Summary
The purpose of this paper is to present a comprehensive ultrasonographic technique to image the palmar/plantar aspect of the fetlock in the horse, from the manica flexoria (MF) down to the base of the proximal sesamoid bones (PSBs) and to describe the normal images. Ultrasonography, in combination with radiography, is the technique of choice to identify and document tendon and ligament injuries in routine practice and has been shown adequate for evaluating the palmar/plantar aspect of the fetlock. Detailed descriptions of transverse and longitudinal sections performed on the weightbearing or flexed limb are provided, as well as the technique for dynamic examination of the area. A thorough knowledge of detailed ultrasonographic anatomy is critical to identify abnormal images and establish an accurate diagnosis of palmar/plantar fetlock injuries.
Fractures of the distal humerus are most commonly fixed by open reduction and internal fixation, using plates and screws, either in a locking or in a non-locking construct. Three different plating systems are commonly used in practice. The most important differences between them are in plate orientation, which affects both the rigidity of the osteosynthesis and invasiveness of the surgical procedure. Unfortunately, there is no common agreement between surgeons about which plate configuration brings the best clinical outcome. In this study, we investigate the theoretical rigidity of plate osteosyntheses considering two types of AO/ASIF configurations (90° angle between plates), Mayo clinic (Acumed) configuration (180° between plates) and dorsal fixation of both plates. We also compared the results for cases with and without contact between the bone fragments. In the case of no bone contact, the Mayo clinic plate configuration is found to be the most rigid, followed by both AO/ASIF plate configurations, and the least rigid system is the Korosec plate configuration. On the other hand, no significant differences between all types of fixation configurations are found in cases with contact in-between the bone fragments. Our findings show that this contact is very important and can compensate for the lack of load carrying capacity of the implants. This could therefore incite other implant fixation solutions, leading to less invasive surgical procedures and consequently improved clinical outcome.
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