A novel transcoronal surgical technique for the treatment of cystic lesions of the distal phalanx: A cadaveric study

OBJECTIVE

To assess the feasibility of a novel transcoronal approach for the treatment of axial type 3 cysts of the palmar/plantar aspect of the distal phalanx (P3).

STUDY DESIGN

Ex vivo, experimental study.

SAMPLE POPULATION

Ten cadaveric specimens, four forelimbs and six hindlimbs.

METHODS

All cadaveric specimens underwent radiographically guided drilling, followed by cortical screw placement. The cartilage was macroscopically assessed after disarticulation of the distal interphalangeal joint. The entry point and trajectory were evaluated with computed tomography. Results were categorized as: axial, near-axial and abaxial. The minimal distance from the outer margin of the drill hole and the proximal border of the subchondral bone plate was measured using frontal computed tomographic slices.

RESULTS

Eight of the 10 screws were in an axial to near-axial position and nine followed the desired axial to near-axial trajectory. One screw was inserted axially but continued in an abaxial trajectory. Iatrogenic damage to the joint cartilage, flexor cortex and solar canal of P3 was not observed. All cortical screws were placed close to the proximal subchondral bone-plate of P3.

CONCLUSION

The desired axial/near-axial drilling and screw placement, under radiographic guidance, was achieved in nine out of 10 specimens.

CLINICAL SIGNIFICANCE

This novel technique seems promising for the treatment of inaccessible P3 cysts. Additional studies are required to investigate its feasibility in clinical cases, and the long-term outcome following transcystic screw placement of type 3 P3 cysts.

An investigation into different measurement techniques to assess equine proximal hoof circumference

Equine hoof conformation is integral to equine performance and soundness. Consequently, it is a major area of interest within the field of equine health. Researchers have measured several hoof shape parameters to study the hoof conformation. Proximal hoof circumference (PHC) is a primary hoof shape parameter, and its assessment may help to recognize the early stages of the development of changes in hoof morphology or poor hoof shape. Previous studies have mainly used a measuring tape to measure PHC. However, some doubts still exist regarding the reliability, repeatability and accuracy of measuring tape in this context. The current study conducted a technical comparison between the measuring tape and two alternative methods of 3D scanning and photogrammetry to measure PHC. Five equine limbs were collected from five adult horses, and the PHC of the limbs was measured using these three methods. The 3D scanner method was considered to be the highest accuracy and the reference for method comparisons. Pairwise correlations between the 3D scanner and the other two methods were conducted using a linear mixed model. The measuring tape and photogrammetry tended to overestimate the mean PHC compared to the 3D scanner by 0.96 mm (P > 0.05) and 2.2 mm (P < 0.05), respectively. In addition, an excellent interrater and intrarater correlation coefficient (ICC) index was reported for the reliability of the tape measurements. The variation of the tape measurements was +/-2 mm, which justified the use of measuring tape for PHC measurements in various clinical and horse management applications.

Radiogrametric Analysis of the Thoracic Limb Phalanges in Arabian Horses and Thoroughbred Horses

In this study, it was aimed to determine the statistical differences between Arabian horses and Thoroughbred horses based on X-ray images of forelimb digital bones. Latero-medial X-ray images of digital bones of thoracic limbs were taken of 25 Arabian horses and 50 Thoroughbred healthy horses. The difference between males and females within the breed was statistically analyzed as well. Nine measurements and three indexes taken from phalanges of thoracic limbs were used. Thoroughbred horses did not differ significantly between sexes, as indicated by the ANOVA. For the Arabian horses, the length of the middle of the proximal phalanx (p < 0.05), the length of the middle of the middle phalanx (p < 0.001), and the length of the dorsal surface of the distal phalanx (p < 0.05) measurement points were found to be differentiated between sexes. In the analysis made between Thoroughbred horses and Arabian horses with no respect to sex, the critical measurement was the depth of the caput of the proximal phalanx. The discriminant analysis enabled the correct classification of 89.33% of the proximal phalanx samples to the exact breed. The correct classification rate was 77.33% in the case of middle phalanx and 54.67% in the case of distal phalanx. Measurement results of the distal phalanx were found to be insignificant between both breeds and sexes. The radiological measurements of digital bones showed that sexual dimorphism was not too expressed and that decisive differences were found between the breeds.