The influence of a tension band fixation as an adjunct for arthrodesis of the metacarpophalangeal joint in the horse.

OBJECTIVES: To determine the influence of a stainless-steel cable (SSC) tension band fixation as an adjunct to a locking compression plate (LCP) for arthrodesis of the equine metacarpophalangeal (MCP) joint. STUDY DESIGN: Experimental. An ex vivo biomechanical paired equine cadaver limb study. SAMPLE POPULATION: Five MCP joint pairs were collected from adult Thoroughbred horses, euthanized for reasons unrelated to orthopedic disease. METHODS: Each pair of MCP joints were randomly implanted with either a dorsally placed 5.5 mm LCP and a palmarly placed 2.0 mm SSC or a dorsally placed 5.5 mm LCP alone. Each construct was tested in cyclic loading followed by single cycle to failure in axial compression. Displacement at a target load of 1 kN over 3600 cycles at 1 Hz was recorded prior to single cycle to failure testing. RESULTS: In cyclic testing, displacement was not significantly different between the first and last 5% of testing cycles regardless of construct. Maximum displacement of each construct during cyclic testing was <1.1 mm. In single cycle testing, the observed yield point did not reveal any difference between LCP and LCP-SSC (p = .440). The maximum load at failure was significantly higher in LCP-SSC compared to constructs with the LCP alone (p = .046). CONCLUSION: The addition of the SSC to the LCP did not statistically affect construct displacement during cyclic loading or construct yield load during subsequent single cycle to failure. CLINICAL SIGNIFICANCE: This study provided much needed information regarding the necessity of a tension band SSC application in the arthrodesis of the MCP/MTP joint in horses.

Partial tarsal arthrodesis with closing wedge ostectomy for treatment of bilateral twisted leg deformity in a cat.

A 5-month-old male domestic shorthair cat was presented with severe bilateral hind-limb deformities that caused the cat to walk on the dorsal aspect of the metatarsals. Computed tomography (CT) images revealed that the calcaneus was externally rotated, and the distal end of the calcaneus was turned medially to the talus in both hind limbs. The cat was diagnosed with twisted leg deformity, a congenital tarsal hyperextension deformity (clubfoot). Based on CT images, closing wedge ostectomy was done at the level of the tarsometatarsal joint with the wider part facing laterally. Partial transection of the common calcaneal tendon was not performed. Nine weeks after surgery, the cat was able to walk and jump, with its paws correctly placed on the ground, despite the limited range of motion in the tarsal joints. Based on radiographs with maximum tarsal flexion, the angle of the partial tarsal arthrodesis limited the range of motion. This is apparently the first case report describing CT images and closing wedge ostectomy in a cat with twisted leg deformity. Key clinical message: This article reports the findings obtained from CT imaging of a cat with twisted leg deformity. The current case was successfully managed by closing wedge ostectomy without partial transection of the common calcaneal tendon.

Arthrodèse partielle du tarse avec ostectomie de fermeture pour le traitement d'une déformation bilatérale des pattes tordues chez un chat. Un chat domestique à poil court mâle âgé de 5 mois a été présenté avec de graves déformations bilatérales des membres postérieurs qui ont amené le chat à marcher sur la face dorsale des métatarsiens. Les images de tomodensitométrie (CT) ont révélé que le calcanéus était en rotation externe et que l'extrémité distale du calcanéum était tournée médialement vers le talus dans les deux membres postérieurs. Le chat a été diagnostiqué avec une déformation de la jambe tordue, une déformation congénitale du tarse en hyperextension (pied bot). Sur la base d'images par CT, une ostectomie de fermeture a été réalisée au niveau de l'articulation tarsométatarsienne avec la partie la plus large tournée latéralement. Aucune section partielle du tendon calcanéen commun n'a été réalisée. Neuf semaines après l'opération, le chat était capable de marcher et de sauter, les pattes correctement posées au sol, malgré l'amplitude de mouvement limitée des articulations du tarse. Sur la base de radiographies avec une flexion tarsienne maximale, l'angle de l'arthrodèse partielle du tarse limitait l'amplitude de mouvement. Il s'agit apparemment du premier rapport de cas décrivant des images CT et une ostectomie de fermeture chez un chat présentant une déformation de la jambe tordue.Message clinique clé:Cet article rapporte les résultats obtenus à partir de l'imagerie CT d'un chat avec une déformation des pattes tordues. Le cas actuel a été géré avec succès par une ostectomie de fermeture sans section partielle du tendon calcanéen commun.(Traduit par Dr Serge Messier).

