Clinical use of computed tomography and surface markers to assist internal fixation within the equine hoof.

The research investigated the use of computed tomography (CT) scans and hoof surface markers in facilitating precise internal fixation during hoof surgeries in horses. The study showed promising results with near-optimal positioning and length of the screws, and visible fracture reductions in the hoofs.

Research Methodology

• The retrospective case series involved 16 horses which had undergone CT-guided internal fixation of the distal phalanx (DP) or distal sesamoid bone (DSB), bones located within the hoof.
• The drill bit’s entry points and directions were planned using CT scan images. Hooves marked with grids of barium paste dots at intended entry and projected exit sites.
• After implantation, CT images were taken again to verify the position and length of the screws and assess the reduction of the fracture.
• Researchers also analyzed imaging, reduction, and both surgical and general anesthesia times. Final outcomes were recorded for each case.

Results

• The position and length of the screws were deemed nearly optimal in all cases, with no significant misplacement of drill bits or screws.
• Observations showed evident fracture reduction in all horses in the study.
• Preoperative planning times, which included at least two rounds of CT scans and the creation of grids, ranged from 10 to 20 minutes.
• The duration of surgeries varied from 45 to 90 minutes, averaging at 61 minutes, while anesthesia times ranged from 115 to 220 minutes, with an average of 171 minutes.

Conclusion

• The study concluded that the amalgamation of CT scans with surface marker grids could allow accurate positioning of screws during clinical surgeries for DP and DSB fractures.
• The demonstrated technique was marked by its simplicity and speediness. An aiming device proved beneficial for the technique.

This research provides a potentially valuable contribution to equine surgical procedures by increasing the precision and safety of operations within the confines of the hoof wall.