In vitro comparison of transfixation and standard full-limb casts for prevention of displacement of a mid-diaphyseal third metacarpal osteotomy site in horses.

OBJECTIVE: To compare transfixation and standard full-limb casts for prevention of in vitro displacement of a mid-diaphyseal third metacarpal osteotomy site in horses. SAMPLE POPULATION: 6 forelimbs from 6 horses euthanatized for reasons not related to the musculoskeletal system. PROCEDURE: A 30 degrees osteotomy was performed in the mid-diaphysis of the third metacarpal bone. Two 4.5-mm cortical bone screws were placed across the osteotomy site to maintain alignment during casting. Two 6.35-mm Steinmann pins were placed from a lateral-to-medial direction in the distal aspect of the radius. A full-limb cast that incorporated the pins was applied. An extensometer was positioned in the osteotomy site through a window placed in the dorsal aspect of the cast, and after removal of the screws, displacement was recorded while the limb was axially loaded to 5,340 N (1,200 lb). Pins were removed, and the standard full-limb cast was tested in a similar fashion. RESULTS: The transfixation cast significantly reduced displacement across the osteotomy site at 445 N (100 lb), 1,112 N (250 lb), 2,224 N (500 lb), and 4,448 N (1,000 lb), compared with the standard cast. CONCLUSION AND CLINICAL RELEVANCE: A full-limb transfixation cast provides significantly greater resistance than a standard full-limb cast against axial collapse of a mid-diaphyseal third metacarpal osteotomy site when the bone is placed under axial compression. Placement of full-limb transfixation casts should be considered for the management of unstable fractures of the third metacarpal bone in horses.

Effect of different full-limb casts on in vitro bone strain in the distal portion of the equine forelimb.

OBJECTIVE: To determine the ability of a full-limb transfixation pin cast to protect the distal portion of the equine forelimb from weight-bearing forces by measuring bone strain in vitro on cadaver limbs loaded in a mechanical testing machine. SAMPLE POPULATION: 6 forelimbs from 6 horses. PROCEDURE: Each limb was instrumented with 3 unidirectional metal foil electrical resistant strain gauges. Gauges were placed on the dorsal aspect of the distal portion of the radius and the mid-dorsal portion of the cortex of the third metacarpal bone and the first phalanx. Each limb was tested 3 times, once supported with a transfixation pin cast, once supported by a standard full-limb cast, and finally, uncast. The limbs were tested in a mechanical testing machine under axial loads ranging from 100 to 1,000 lb, and bone strains were recorded at each load. RESULTS: Compared with values for the uncast limb, the transfixation pin cast and the standard full-limb cast significantly (P < 0.001) reduced bone strain on the distal portion of the radius, third metacarpal bone, and first phalanx. Compared with the standard full-limb cast, the transfixation pin cast significantly (P < 0.001) reduced bone strain on the first phalanx. CONCLUSION AND CLINICAL RELEVANCE: Compared with the standard full limb cast, the full-limb transfixation pin cast is more protective of the first phalanx.

Effect of pin hole size and number on in vitro bone strength in the equine radius loaded in torsion.

OBJECTIVE: To determine the effect of pin hole size and number on the breaking strength of the adult equine radius when loaded in torsion to failure. SAMPLE POPULATION: 54 pairs of equine radii from adult horses. PROCEDURE: For test one, 12 pairs of radii were used to determine the effect of pin hole size on torsional breaking strength. A 6.35-mm hole was drilled in 1 radius, and a 9.5-mm hole was drilled in the contralateral radius. For test two, 36 pairs of radii were randomly assigned to 1 of 3 treatment groups (n = 12) to determine the effect of pin hole number on the torsional breaking strength of the equine radius. One radius of each pair served as a control, and one, three, or six 6.35-mm transcortical holes were drilled in the contralateral radius. For test three, 6 pairs of radii had torsional forces applied directly to the transfixation pins, as opposed to the bone itself. One radius of a pair served as a control, and three 6.35-mm smooth Steinman pins were placed in the contralateral radius. All radii were loaded in torsion to failure, and the breaking strengths were recorded. RESULTS: Compared with the 6.35-mm hole, the 9.5-mm hole significantly decreased torsional strength of the radius. There was no significant difference in mean torsional strength between the control radii and the radii with 1, 3, or 6 transcortical holes or when the transfixation pins were loaded. CONCLUSION: Use of up to three 6.35-mm transfixation pins can be used in a full-limb transfixation pin cast to optimize stiffness without a significant decrease (12%) in bone strength.

Relationship between locomotor forces, hoof position and joint motion during the support phase of the stride of galloping horses.

