Pastern Arthrodesis (fusion) in horses

It is the first report I have seen of a technique that provides a good prognosis for return to function using arthrodesis (fusion).
DrO

Proximal Interphalangeal Locking Compression Plate for Pastern Arthrodesis in horses
Equine Vet J. 2021 Jun 1.
Authors
Rebecca B Hicks 1 , Kati G Glass 1 , Jeffrey P Watkins 1
Affiliation

1 Department of Large Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA.

Background: Outcomes following proximal interphalangeal joint (PIPJ) arthrodesis by a variety of surgical methods are available. Reports detailing clinical outcomes following PIPJ arthrodesis utilising the proximal interphalangeal joint locking compression plate (PIP-LCP) and abaxial transarticular lag screws technique are limited.

Objectives: To report survival, radiographic, and clinical outcomes following PIPJ arthrodesis with PIP-LCP and abaxial transarticular lag screw fixation.

Study design: Retrospective case series.

Methods: Medical records of all horses undergoing pastern arthrodesis from 2009-2018 were reviewed. Arthrodeses performed using a 3-hole, 4.5 mm narrow LCP, specifically designed for the proximal interphalangeal joint, were included. Patient details, presentation, radiographic findings, intraoperative and postoperative data, and complications were documented. Short and long term follow-up was available for 23 horses.

Results: Thirty PIPJ arthrodeses were performed in 29 horses meeting the criteria for inclusion. Twenty-eight horses (97%, 95%CI 83-100) survived to discharge. Twenty-three horses (79%, 95%CI 60-92%) had successful outcomes including 12 of the 15 forelimb cases and 11 of the 13 hindlimb cases with available follow-up. Fifteen of 19 performance horses returned to athletic activity. Soundness in performance horses was recognised at less than 3 months in 1 case, 3 to 6 months in 6 cases, 6 to 12 months in 5 cases, and greater than 12 months in 6 cases. Complications included 3 implant infections, support limb laminitis (2 horses), and fragmentation of the extensor process of the distal phalanx (1 horse).

Main limitations: A retrospectively reviewed, small study population with a variety of breeds and disciplines.

Conclusions: The PIP-LCP construct provides a very good prognosis for performance and an excellent prognosis for pasture soundness.

Keywords: LCP; degenerative joint disease; horse; osteoarthritis; ringbone; transarticular screws.