Risk Factors Associated with Plantar Necrosis following Tarsal Arthrodesis in Dogs.

OBJECTIVES: The aim of this study was to define landmarks of the intermetatarsal channel of the dorsal pedal artery and to assess whether damage to the dorsal pedal artery during metatarsal screw placement in dogs undergoing pan- and partial-tarsal arthrodesis (PanTA/ParTA) could be a mechanism in the development of plantar necrosis. STUDY DESIGN: This study was divided in to two parts: (1) ex-vivo anatomical study: 19 canine cadavers, (2) retrospective clinical study: 39 dogs. Cadaveric dissection documented the mean intermetatarsal channel position. Metatarsal screw position was evaluated on postoperative radiographs of dogs after PanTA or ParTA. Screw position, arthrodesis type and surgical approach were assessed for their impact on complications, including plantar necrosis. RESULTS: The mean proximal and distal extent of the intermetatarsal channel lies between 4.3% ± 1.9 and 22.8% ± 2.9 the length of metatarsal III (MTIII) respectively. The intermetatarsal channel lies within the most proximal 25% of MTIII in 95% of cases. At least one screw risked damaging the mean intermetatarsal channel position in 92% of dogs; 8% of these dogs went on to develop plantar necrosis. The mean screw position did not differ between ParTA cases with or without plantar necrosis (p > 0.05). CONCLUSION: Violation of the intermetatarsal channel is possible during metatarsal screw placement. Care should be taken when placing screws in the proximal 25% of the metatarsals, specifically avoiding exiting dorsally between MTII and MTIII and across the distal region of the intermetatarsal channel, where the perforating metatarsal artery passes interosseously, as damage may contribute to the aetiology of plantar necrosis.

Acute limb shortening and modified pantarsal arthrodesis for the treatment of a highly comminuted distal tibial articular fracture in a dog.

A three-year-old female spayed Lurcher was referred for the treatment of a highly comminuted distal tibial articular fracture. Resection of the area of comminution with a transverse osteotomy of the tibial diaphysis and talar ridges was performed, followed by modified pantarsal arthrodesis and a calcaneotibial screw. The treatment resulted in 7 cm of tibial shortening, equating to a 28% reduction in the total tibial length. Radiographic union of the arthrodesis was successful. Fair use of the pelvic limb was documented long-term. Combined acute limb shortening and modified pantarsal arthrodesis resulted in an acceptable outcome and could be considered in cases of highly comminuted distal tibial fractures.

Minimally Invasive Arthrodesis of the Equine Proximal Interphalangeal Joint: A Biomechanical Comparison of Three 5.5-mm Cortical Screws Inserted in Lag Fashion and Two 7.0-mm Headless Cannulated Dual-Pitch Compression Screws.

OBJECTIVE: The aim of this study was to compare the biomechanical properties of two minimally invasive arthrodesis techniques of the equine proximal interphalangeal (PIP) joint (three transarticular 5.5-mm cortical screws [AO-3TLS] vs. two transarticular 7.0-mm headless cannulated multi-use compression screws [MUC-2TS]) in dynamic non-destructive testing and compression testing to failure. STUDY DESIGN: The experimental study included six pairs of cadaveric adult equine forelimbs; one limb from each horse was randomly assigned to one of the treatments, and the contralateral limb was submitted to the remaining treatment. The dynamic test was performed alternating non-destructive compression tests at a displacement rate of 5 mm/min up to 5,000 N and sinusoidal compressive cyclic tests at 6 Hz, using a 3,600-N amplitude for 8,550 cycles. Construct stiffness and maximum sagittal plane rotation about the PIP joint markers were determined during the dynamic test. After the dynamic test reached 136,800 cycles, the monotonic compressive test until failure was performed on each construct: load, displacement and sagittal plane rotation about the PIP joint marker at failure were analysed. RESULTS: The evaluated biomechanical properties showed no statistical difference between the AO-3TLS and MUC-2TS treatment groups in any of the ramps of the dynamic non-destructive test and in the compression loading until failure test. CONCLUSION: The MUC-2TS treatment produced biomechanical properties equivalent to the AO-3TLS treatment for PIP joint arthrodesis.

