the minimally invasive group, but no statistical difference was found. Spiralling condylar fractures were successfully managed, without catastrophic fracture. Conclusions and potential relevance: Minimally invasive percutaneous plate osteosynthesis (MIPPO) can be successfully used for select applications in horses, and may reduce morbidity and mortality in equine fracture repair.

Surgical repair of propagating condylar fractures of the third metacarpal/metatarsal bones with cortical screws placed in lag fashion in 26 racehorses (2007–2015)

“…Overall return to racing, in the current study is similar to other studies which report return to racing between 25 and 62% . In one report evaluating a lag fashion fixation of propagating condylar fractures under general anaesthesia associated with a long open approach, 14 out of 18 horses returned to training, of which 5 raced .…”

“…Despite the low number of cases, this proportion is slightly higher than previously reported . Mean time to first start was also comparable with other studies reporting a return in 11.6–14.5 months .…”

“…Cast was removed within 24 h after recovery in 21 cases (81%). Horses were hospitalised for an average of 6 days after fracture fixation. The mean time between fracture repair and screw removal was 14 weeks [10–36].…”

Surgical site infection associated with equine orthopedic internal fixation: 155 cases (2008–2016)

“…In an earlier review of infection after all types of equine orthopedic surgery, authors identified SSI in 10% of all cases but identified a much higher prevalence in cases that required implants . In several studies specifically examining the clinical use of orthopedic plates for equine lower limb fracture repair or arthrodesis, SSI was identified in 32%–80% of cases …”

Pancarpal and partial carpal arthrodesis with 3 locking compression plates in 6 horses

“…This technique was used for articular debridement because the advanced osteoarthritis precluded adequate flexion of the joints for effective arthroscopic debridement. A 2‐cm skin incision was made over the proximal dorsolateral aspect of the third metacarpal bone, and a plate passer was used to create a subcutaneous tunnel over the dorsolateral aspect of the carpus to facilitate placement of the plate . The first plate was contoured to the limb by using fluoroscopic guidance.…”