Standing fracture repair – a new chapter

Ex Vivo Comparison of the Accuracy of a Clamped with a Hand-Held Drill Guide for Drilling Distal Third Metacarpals and Metatarsals in Equids

“…1,2 Some fractures, such as those of the lateral condyle of the third metacarpal/tarsal bones, are amenable to surgical repair. 3,4 Fracture repairs at these sites are frequently performed in the standing horse, where both speed and accuracy are important. 3,4 Intraarticular fractures can often lead to post-traumatic osteoarthritis and long-term morbidity, which can be prevented by surgical restoration of articular surfaces.…”

“…3,4 Fracture repairs at these sites are frequently performed in the standing horse, where both speed and accuracy are important. 3,4 Intraarticular fractures can often lead to post-traumatic osteoarthritis and long-term morbidity, which can be prevented by surgical restoration of articular surfaces. 5,6 Accurate place-ment of implants has been shown to improve joint congruity and prevent displacement following lag screw tightening.…”

“…Alternative drill guide options include stereolithographic surgical guides (a three-dimensional guide created from preoperative computed tomography [CT] images) 8,9 or clamped drill guides (also known as universal aiming devices) 10 ; these are used in both human and small animal surgery. These guides have been shown to improve accuracy of screw placement by reducing human error, decrease surgery time and reduce complications, 3,4,[11][12][13][14][15] particularly in areas of poor or complicated access. 16 A clamped drill guide has been developed for use in horses at this clinic by modifying and straightening an existing angled clamped drill guide (Adjustable Drill Guide; Kruuse, Langeskov, Denmark) (►Fig.…”

“…Box and whisker plot depicting the spread of proximodistal deviation of the drill hole for the different surgeons[1][2][3][4] using either the hand-held (H) or clamped drill guide (C), where negative deviation is in a proximal direction and positive deviation is in a distal direction. Middle box line (bold) ¼ median; lower and upper box lines ¼ 25th and 75th percentiles, respectively; lower and upper whiskers ¼ lower and upper adjacent values; open circles ¼ outliers.…”

Is general anaesthesia avoidable for limb fracture repair in horses?

“…The temperament of the horse is paramount as it is imperative that the horse stands square and remains still throughout the duration of surgery (Compston & Payne, 2013;Lean & Ahern, 2020).…”