Proximal Interphalangeal Arthrodesis in Horses: A Meta-Analysis of Retrospective Studies.

The aim of this study was to determine the clinical outcomes reported in retrospective studies of proximal interphalangeal arthrodesis (PIA) in horses through a meta-analysis of retrospective studies. CAB Abstracts, PubMed, ScienceDirect, Web of Science, and Scopus were searched. The primary outcomes included survival and surgical site infection (SSI) rates, return to activities, and time of hospital stay and casting. Subgroups were formed for fractures and other conditions. Meta-analyses were performed with fixed and random effects models to estimate proportions, mean values, and effect size by odds ratio (OR) with 95% confidence intervals (CI). Twenty-one full articles were included, totaling 458 horses. The survival rate was 90% (95% CI [86%-93%]), return to activities was 65% (95% CI [61%-70%]), and SSI was 12% (95% CI [8%-16%]). The mean hospitalization was 25 days (95% CI [18-35 days]) and time of casting was 29 days (95% CI [21-42 days]). The OR of survival (P = .769), return to activities (P = .576), and SSI (P = .467) were similar between cases of fractures and other conditions. PIA is an efficient and safe method to treat injuries in the pastern region, with a high survival rate and low SSI. However, the rate of return to soundness for intended use was modest, being potentially lower for fracture cases. Thus, investigations of more efficient interventions are needed to improve this outcome.

Use of Locking Compression Plate and Locking Compression T-Plate for Surgical Arthrodesis of the Carpometacarpal and Distal Tarsal Joints in 13 Horses.

OBJECTIVE: The aim of this study was to describe the use of the locking compression plate (LCP) and locking compression T-plate (LCTP) in cases of carpometacarpal and distal tarsal arthrodesis for the treatment of osteoarthritis and small carpal or tarsal bone fractures, and to document clinical outcomes. STUDY DESIGN: Case records of horses treated with carpometacarpal or distal tarsal arthrodesis via internal fixation using an LCP or LCTP between 2013 and 2021 were reviewed. All cases were evaluated retrospectively. Follow-up information was gained via phone conversation with owners and referring veterinarians. RESULTS: Data were collected for 13 horses that fulfilled the study criteria. A total of eight horses underwent distal tarsal arthrodesis, and five underwent carpometacarpal arthrodesis. Twelve of thirteen horses went back to some level of athletic performance. Eight of 13 returned to the same level, while 4 of 13 returned to a lower level. Minor postoperative complications were recorded in 3 of 13 cases, with all horses suffering manageable short-term complications returning to the same level of work. Two horses suffered a major complication, with one resulting in euthanasia. CONCLUSION: Carpometacarpal and distal tarsal arthrodesis performed using the LCP and LCTP allowed all surviving horses in the study to obtain immediate postoperative comfort and eventual return to use.

Functional outcomes of dogs undergoing shoulder arthrodesis with 2 locking compression plates.

OBJECTIVE: To report the outcomes of dogs undergoing shoulder arthrodesis with the application of 2 locking compression plates (LCPs). STUDY DESIGN: Retrospective case series. ANIMALS: Twelve client owned dogs undergoing shoulder arthrodesis using 2 LCPs as the principal method of fixation. METHODS: Medical records were searched for dogs who had undergone shoulder arthrodesis at a hospital between 2014-2021. Inclusion criteria required at least 6 months postoperative follow up and the use of 2 LCPs as the principal method of arthrodesis. Outcomes recorded include clinical assessment, Liverpool Osteoarthritis in Dogs (LOAD) scoring, force plate analysis, and a client visual-analogue scale with at least 6 months follow up. RESULTS: All shoulders were immobilized with 2 LCPs and no postoperative external coaptation. The duration of follow up was 855.9 days (174-2135). Minor complications were recorded in 2/12 dogs, neither requiring surgical revision. Preoperative to postoperative mean lameness scores reduced from 2.9 to 0.8 (0-5), with 11/12 dogs making a full functional recovery, with a mean long-term LOAD score of 12.9 (4-23). Gait analysis was available in 5/12 dogs, placing a mean of 31.9% of their bodyweight on the operated limb, with a mean symmetry index of 8.7%. Owners scores (n = 11/12) were consistent with a high level of satisfaction (9.6/10). CONCLUSION: Shoulder arthrodesis with 2 LCPs was associated with low morbidity and good outcomes in our clinical setting. CLINICAL SIGNIFICANCE: Canine shoulder arthrodesis performed with 2 LCPs should be considered as a suitable alternative in dogs with severe shoulder joint pathology.

