Locking Compression Plate Fixation of Equine Tarsal Subluxations

Use of Locking Compression Plate and Locking Compression T-Plate for Surgical Arthrodesis of the Carpometacarpal and Distal Tarsal Joints in 13 Horses

OBJECTIVE

 The aim of this study was to describe the use of the locking compression plate (LCP) and locking compression T-plate (LCTP) in cases of carpometacarpal and distal tarsal arthrodesis for the treatment of osteoarthritis and small carpal or tarsal bone fractures, and to document clinical outcomes.

STUDY DESIGN

 Case records of horses treated with carpometacarpal or distal tarsal arthrodesis via internal fixation using an LCP or LCTP between 2013 and 2021 were reviewed. All cases were evaluated retrospectively. Follow-up information was gained via phone conversation with owners and referring veterinarians.

RESULTS

 Data were collected for 13 horses that fulfilled the study criteria. A total of eight horses underwent distal tarsal arthrodesis, and five underwent carpometacarpal arthrodesis. Twelve of thirteen horses went back to some level of athletic performance. Eight of 13 returned to the same level, while 4 of 13 returned to a lower level. Minor postoperative complications were recorded in 3 of 13 cases, with all horses suffering manageable short-term complications returning to the same level of work. Two horses suffered a major complication, with one resulting in euthanasia.

CONCLUSION

 Carpometacarpal and distal tarsal arthrodesis performed using the LCP and LCTP allowed all surviving horses in the study to obtain immediate postoperative comfort and eventual return to use.

A retrospective multicenter study on the use of locking compression plates for scapulohumeral arthrodesis in small equids

OBJECTIVE

To report on technical aspects and outcomes after scapulohumeral arthrodesis (SHA) with a locking compression plate (LCP) in small equids.

STUDY DESIGN

Retrospective multicenter case series.

ANIMALS

Client-owned Shetland Ponies, Miniature Shetlands, and American Miniature Horses (n = 15).

METHODS

Inclusion criteria were completed SHA with an LCP to treat scapulohumeral osteoarthritis/subluxation and availability of postoperative radiographs. Contributing surgeons completed a questionnaire to collect data. All radiographs were reviewed for this study. Follow-up information was obtained via re-admission to the hospital or telephone interview of the referring veterinarian or owner. Outcome was subjectively scored as excellent, good, moderate, or poor based on lameness and function.

RESULTS

Sixteen SHAs were performed in 15 equids (body weight 65-145 kg) by nine different surgeons. A narrow 4.5/5.0 mm LCP (7-16 holes) was used in 14 of the 16 SHAs. Follow-up was collected 2.5 years after surgery (median; range: 9 weeks to 10 years). Major complications related to the SHAs were noted in 4 of the 13 horses alive long term, consisting of implant failure (n = 1), surgical site infection (n = 2), and scapular fracture (n = 1). The outcome was graded as excellent in 4, good in 5, and moderate in 4 horses. Two ponies were euthanized because scapulohumeral osteoarthritis and subluxation developed in the contralateral limb.

CONCLUSION

Although major complications occurred in about one-third of ponies, SHA with LCP led to long-term survival with good function in most ponies.

CLINICAL SIGNIFICANCE

SHA with an LCP offers a high chance for good long-term outcome in small equids although contralateral disease may affect outcome.

Internal fixation of a complete ventral luxation of the dens axis in an American quarter horse yearling

OBJECTIVE

To report surgical treatment of a complete luxation of the atlantoaxial articulation with a 4.5-mm T-locking compression plate (T-LCP) in a horse.

STUDY DESIGN

Case report.

ANIMALS

A one-year-old American quarter horse filly.

METHODS

A one-year-old American quarter horse filly presented with a complete luxation of the atlantoaxial articulation. Closed and open reduction of the luxation were attempted under general anesthesia with the aid of a pulley system. Because the manual reduction was unsuccessful, the dens axis was excised, and the atlas and axis were stabilized with a 4.5-mm T-LCP. Four 5.5-mm cortex screws were placed across the atlantoaxial articulation in lag fashion to provide additional stability.

RESULTS

The horse made an uneventful recovery from surgery and remained comfortable thereafter. Nine months postsurgery, the filly had developed normally and did not show any sign of ataxia or reduced mobility of the cranial neck.

CONCLUSION

The described surgical approach resulted in the successful stabilization of a complete luxation of the atlantoaxial articulation in an American quarter horse yearling, with a favorable outcome.

CLINICAL SIGNIFICANCE

Complete atlantoaxial luxation is associated with a poor prognosis for survival in horses. This is the first report of a favorable outcome after surgical stabilization. The described approach presents a valuable alternative to the manual reduction of atlantoaxial luxation in horses.