Fixation of supraglenoid tubercle fractures using distal femoral locking plates in three Warmblood horses.
Abstract: Three horses that were presented with supraglenoid tubercle fractures were treated with open reduction and internal fixation using distal femoral locking plates (DFLP). Placing the DFLP caudal to the scapular spine in order to preserve the suprascapular nerve led to a stable fixation, however, it resulted in infraspinatus muscle atrophy and mild scapulohumeral joint instability (case 1). Placing the DFLP cranial to the scapular spine and under the suprascapular nerve resulted in a stable fixation, however, it resulted in severe atrophy of the supraspinatus and infraspinatus muscles and scapulohumeral joint instability (case 2). Placing the DFLP cranial to the scapular spine and slightly overbending it at the suprascapular nerve passage site resulted in the best outcome (case 3). Only a mild degree of supraspinatus and infraspinatus muscle atrophy was apparent, which resolved quickly and with no effect on scapulohumeral joint stability. In all cases, fixation of supraglenoid tubercle fractures using DFLP in slightly different techniques led to stable fixations with good long-term outcome. One case suffered from a mild incisional infection and plates were removed in two horses. Placement of the DFLP cranial to the scapular spine and slightly overbending it at the suprascapular nerve passage prevented major nerve damage. Further cases investigating the degree of muscle atrophy following the use of the DFLP placed in the above-described technique are justified to improve patient outcome.
Publication Date: 2016-04-12 PubMed ID: 27070124DOI: 10.3415/VCOT-15-10-0164Google Scholar: Lookup
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Summary
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The study examines the impact of using distal femoral locking plates (DFLP) in different placements for treating supraglenoid tubercle fractures in horses. The best outcome was noted when the DFLP was placed cranial to the scapular spine and slightly curved over the suprascapular nerve, which significantly minimizes muscle atrophy and preserves joint stability.
Methodology and Cases
- The study encompassed three cases where warmblood horses had encountered supraglenoid tubercle fractures. The fractures were treated with open reduction and internal fixation using distal femoral locking plates (DFLP).
- In the first case, the DFLP was installed caudal (towards the tail) to the scapular spine to safeguard the suprascapular nerve, resulting in stable fixation. However, this placement led to infraspinatus muscle atrophy and mild instability in scapulohumeral joint.
- In the second case, the DFLP was fixed cranial (towards the head) to the scapular spine and under the suprascapular nerve, again yielding stable fixation. Nevertheless, severe atrophy in supraspinatus and infraspinatus muscles was observed alongside scapulohumeral joint instability.
- The best outcomes were recorded in the third case, where the DFLP was placed cranial to the scapular spine with mild bending over the suprascapular nerve. This method only resulted in modest atrophy in supraspinatus and infraspinatus muscles and preserved scapulohumeral joint stability.
Outcomes and Further Research
- Regardless of the different techniques used for placing the DFLP, all led to stable fixations and positive long-term outcomes.
- One case experienced minor incisional infection, and plates were taken out in two cases after treatment.
- The most beneficial plate placement was found to be cranial to the scapular spine, with the plate slightly curved over the suprascapular nerve; this method helped prevent significant nerve damage.
- Further study of muscle atrophy following use of the DFLP positioned in the aforementioned manner is required to improve patient outcomes further.
Cite This Article
APA
Frei S, Fürst AE, Sacks M, Bischofberger AS.
(2016).
Fixation of supraglenoid tubercle fractures using distal femoral locking plates in three Warmblood horses.
Vet Comp Orthop Traumatol, 29(3), 246-252.
https://doi.org/10.3415/VCOT-15-10-0164 Publication
Researcher Affiliations
- Andrea S. Bischofberger, Equine Hospital, Equine Department, Vetsuisse-Faculty, University of Zürich, Winterthurerstrasse 260, 8057 Zürich, Switzerland, E-mail: abischofberger@vetclinics.uzh.ch.
MeSH Terms
- Animals
- Bone Plates / veterinary
- Female
- Femur / surgery
- Follow-Up Studies
- Fracture Fixation, Internal / methods
- Fracture Fixation, Internal / veterinary
- Fractures, Bone / surgery
- Fractures, Bone / veterinary
- Horses / injuries
- Horses / surgery
- Male
- Scapula / injuries
- Scapula / surgery
- Treatment Outcome
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