Proximal interphalangeal arthrodesis in 22 horses.

This study examines a new method of pastern arthrodesis surgery in horses, aiming to improve recovery time and reduce complications. By assessing various surgical techniques and post-operative care procedures, this research aims to streamline the treatment and recovery of horses affected by chronic osteoarthritis or trauma to the pastern.

Research Background

• The research revolves around pastern arthrodesis, a common surgery in equine veterinary for horses suffering from chronic osteoarthritis or traumatic injuries in the pastern. It primarily targets to reinstate the weight-bearing functionality of the bones.
• While non-surgical and surgical treatment methods are commonplace within this discipline, they can often lead to complications such as excessive periarticular exostoses or increased cast-on time due in part to an extended bone fusion timeline.
• The study aimed to explore alternate surgical methods which could eliminate those complications and expedite the recovery process, thereby returning the equine patient to its original performance level faster.

Study Methodology

• The research study involved a review of hospital records from the Rood and Riddle Equine Hospital, based out of Lexington, Kentucky, selecting 22 cases fitting the study criteria.
• It focused on horses diagnosed with chronic osteoarthritis in the proximal interphalangeal joint or those with acute traumatic injuries in the pastern, the latter designated to undergo pastern arthrodesis.
• However, equine patients with severe comminution of the middle phalanx were not considered for the study.

Study Variables

• The research team assessed alternate surgical and postoperative care techniques, focusing specifically on the use of three 5.5 mm cortical bone screws, applied either alone or combined with a 4 or 3-hole dynamic compression plate affixed using 4.5 mm cortical bone screws.
• A lower limb fiberglass cast was applied to every horse following surgery.

Study Outcomes

• The study found that, out of eight horses with affected hind limbs treated using the combination technique, seven returned to soundness. For horses with affected front limbs, three out of six achieved the same result.
• The use of screws only resulted in intended performance restoration in all four cases in horses with hind limbs and one of the two with front limbs.
• The choice between surgical techniques did not seem to impact the overall number of equine patients returning to their intended performance level.
• Notably, the horses operated on with the combination technique demonstrated a reduced casting period along with a quicker recovery time.
• It was concluded that in the immediate postoperative period, using the combination of the parallel screw technique along with a dorsally-applied dynamic compression plate offered the most secure and stable fixation. This minimized motion, hastened bone remodeling, and thus facilitated a quicker joint fusion.