Ex-vivo articular cartilage removal from equine proximal interphalangeal joints using cannulated drill bits.

Objective: This report evaluates the use of 4.5- and 5.5-mm cannulated drill bits for articular cartilage removal from the proximal interphalangeal joints of equine cadaver limbs. Animals: Limbs from 8 equine cadavers, all with normal proximal interphalangeal joints. Procedure: Proximal interphalangeal joints of 32 limbs from 8 equine cadavers were drilled using either 4.5- or 5.5-mm cannulated drill bits. Pastern joints were then disarticulated, and intra-articular drilling was evaluated by visual inspection. Results: Post-drilling evaluation revealed complete intra-articular drilling occurred in all 32 joints. Conclusion: Canulated 4.5- and 5.5-mm drill bits resulted in consistent accurate intra-articular drilling in the proximal interphalangeal joint of horses. Clinical relevance: Cannulated drill bits provided an effective and consistent modality for articular cartilage removal with potential for improved accuracy of articular drilling and applications in minimally invasive proximal interphalangeal joint arthrodesis.

Objectif: Ce rapport évalue l'utilisation de forets canulés de 4,5 et 5,5 mm pour l'élimination du cartilage articulaire des articulations interphalangiennes proximales des membres de cadavres équins. Animaux: Membres provenant de huit cadavres équins, tous avec des articulations interphalangiennes proximales normales. Procédure: Les articulations interphalangiennes proximales de 32 membres de huit cadavres équins ont été percées à l'aide de forets canulées de 4,5 ou 5,5 mm. Les articulations du paturon ont ensuite été désarticulées et le forage intraarticulaire a été évalué par inspection visuelle. Résultats: L'évaluation post-forage a révélé qu'un forage intra-articulaire complet s'était produit dans les 32 articulations. Conclusion: Les forets canulés de 4,5 et 5,5 mm ont permis un forage intra-articulaire précis et constant dans l'articulation interphalangienne proximale des chevaux. Pertinence clinique: Les forets canulés ont fourni une modalité efficace et constante pour l'élimination du cartilage articulaire avec un potentiel d'amélioration de la précision du forage articulaire et des applications dans l'arthrodèse de l'articulation interphalangienne proximale de manière minimalement invasive.(Traduit par Dr Serge Messier).

Retrospective Comparison of Titanium Hybrid Locking Plate with Stainless Steel Hybrid Dynamic Compression Plate for Pancarpal Arthrodesis: 23 Dogs.

OBJECTIVE: The aim of this study was to evaluate outcomes and complications of dogs that had pancarpal arthrodesis (PCA) using a titanium hybrid advanced locking plate system (ALPS) and stainless steel hybrid dynamic compression plate (HDCP). STUDY DESIGN: Retrospective observational study. METHODS: Medical records (2007-2020) were reviewed for cases that had PCA performed using ALPS or HDCP. Implant characteristics including metacarpal coverage (MCov), metacarpal width occupied by screw diameter percentage and carpal arthrodesis angle (CAA), complications and outcomes were recorded. RESULTS: Pancarpal arthrodesis was performed with ALPS on 15 limbs from 12 dogs, and HDCP on 14 limbs from 11dogs. Median follow-up time was 1,157 days (range: 62-1,902 days) for ALPS group and 340 days (range: 43-1,465 days) for HDCP. Median MCov for ALPS group was 74% (range: 60-87.5%) compared with 56.5% (range: 49.7-91.3%) for HDCP (p = 0.001). There was no difference in CAA and metacarpal width to screw diameter percentage between ALPS and HDCP group. Major and minor complications and surgical site infection rates were not statistically different between the two groups. Plate fracture occurred in 2/15 ALPS PCA and screw loosening occurred in 4/14 HDCP PCA. Full function was achieved in 8/12 and 8/11 of ALPS and HDCP cases, respectively, which was not statistically different (p = 0.76). CONCLUSION: The use of ALPS offers comparable performance to HDCP for PCA.

