RESUMEN
OBJECTIVE: To assess fracture gap reduction and stability of linear vs triangular 4.5-mm lag screw repair of experimental, uniarticular, and complete forelimb proximal phalanx (P1) fractures. STUDY DESIGN: Experimental. SAMPLE POPULATION: Fourteen equine cadaver limbs/horses. METHODS: Simulated fractures were repaired with 2 lag screws under 4-Nm insertion torque (linear repair). Computed tomography (CT) imaging was performed with the leg unloaded and loaded to forces generated while walking. The fracture repair was revised to include 3 lag screws placed with the same insertion torque (triangular repair) prior to CT. The width of the fracture gap was assessed qualitatively by 2 observers and graded on the basis of gap measurements relative to the average voxel size at dorsal, mid, and palmar P1 sites. Interobserver agreement was assessed with Cohen's κ. The effect of repair type, loading condition, and measurement site on fracture gap grades was evaluated by using Kendall's τ-b correlation coefficients and paired nonparametric tests. Significance was set at P ≤ .05. RESULTS: Agreement between loading and fracture gap widening was fair in triangular (κ = 0.53) and excellent in linear (κ = 0.81) repairs. Loading resulted in fracture gap distraction in linear repairs (Plinear = .008). Triangular repairs reduced fractures better irrespective of loading (Punloaded = .003; Ploaded < .001). The type of repair was not correlated with fracture gap grades at unloaded mid and loaded dorsal P1 sites. CONCLUSION: Repair of uniarticular complete parasagittal fractures with a triangular screw configuration improved in vitro fracture gap reduction and stability. CLINICAL SIGNIFICANCE: Triangular lag screw repair likely improves biomechanical conditions during postoperative weight bearing.
Asunto(s)
Fijación de Fractura/veterinaria , Fracturas Óseas/veterinaria , Caballos/cirugía , Falanges de los Dedos del Pie/cirugía , Animales , Fenómenos Biomecánicos , Tornillos Óseos/veterinaria , Cadáver , Femenino , Miembro Anterior/lesiones , Miembro Anterior/cirugía , Fijación de Fractura/métodos , Fracturas Óseas/cirugía , Caballos/lesiones , Masculino , Tomografía Computarizada por Rayos X , Caminata/fisiologíaRESUMEN
OBJECTIVES: To record the angiographic anatomy of the equine internal carotid artery (ICA) using angiography techniques. STUDY DESIGN: In vitro descriptive study. SAMPLE POPULATION: Equine cadaver specimens (n = 50). METHODS: Head and neck specimens from horses of mixed breed, age, sex, and use without a history of guttural pouch disease had carotid and cerebral angiography using conventional (n = 7) and rotational angiography (43). Angiographic findings were verified by arterial latex casts. RESULTS: Variation in ICA anatomy was categorized into 4 groups: (1) the internal carotid and occipital arteries arising as a common trunk; (2) an aberrant branch of the extra-cranial ICA connected to the basilar artery; (3) an aberrant branch of the ICA ramifying into the surrounding tissue and not connected to any other vessels; and (4) an aberrant branch of the ICA giving rise to several smaller satellite branches, including connections to the caudal branch of the ipsilateral occipital artery. CONCLUSION: Rotational angiography is useful for identification of anatomic variation in the ICA that could be important in achieving vascular occlusion in the treatment of guttural pouch mycosis.