Use of a locking compression plate for equine proximal interphalangeal joint arthrodesis: 29 cases (2008–2014)

Abstract

OBJECTIVE To describe clinical use of a locking compression plate (LCP) for proximal interphalangeal joint (PIPJ) arthrodesis in horses and compare outcomes for horses that underwent the procedure as treatment for fracture of the middle phalanx (P2) versus other causes. DESIGN Retrospective case series. ANIMALS 29 client-owned horses. PROCEDURES Medical records of 2 veterinary teaching hospitals from 2008 through 2014 were reviewed to identify horses that underwent PIPJ arthrodesis of 1 limb. Signalment, surgical, and outcome-related variables were recorded. Owners were contacted from 1 to 6 years after surgery to determine rehabilitation time, current use of the horse, and overall owner satisfaction with the procedure. Success was determined on the basis of owner satisfaction and outcome for intended use. Variables of interest were compared statistically between horses that underwent surgery for P2 fracture versus other reasons. RESULTS 14 horses underwent surgery for treatment of P2 fracture, and 15 had surgery because of osteoarthritis, subluxation, or osteochondrosis. Median convalescent time after surgery (with no riding or unrestricted exercise) was 7 months. Four horses were euthanized; of 23 known alive at follow-up, 22 were not lame, and 18 had returned to their intended use (8 and 10 at higher and lower owner-reported levels of work, respectively). Horses undergoing arthrodesis for reasons other than fracture were significantly more likely to return to their previous level of work. Twenty-two of 24 owners contacted indicated satisfaction with the procedure. CONCLUSIONS AND CLINICAL RELEVANCE Surgical arthrodesis of the PIPJ was successful in most horses of the study population. Various nuances of the system for fracture repair need to be understood prior to its use.

Proximal interphalangeal joint arthrodesis in horses: concepts, indications, and techniques

“…Clinical results from retrospective studies showed that outcomes are better by using LCP (Sakai et al, 2018;Schaer et al, 2010). However, a retrospective study with 82 horses found no significant differences in animal performance among three-screw technique, DCP, and LCP (Herthel et al, 2016).…”

“…Some authors assessed stability improvements using the following implants: two plates (Watt et al, 2002), a T-plate (Steenhaut et al, 1985), a Y-plate (Galuppo et al, 2000), and a spoon plate (Sod et al, 2007). However, clinical results were better using a 3-hole, 4.5-mm DCP (Knox & Watkins, 2006) or LCP (Sakai et al, 2018), when associated with two 5.5-mm transarticular cortex screws. Vidović et al (2020) proposed a new implant, whose fixation system belongs to a new generation of point contact fixators developed in the 1980s (Perren & Buchanan, 1995).…”

“…Surgical options for arthrodesis of the PIJ include using two or three transarticular cortex screws in lag fashion (MacLellan et al, 2001;Schneider, et al, 1978), dynamic compression plate (DCP), or low-contact DCP (LC-DCP) (Ahern et al, 2013), and locking compression plates (LCP) (Sakai et al, 2018;Vidović et al, 2020;Zoppa et al, 2011). Several studies have evaluated the ex vivo mechanical properties of these constructions, using different methods.…”

Highlights of recent clinically relevant papers

“…In this retrospective study Russell Sakai and colleagues in the USA described the clinical use of a locking compression plate (LCP) for proximal interphalangeal joint (PIPJ) arthrodesis in 29 horses and compared outcomes for horses that underwent the procedure as a treatment for fracture of the middle phalanx (P2) versus other causes .…”

Langetermijnresultaat van artrodese van het proximale interfalangeale gewricht bij twee volwassen warmbloedpaarden gebruikmakend van een “locking” compressieplaat en vier trekschroeven

“…Different arthrodesis techniques of the PIPJ have been reported: two diverging 4.5 or 5.5 mm transarticular cortical screws placed in lag fashion (TCS-LF) (Herthel et al, 2016), three parallel 4.5 or 5.5 mm TCS-LF (Read et al, 2005;Carmalt et al, 2010), a combination of dynamic compression plate (DCP) with two 5.5 mm TCS-LF (Sod et al, 2011), a combination of limited-contact dynamic compression plate (LC-DCP) with two 5.5 mm TCS-LF (Rocconi et al, 2015), a combination of locking compression plate (LCP) with two 5.5 mm TCS-LF (Sod et al, 2011;Sakai et al, 2018), double DCP or LCP plating (Cra- , 1995;McCormick and Watkins, 2017) and a combination of a three-hole proximal interphalangeal locking compression plate (PIP plate) with two 5.5 mm TCS-LF (Zoppa et al, 2011;Ahern et al, 2013). The successful outcome of an arthrodesis procedure depends on the method used, the limb affected, the breed of the horse and the underlying pathology present (Schaer et al, 2001;Zubrod and Schneider, 2005;Knox and Watkins, 2006;Sod et al, 2011;Zoppa et al, 2011;Lischer and Auer, 2012;Ahern et al, 2013;Rocconi et al, 2015;Herthel et al, 2016;Sakai et al, 2018). Surgical arthrodesis of the PIPJ using a three-hole PIP plate and two 5.5 mm TCS-LF is currently considered the gold standard (Schaer et al, 2001;Zubrod and Schneider, 2005;Knox and Watkins, 2006;Sod et al, 2011;Zoppa et al, 2011;Lischer and Auer, 2012;Ahern et al, 2013;Rocconi et al, 2015;Herthel et al, 2016).…”