Evaluation of factors associated with surgical site infection in equine proximal interphalangeal joint arthrodesis: 54 cases (2010-2019).

BACKGROUND: The frequency of surgical site infection (SSI) following orthopaedic implant placement in horses has been reported but not compared with respect to specific antibiotic protocols administered. OBJECTIVES: To determine factors associated with SSI in horses undergoing proximal interphalangeal joint (PIPJ) arthrodesis including perioperative antibiotic protocols. METHODS: Records were evaluated (2010-2019), and horses undergoing PIPJ arthrodesis were identified. Patient signalment, supervising surgeon, reason for surgery, limb, implants placed, anaesthetic time, duration casting/coaptation postoperatively, antibiotic regimen and incidence/onset SSI were recorded. Bayesian and frequentist logistic regressions were used to estimate the contribution of covariates to infection occurrence. RESULTS: Fifty-four PIPJ arthrodeses were performed. SSI occurred in 2/54 (3.7%) on day 15,30. Arthrodesis was performed most commonly for osteoarthritis (33/54, 61.1%), fracture (11/54, 20.4%), and subluxation (5/54, 9.3%). Perioperative systemic antibiotics were administered 1-3 days (15/54, 27.8%) or > 3 days (39/54, 72.2%). Antibiotic protocols included cefazolin/gentamicin (20/54, 37%), cefazolin/gentamicin/doxycycline (14/54, 25.9%) and potassium penicillin/gentamicin (10/54, 18.5%). Regional limb perfusion was performed preoperatively 31/54 (57.4%) and postoperatively 7/54 (13%). Survival to dismissal was 98.1% (53/54 horses) with one horse euthanized due to support limb laminitis. No association was identified between antibiotic selection or duration (1-3 vs. > 3 days), pre-operative regional antibiotic perfusion, intraoperative antibiotic lavage or anaesthetic time (< or > 3 h) and SSI; however, modelling was complicated by quasi-complete or complete separation of the data. Bayesian analysis (but not frequentist analysis) indicated an association between post-operative regional antibiotic perfusion and SSI. Limitations include the retrospective nature of data collection and the low rate of infection overall. CONCLUSIONS: The prevalence of SSI in this population was lower than that in previous reports of equine orthopaedic internal fixation. There was no difference in SSI rate in cases administered systemic antibiotics for 1-3 days or >3 days, or for those horses that did or did not receive preoperative regional antibiotic perfusion.

Treatment of shoulder joint luxation with glenoid ostectomy in a miniature donkey.

CASE DESCRIPTION: A 13-year-old 128-kg miniature donkey gelding was evaluated for right forelimb lameness of 7 weeks' duration. CLINICAL FINDINGS: Muscular atrophy of the infraspinatus and supraspinatus muscles over the right scapula with a palpable bony prominence over the point of the shoulder was evident. At the walk, the cranial phase of the stride was reduced with adduction of the distal aspect of the limb, dragging of the toe, and lameness (grade, 4/5). Lateral and craniocaudal radiographs of the right shoulder joint revealed lateral luxation of the humerus in relation to the scapula with bony proliferation and remodeling of the humeral head. TREATMENT AND OUTCOME: Glenoid ostectomy was performed. Immediately after surgery, the donkey was able to intermittently stand squarely on the limb but maintained a reduced cranial phase of the stride at the walk. The donkey had no short-term complications and was discharged from the hospital 11 days after surgery. Following discharge, the donkey was confined to a box stall for 60 days, followed by a gradual increase in movement to full pasture turnout. The lameness continued to improve, and at 15 months after surgery the donkey was turned out in pasture and had mild lameness (grade, 3/5) at the trot. Mild muscular atrophy of the supraspinatus and infraspinatus muscles was present with no signs of pain on palpation or manipulation of the limb. Shoulder joint radiography at 15 months after surgery revealed remodeling of the glenoid cavity of the scapula and humeral head with formation of a pseudoarthrosis. CLINICAL RELEVANCE: Glenoid ostectomy should be considered as an alternative to shoulder joint arthrodesis in small equids with shoulder joint luxation. Other indications for this procedure could include chronic osteoarthritis or fractures affecting the shoulder joint.

