Influence of screw configuration on reduction and stabilization of simulated complete lateral condylar fracture in equine limbs.
Abstract: To determine the influence of screw configuration on the reduction and stabilization of simulated complete lateral condylar fracture. Methods: Randomized experimental crossover study. Methods: A lateral condylar fracture was simulated in 18 cadaver limbs from nine horses. Each limb underwent repair with 4.5 mm diameter cortex screws, tightened to 4 Nm, in a linear and triangular configuration. Computed tomography (CT) of each repair was performed with the limbs in unloaded and loaded conditions. Fracture gaps were measured at the dorsal, palmar, and middle locations of the third metacarpal condyle. Fracture gap measurements were graded 0-4, based on voxels. Following descriptive analysis, a Bayesian network (BN) model was fitted to the data. Results: The median fracture grade was 0 (range: 0-4) for unloaded linear repairs and 2 (0-4) for loaded linear repairs. The median fracture grade was 0 (0-3) for unloaded triangular repairs and 1 (0-3) for loaded triangular repairs. Bayesian network sensitivity analysis showed that the construct configuration reduced the uncertainty in the measured fracture outcome by 0.8%. Conclusions: Triangular screw configuration resulted in better fracture reduction and stability in comparison with linear screw configuration. However, the BN sensitivity analysis results showed that the effect of construct configuration on fracture outcome was weak. Conclusions: These findings indicate a low probability that triangular repair of lateral condylar fracture will result in improved outcomes, when compared with linear repair.
© 2024 The Authors. Veterinary Surgery published by Wiley Periodicals LLC on behalf of American College of Veterinary Surgeons.
Publication Date: 2024-02-21 PubMed ID: 38380523DOI: 10.1111/vsu.14077Google Scholar: Lookup
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Summary
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The research investigates the impact of different screw configurations in treating simulated complete lateral condylar fractures in horse limbs. It suggests that a triangular screw configuration provides better fracture stabilization and reduction than a linear configuration, although the difference in outcomes is relatively small.
Research Approach
- The research was undertaken as a randomized experimental crossover study.
- A lateral condylar fracture, a common type of horse limb fracture, was simulated in 18 limbs sourced from nine horses.
- Each limb was repaired using 4.5mm diameter cortex screws, tightened to 4 Nm, implemented in two configurations: linear and triangular.
- Immediately after repairs, the limbs underwent Computed Tomography (CT) scans, both unloaded and under load. The goal of these scans was to evaluate the effectiveness of the screw alignment.
- The fracture gaps were evaluated at three different locations on the third metacarpal condyle, the bone where the fracture was simulated.
- Measurements obtained from the scans were assessed on a scale from 0-4 based on voxel (3D pixel) size.
- A Bayesian network (BN) model was employed in the analysis of the data. The BN model offers a statistical approach to understanding how different factors connect and influence outcomes.
Study Findings
- Repairs with a linear screw configuration saw median fracture grades of 0 under no load, and 2 when loaded.
- Repairs with a triangular screw pattern had median fracture grades of 0 without load and 1 when loaded.
- In the BN sensitivity analysis, the configuration of the screws (construct configuration) was found to decrease uncertainty in the outcome by roughly 0.8%.
- However, while the triangular screw configuration performed better in reducing and stabilizing the fracture, this difference was only slight. Hence, the researchers suggested that the overall impact of the construct configuration on fracture outcomes is marginal.
- Consequently, the authors deduced that the likelihood of realizing improved outcomes with a triangular repair strategy for lateral condylar fractures, when compared to linear repair, is low.
Conclusion
Cite This Article
APA
Brabon A, Hughes KJ, Jensen K, Xie G, Labens R.
(2024).
Influence of screw configuration on reduction and stabilization of simulated complete lateral condylar fracture in equine limbs.
Vet Surg.
https://doi.org/10.1111/vsu.14077 Publication
Researcher Affiliations
- School of Agricultural, Environmental and Veterinary Sciences, Faculty of Science, Charles Sturt University, Wagga Wagga, New South Wales, Australia.
- School of Agricultural, Environmental and Veterinary Sciences, Faculty of Science, Charles Sturt University, Wagga Wagga, New South Wales, Australia.
- School of Agricultural, Environmental and Veterinary Sciences, Faculty of Science, Charles Sturt University, Wagga Wagga, New South Wales, Australia.
- Quantitative Consulting Unit, Charles Sturt University, Wagga Wagga, New South Wales, Australia.
- School of Agricultural, Environmental and Veterinary Sciences, Faculty of Science, Charles Sturt University, Wagga Wagga, New South Wales, Australia.
Grant Funding
- Charles Sturt University
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