Three methods were used simultaneously to determine the relationships between the vertical forces exerted on the hooves and the positions of the limbs and hooves at the times of peak vertical forces from 2 horses galloping on a track straightaway. Vertical forces were recorded from an instrumented shoe, fetlock joint motion was measured with an electrogoniometer and the angles of the carpus, fetlock and hoof were determined from slow-motion films. At hoof contact, the mean angles of the carpus and fetlock were 181-182 degrees and 199-206 degrees, respectively. Peak vertical forces on the heel occurred at or near maximum extension of the carpal and fetlock joints. Peak forces on the toe occurred during flexion of the fetlock joint and at mean hoof angles of 28-31 degrees from the horizontal. The mean angles of the hoof from the horizontal at the time of heel contact were 6-7 degrees. Hoof lift occurred at mean carpal angles of 173-174 degrees and mean fetlock angles of 199-200 degrees.

Suspensory apparatus prosthesis in the horse. Part 1: In vitro mechanical properties.

Mechanical properties of equine suspensory apparatus preparations and three braided synthetic prostheses were evaluated in vitro. Force versus displacement plots and failure modes were recorded from single load-to-failure testing in 18 cadaver limbs before and after replacement of each suspensory apparatus with a prosthesis. Mean load at failure, energy to failure, and stiffness values of polytetrafluoroethylene (PTFE) prostheses were lower than those of the suspensory apparatus and aramid prosthesis. The PTFE prosthesis failed by elongation or rupture of the prosthesis. Mechanical properties of the aramid prosthesis with collar augmentation were not significantly different from the suspensory apparatus. The main site of failure in both aramid prostheses was at the screw fixation to bone.

Suspensory apparatus prosthesis in the horse. Part 2: In vivo evaluation in a suspensory apparatus disruption model.

The suspensory apparatus of one forelimb was surgically disrupted in six adult horses by transecting the distal sesamoidean ligaments. A double-braided prosthetic ligament made of aramid yarn was installed to support the flexor surface of the metacarpophalangeal joint. The prosthesis was routed through tunnels in the third metacarpal bone and proximal phalanx, and secured to bone with screws. Evaluation by radiography, synovial fluid analysis, cinematography, and dynamography was performed before surgery and at weeks 16 and 30. Supracondylar cortical lysis and periosteal proliferation were observed on postoperative radiographs. Synovitis and fragmentation of the prosthesis were apparent from synovial fluid evaluation. Weight bearing and metacarpophalangeal joint motion were decreased and loading was transferred in part to the opposite forelimb. Clinical lameness improved and weight bearing increased during the second half of the 30-week period. At necropsy, there was abrasion of the prosthesis and the articular surfaces in contact with the prosthesis. Diffuse granulomatous synovitis developed in response to aramid fiber fragments within the synovium.

A modified Cloward's technique for arthrodesis of the normal metacarpophalangeal joint in the horse.

A modified Cloward's technique was performed for arthrodesis of one metacarpophalangeal (MCP) joint in eight horses. Dorsal arthrotomies were performed medial and lateral to the common digital extensor tendon and two 16 mm holes were drilled through the joint. A perforated cylindrical stainless steel basket filled with cancellous bone was impacted into each hole. The limbs were supported in casts for 8 weeks. The joints were examined and radiographed at 4 weeks, 8 weeks, 6 months, and 10 months. One horse was euthanatized at week 14 to assess the progress of the arthrodesis. In the other seven horses, there was clinical fusion at month 6. Dynamographic evaluations were performed 11 months after surgery at the walk and trot. The maximum vertical forces exerted during weight bearing by treated and control limbs were compared. No difference was detected at the walk; however, a significant difference was present at the trot (p less than 0.05). It was calculated that at the trot the horses placed 90% as much force on the treated limb as on the control limb. Eleven months after surgery, the baskets contained compact and cancellous bone. Ingrowth of bone occurred through all openings, completely filling the baskets and fusing the joints.

Changes in digital venous pressures of horses moving at the walk and trot.

Blood pressures from the catheterized lateral digital vein of the fore-limbs of 6 clinically normal horses were measured at rest, at the walk, and at the trot. Digital venous pressures were compared with the phases of the stride and weight-bearing forces, using electrogoniometry and a force platform. Rapid increases in digital venous pressures to maximal values were observed immediately before maximal forces during the support period of the stride. At the trot, increases in peak vertical forces were paralleled by increases in peak digital venous pressures. Seemingly, the hydrodynamics of the digital circulatory system help to dissipate the initial impact of hoof strike at the walk and the trot.

Cervical vertebral interbody fusion in the horse: a comparative study of bovine xenografts and autografts supported by stainless steel baskets.

A modified form of the Cloward technique for anterior cervical fusion in human beings was used in the application of different grafts for evaluation of their effectiveness in stabilizing equine cervical vertebrae. Results of bovine xenograft implants in 8 horses were compared with results of stainless steel baskets (SSB) packed with cancellous autogenous bone in 8 horses. Graft material was incorporated in all cases. Evidence of graft rejection was not present. Both forms of implants decreased the mobility of the intervertebral space in which they were implanted. A fibrous connective tissue union was prevalent after xenograft implantation. Osseous union was prevalent after implantation of the SSB. Reduction in range of motion was greatest at those sites with the SSB.