Mechanical Evaluation of Two Hybrid Locking Plate Designs for Canine Pancarpal Arthrodesis.

Hybrid locking pancarpal arthrodesis plates were designed with either a round (RH) or an oval (OH) radiocarpal hole, the latter allowing varied screw positioning. Due to concerns about potential decreased structural properties of the OH design, our aim was to compare the mechanical behavior of the contrasting plates using combined finite element analysis (FEA) and mechanical testing. Pancarpal arthrodesis plates with RH or OH design were assigned to three fixation techniques (n = 6), prebent at 20°, and fixed to canine forelimb models with simulated radius and radiocarpal and 3rd metacarpal bones. OH plates were instrumented with a radiocarpal screw inserted either most proximal (OH-P) or most distal (OH-D). Specimens were axially loaded to 300 N over 10 ramped cycles at 0.5 Hz. Plate strains were measured with strain gauges placed at areas of highest deformations as predicted by FEA under identical loading conditions. FEA predicted the highest strains (µm/m) adjacent to the radiocarpal hole (2,500 [RH], 2,900 [OH-P/OH-D]) and plate bending point (2,250 [RH], 1,900 [OH-P/OH-D]). Experimentally, peak radiocarpal hole strains were not influenced by the OH screw position (3,329 ± 443 [OH-P], 3,222 ± 467 [OH-D]; P = 0.550) but were significantly higher compared to the RH design (2,123 ± 154; P < 0.001). Peak strains at the bending point were significantly lower for OH-P (1,792 ± 174) and OH-D (1,806 ± 194) versus RH configurations (2,158 ± 114) (P ≤ 0.006). OH plates demonstrated highest peak strains next to the radiocarpal hole and were associated with more heterogenous plate strain distribution. Structural weakening associated with radiocarpal OH plate design could result in decreased fixation strength and increased risk of plate fatigue failure.

Medial malleolus fragmentation following talocalcaneal arthrodesis by a dorsomedial approach in a horse.

A 16-year-old, Quarter Horse mare was presented for a 3/5 right hind lameness associated with osteoarthritis of the talocalcaneal joint (TCLJ). Positron emission tomography (PET) and computed tomography (CT) demonstrated marked increased uptake of 18F-sodium fluoride and bone remodeling at the medial facet of the TCLJ, respectively. Under general anesthesia 2 cortical screws (4.5 and 5.5 mm) were placed in neutral fashion via an arthrotomy from dorsomedial to plantaromedial through the medial facet of the TCLJ followed by copious lavage of the tarsocrural joint. Eight weeks after surgery, observable effusion of the tarsocrural joint was present and lameness had worsened. Radiographic examination revealed a fragmented medial malleolus of the tibia, likely secondary to repetitive trauma of the screw heads during tarsal flexion. Repeated CT showed partial fusion of the TCLJ. Both screws were removed and the tarsocrural joint was thoroughly lavaged arthroscopically. At a 20-month recheck the lameness had not improved, and ultrasound examination revealed severe thickening of the TCLJ capsule. Recheck examination 48 mo after surgery showed complete fusion of the TCLJ and resolution of the lameness. Key clinical message: Diagnosis of osteoarthritis of the TCLJ is challenging. Management by arthrodesis using a dorsomedial approach can result in fragmentation of the medial malleolus, with secondary synovitis and capsulitis of the tarsocrural joint.

