Tarsometatarsal subluxation in dogs: partial arthrodesis by plate fixation

Abstract

In a retrospective study of tarsometatarsal joint subluxation in eight dogs, secondary fractures were identified in six dogs, particularly of the fourth tarsal bone and the proximal fifth metatarsal bone. Common causes of tarsometatarsal joint injury included jumping or falling and direct trauma to the foot. Partial tarsal arthrodesis, with the use of bone-plate stabilization and cancellous bone grafting of joint spaces after removal of articular cartilage, led to progressive bone healing in all dogs. Implant breakage did not occur in any dog.

Tarsometatarsal Arthrodesis Using Tarsometatarsal Intramedullary Pin Stabilization

“…External coaptation (bivalved cast or plantar half cast) was used to supplement stabilization of the tarsometatarsal joint during healing and to alleviate discomfort during weight bearing because the pins exit through the metatarsophalangeal joint. Use of external coaptation resulted in pressure sores, the most common complication in this and other reports where external coaptation was used to supplement joint stabilization . Such sores can be minimized with frequent bandage changes and appropriate bandage adjustments, and were considered a minor complication with full resolution and return to function.…”

“…The strong tarsometatarsal joint capsule and plantar ligaments can make fixation of this joint more difficult than in other tarsal joints. Seemingly, current research has focused on treating tarsometatarsal instability with a bone plate because of concerns about implant breakage using other techniques . However, others state that bone plating has no distinct advantage over other techniques because the tension‐band side of the tarsus is not stabilized unless the plate is placed on the plantar aspect of the tarsus …”

“…The complexity of these ligaments make primary repair difficult and conservative management is ineffective . Arthrodesis is recommended to restore long‐term stability of the joint and can be accomplished by use of an intramedullary Steinmann pin and 2 cross‐pins; pin and tension band combination; linear or circular external fixation; and lateral, medial, or plantar bone plate fixation …”

Ankylosis of tarsometatarsal luxations using external fixation

“…There are numerous orthopaedic implants, such as a laterally applied plate (Muir and Norris 1999), that are used to achieve arthrodesis of the tarsometatarsal joints. These surgical techniques have several disadvantages including difficult surgical approaches, high degree of soft tissue dissection, use of bulky implants that impede skin closure, postoperative swelling, risk of implant failure, risk of iatrogenic bone fracture and the potential requirement for a second surgical procedure to remove implants (Newton 1996).…”

Kangal ırkı bir köpekte tarsal artrodez olgusu

“…tarsi luksasyonlarında, eklemin lokal şişkin-lik, ağrı, laksite, hareket kısıtlılığı ve deformite yönünden muayeneleri yapılmalıdır. Bunun için ekleme; kompresyonda varus, valgus, mediolateral ve dorsoplantar translasyon uygulanarak zarar gören ligamentlerin tespiti yapılır (1,2,3,5).…”