Arthrodesis of the equine proximal interphalangeal joint: a biomechanical comparison of two 7-hole 3.5-mm broad and two 5-hole 4.5-mm narrow dynamic compression plates.
OBJECTIVE
To compare the biomechanical characteristics and mode of failure of two different dynamic compression plate (DCP) techniques for proximal interphalangeal joint (PIPJ) arthrodesis in horses.


STUDY DESIGN
Randomized block-design blocking on horse (1-5), method of fixation (two 7-hole, 3.5-mm broad DCP vs two 5-hole, 4.5-mm narrow DCP), side (left, right), and end (front, hind). Constructs were loaded to failure in 3-point bending in a dorsal-to-palmar (plantar) direction.


SAMPLE POPULATION
Ten paired limbs from 5 equine cadavers.


METHODS
Two 7-hole, 3.5-mm broad dynamic compression plates (bDCP) were used in 1 limb of a pair, and two 5-hole 4.5-mm narrow dynamic compression plates (nDCP) were used on the contralateral limb. Plates were positioned abaxially across the dorsomedial and dorsolateral aspect of the PIPJ. Arthrodesis constructs were loaded (19 mm/s) in 3-point bending in a dorsal-to-palmar (plantar) direction using a materials-testing machine. Composite stiffness, yield point, and maximal bending moment at failure were obtained from bending moment-angular deformation curves. Data were analyzed using ANOVA, X(2) analysis, and Fisher's exact tests; the power of the test was calculated when differences were not significant.


RESULTS
There were no significant differences in composite stiffness (P >.05; power = 0.8 @ delta = 21.9%), yield point (P >.05; power = 0.8 @ delta = 34.4%), or maximal bending moment (P >.05; power = 0.8 @ delta = 17.8%) between the two fixation techniques. For bDCP constructs, 11% (15 of 140) of the 3.5-mm screws were damaged; 7 of the screw heads pulled through plates where the plates bent, 1 screw head broke off, and 7 screws were bent or pulled out of the phalanx. For nDCP constructs, 8% (8 of 100) of the 4.5-mm screws were damaged; 1 screw head pulled through a plate, 1 screw head broke off, and 6 screws were bent or pulled out of the phalanx.


CONCLUSIONS
There were no biomechanical or failure differences between bDCP and nDCP fixation of the PIPJ in horses when evaluated in single-cycle 3-point bending to failure.


CLINICAL RELEVANCE
There is no biomechanical advantage to the use of two 7-hole, 3.5-mm bDCP in equine proximal interphalangeal arthrodesis compared with two 5-hole, 4.5-mm nDCP. Two 5-hole, 4.5-mm nDCP may be easier to place, whereas two 7-hole, 3.5-mm bDCP may provide more versatility in fracture repair.
Arthrodesis of the equine proximal interphalangeal joint: a biomechanical comparison of two parallel headless, tapered, variable-pitched, titanium compression screws and two parallel 5.5 mm stainless-steel cortical screws.
OBJECTIVE
To compare the biomechanical characteristics, failure mode, and effects of side (left or right limb) and end (forelimb or hindlimb) of different screws in 2-screw, parallel-screw proximal interphalangeal joint arthrodesis constructs in horses.


STUDY DESIGN
In vitro experimental study.


SAMPLE POPULATION
Twenty limbs from 6 cadavers (4 complete limb sets, 2 partial sets-total of 4 forelimb and 6 hindlimb pairs).


METHODS
Two parallel 5.5 mm cortical (AO) screws were inserted in lag fashion in 1 randomly allocated limb of a pair, and 2 parallel headless, tapered, variable-pitched, titanium compression screws (Acutrak-Plus) were inserted in the contralateral limb. Constructs were tested in 3-point bending in a dorsopalmar (plantar) direction using a materials-testing machine at a loading rate of 5.83 mm/s. Maximal bending moment at failure and composite stiffness were calculated from data generated on load-displacement curves. Data were analyzed using a Friedman 2-way analysis of variance and Wilcoxon's signed-rank tests.


RESULTS
No significant difference was detected for bending moment or stiffness values in proximal interphalangeal joint arthrodesis constructs using 2 parallel Acutrak-Plus or AO screws for fixation. Mean stiffness values were significantly different between forelimb and hindlimb constructs.


CONCLUSIONS
Performance of 2 parallel Acutrak-Plus screws was biomechanically comparable with 2 parallel AO 5.5 mm cortical screws in in vitro pastern arthrodesis constructs.


CLINICAL RELEVANCE
Acutrak-Plus screws may provide an alternative means of fixation for proximal interphalangeal joint arthrodesis.
Treatment of a comminuted middle phalangeal fracture in a horse by use of a broad dynamic compression plate.
Comminuted middle phalangeal fractures, extending into the proximal and distal portions of the interphalangeal joint, are associated with a poor prognosis for return to athletic performance. An 11-year-old horse with this type of fracture was treated successfully by use of a broad dynamic compression plate.