Fragmentation de la malléole médiale suite à une arthrodèse talo-calcanéenne par voie dorsomédiale chez un cheval. Une jument Quarter Horse âgée de 16 ans a été présentée pour une boiterie postérieure droite de 3/5 associée à une arthrose de l'articulation talo-calcanéenne (TCLJ). La tomographie par émission de positrons (TEP) et la tomodensitométrie (CT) ont démontré une augmentation marquée de l'absorption du fluorure de sodium-18F et un remodelage osseux significatif au niveau de la facette médiale du TCLJ, respectivement. Sous anesthésie générale, deux vis corticales (4,5 et 5,5 mm) ont été placées de façon neutre via une arthrotomie dorsomédiale à plantaro-médiale à travers la face médiale du TCLJ suivie d'un lavage abondant de l'articulation tarsocrurale. Huit semaines après la chirurgie, un épanchement significatif de l'articulation tarso-crurale était présent et la boiterie s'était aggravée. L'examen radiographique a révélé une malléole médiale du tibia fragmentée, probablement secondaire à un traumatisme répétitif des têtes de vis lors de la flexion du tarse. La tomodensitométrie répétée a montré une fusion partielle du TCLJ. Les deux vis ont été retirées et l'articulation tarso-crurale a été soigneusement lavée par arthroscopie. Lors d'un nouveau contrôle après 20 mois, la boiterie ne s'était pas améliorée, et l'échographie a révélé un épaississement sévère de la capsule TCLJ. Un nouvel examen 48 mois après la chirurgie a montré une fusion complète du TCLJ et une résolution de la boiterie.Message clinique clé :Le diagnostic de l'arthrose du TCLJ est difficile. La prise en charge par arthrodèse par voie dorso-médiale peut entraîner une fragmentation de la malléole médiale, avec synovite secondaire et capsulite de l'articulation tarso-crurale.(Traduit par Dr Serge Messier).

A retrospective multicenter study on the use of locking compression plates for scapulohumeral arthrodesis in small equids.

OBJECTIVE: To report on technical aspects and outcomes after scapulohumeral arthrodesis (SHA) with a locking compression plate (LCP) in small equids. STUDY DESIGN: Retrospective multicenter case series. ANIMALS: Client-owned Shetland Ponies, Miniature Shetlands, and American Miniature Horses (n = 15). METHODS: Inclusion criteria were completed SHA with an LCP to treat scapulohumeral osteoarthritis/subluxation and availability of postoperative radiographs. Contributing surgeons completed a questionnaire to collect data. All radiographs were reviewed for this study. Follow-up information was obtained via re-admission to the hospital or telephone interview of the referring veterinarian or owner. Outcome was subjectively scored as excellent, good, moderate, or poor based on lameness and function. RESULTS: Sixteen SHAs were performed in 15 equids (body weight 65-145 kg) by nine different surgeons. A narrow 4.5/5.0 mm LCP (7-16 holes) was used in 14 of the 16 SHAs. Follow-up was collected 2.5 years after surgery (median; range: 9 weeks to 10 years). Major complications related to the SHAs were noted in 4 of the 13 horses alive long term, consisting of implant failure (n = 1), surgical site infection (n = 2), and scapular fracture (n = 1). The outcome was graded as excellent in 4, good in 5, and moderate in 4 horses. Two ponies were euthanized because scapulohumeral osteoarthritis and subluxation developed in the contralateral limb. CONCLUSION: Although major complications occurred in about one-third of ponies, SHA with LCP led to long-term survival with good function in most ponies. CLINICAL SIGNIFICANCE: SHA with an LCP offers a high chance for good long-term outcome in small equids although contralateral disease may affect outcome.

Medial pantarsal arthrodesis with Compact UniLock 2.0 locking plate system in a cat.

Background: Pantarsal arthrodesis is a salvage procedure carried out for the treatment of tarsal joint disease, including severe osteoarthritis with intractable pain in the tarsocrural joint, tarsal fractures, shearing injuries, tarsocrural joint instability, and failure of the common calcaneal tendon. Although medial plating is preferable, the high incidence of post-surgery complications is possible. Using thin, pre-contouring or easy contouring, locking plates might reduce the incidence of such complications. However, to date, there are no pre-contouring and dedicated locking plates for pantarsal arthrodesis with medial placement. Case Description: The case of an 18-month-old female stray European cat has been referred because of a severe tibiotarsal injury improperly treated with an intramedullary pin. The patient was submitted for medial pantarsal arthrodesis, performed with the Compact UniLock 2.0™ locking plate systema (DePuy Synthes, Oberdorf, Switzerland). The authors hypothesized that this particularly innovative osteosynthesis system could present advantages compared to the systems already in use for medial pantarsal arthrodesis and therefore reduce the risk of complications. Conclusion: This innovative titanium locking system, because of its versatile contour function and thinness, allowed the good functional recovery of the limb and showed numerous advantages over traditional systems.

Canine Carpal Injuries: From Fractures to Hyperextension Injuries.

