Double plate fixation for the management of proximal interphalangeal joint instability in 30 horses (1987–2015)

Abstract

The use of 2 abaxially placed dorsal plates for management of destabilising injuries to the PIJ results in a very good prognosis for survival and a reasonable prognosis for return to functional use.

Proximal interphalangeal locking compression plate for pastern arthrodesis in horses

“…Arthrodesis of the PIPJ is recommended when the horse is unable to perform as intended due to lameness not responsive to medical therapy. Arthrodesis provides a good prognosis for resolution of lameness and often allows the horse to return to its intended use 1‐11 . Methods of PIPJ ankylosis and arthrodesis have been reported including chemically facilitated ankyloses, 12‐14 laser‐facilitated arthrodesis, 15 transarticular lag screws, 1‐4,7,16‐19 and plate‐screw combinations 5,6,8,9,10,17,20 .…”

Langetermijnresultaat van artrodese van het proximale interfalangeale gewricht bij twee volwassen warmbloedpaarden gebruikmakend van een “locking” compressieplaat en vier trekschroeven

“…The most common pathologies affecting the PIPJ include severe osteochondrosis (Watkins, 1996;Lischer and Auer, 2019), joint instability secondary to disruption of the ligamentous or tendinous support (McCormick and Watkins, 2017), fractures of the proximal and/or middle phalanx (Crabill et al, 1995;Watkins, 1996), septic arthritis (Groom et al, 2000), bone cysts and chronic degenerative joint disease (Zubrod and Schneider, 2005;Jones et al, 2009;Lischer and Auer, 2012;Lischer and Auer, 2019).…”

“…Contrary to high-motion joints, arthrodesis of low-motion joints such as the PIPJ can result in a full return to athletic performance (Watkins, 1996;Zubrod and Schneider, 2005;Lischer and Auer, 2012). Different arthrodesis techniques of the PIPJ have been reported: two diverging 4.5 or 5.5 mm transarticular cortical screws placed in lag fashion (TCS-LF) (Herthel et al, 2016), three parallel 4.5 or 5.5 mm TCS-LF (Read et al, 2005;Carmalt et al, 2010), a combination of dynamic compression plate (DCP) with two 5.5 mm TCS-LF (Sod et al, 2011), a combination of limited-contact dynamic compression plate (LC-DCP) with two 5.5 mm TCS-LF (Rocconi et al, 2015), a combination of locking compression plate (LCP) with two 5.5 mm TCS-LF (Sod et al, 2011;Sakai et al, 2018), double DCP or LCP plating (Cra- , 1995;McCormick and Watkins, 2017) and a combination of a three-hole proximal interphalangeal locking compression plate (PIP plate) with two 5.5 mm TCS-LF (Zoppa et al, 2011;Ahern et al, 2013). The successful outcome of an arthrodesis procedure depends on the method used, the limb affected, the breed of the horse and the underlying pathology present (Schaer et al, 2001;Zubrod and Schneider, 2005;Knox and Watkins, 2006;Sod et al, 2011;Zoppa et al, 2011;Lischer and Auer, 2012;Ahern et al, 2013;Rocconi et al, 2015;Herthel et al, 2016;Sakai et al, 2018).…”

Highlights of recent clinically relevant papers

“…This retrospective case series by US‐based authors Justin McCormick and Jeffrey Watkins evaluated 30 cases (13 forelimbs and 18 hindlimbs) of double plate fixation in treating axial instability of the proximal interphalangeal joint .…”