The canine and feline carpus is a complex arrangement of bones, ligaments, and joint spaces that functions as a ginglymus joint to provide carpal flexion and extension. Given the demanding biomechanical demands on the carpus during weight bearing, a variety of region-specific pathology, often secondary to trauma, are reported. This review details carpal anatomy, biomechanical understandings, and current evidence surrounding carpal pathology and its management. Partial carpal arthrodesis and pancarpal arthrodesis outcomes are reviewed in detail.

The effect of plate fixation on supination and pronation of the feline antebrachium: a model of pancarpal arthrodesis.

BACKGROUND: Pancarpal arthrodesis is purported to limit supination and pronation of the feline antebrachium. The objective of this study was to investigate whether plate fixation of the radius to the carpus and metacarpus limits supination and pronation of the ulna relative to the radius as a model for pancarpal arthrodesis in the cat. Eight feline cadaveric forelimbs were rotated from supination to pronation in a testing jig and CT (computed tomography) was performed in the neutral, supinated and pronated positions. A locking plate was then secured dorsally to the radius, radial carpal bone and metacarpal III of each of the limbs. CT was repeated in each of the testing positions following plate application. The radius and ulna of the control specimens, and the radius, ulna and plate of the plated specimens were then segmented using software. Alignment of the bones to the radius in the control specimens, and to the plate in the plated specimens was used to compare the changes in degrees of movement of the ulna relative to the radius in dorsal, sagittal and transverse planes. RESULTS: Based on the results of the paired t test, there was no significant difference in degrees of movement, or total range of motion between control and plated specimens in supinated and pronated testing conditions. CONCLUSION: The results of this ex-vivo study indicate that under the testing conditions employed, plate fixation of the radius to the carpus and metacarpus does not limit supination and pronation of the feline antebrachium.

Traumatic joint luxations in cats: Reduce, repair, replace, remove.

PRACTICAL RELEVANCE: Traumatic joint luxations are usually associated with significant trauma and there may be concomitant systemic injury. Joints are unstable as a result of injury to one or more supporting structures and the clinician should aim to determine which structures are damaged with physical examination, diagnostic imaging and careful assessment under sedation/anaesthesia. The aim is to reduce the joint back to its anatomical position, and then to maintain this through repair of damaged structures. However, where this is not possible, replacement or removal (arthrodesis/excision arthroplasty) of the joint remain viable options. CLINICAL CHALLENGES: Owing to the small size of feline joints and the severity of damage often seen, surgical management of these cases can be challenging. The first priority is to ensure the patient is systemically well before embarking on any specific surgical treatment of a luxated joint. Cats also present challenges in the postoperative period and a lack of patient and owner compliance can be detrimental to postoperative outcomes. AIMS: This article aims to help the reader diagnose joint luxations and to assist decision-making with an overview of the management and treatment options available. EVIDENCE BASE: There are a number of original articles and textbook chapters in the literature covering aspects of different joint luxations, particularly for the more common luxations. This article draws on information from key feline research and, where necessary, extrapolates from relevant canine research. The authors also offer practical guidance based on their own clinical experience.

Corrective osteotomy and partial tarsal arthrodesis in two greyhounds with calcaneal malunion.

OBJECTIVE: To describe the clinical presentation and outcome of two greyhounds with calcaneal malunions that were treated with corrective osteotomy and partial tarsal arthrodesis. STUDY DESIGN: Short case series. ANIMALS: Two adult racing greyhounds. METHODS: Varus and recurvatum deformity of the calcaneus was ascribed to malunion of prior calcaneal fracture with concomitant central bone fracture that had been sustained during racing in both dogs. Both dogs exhibited severe, weight-bearing lameness and had radiographic evidence of moderate to severe osteoarthritis of the proximal intertarsal joint. A closing wedge corrective osteotomy and partial tarsal arthrodesis were performed with a 2.7-mm locking compression plate and cancellous autograft. RESULTS: Calcaneal morphology and alignment of the common calcaneal tendon seemed restored postoperatively. The implant was removed in one dog, while the other dog experienced no postoperative complications. Lameness improved in both dogs, although residual intermittent lameness after heavy exercise was reported by owners of both dogs 1 year after surgery. Overall, owner satisfaction and outcome were considered good-to-excellent in both dogs. CONCLUSION: Corrective osteotomy and partial tarsal arthrodesis for treatment of malunited calcaneal fractures may be considered in dogs with clinical signs related to calcaneal malunion.