Whitelock R G, Dyce J, Houlton J E
Department of Clinical Veterinary Medicine, University of Cambridge, UK.
Vet Surg. 1999 Jan-Feb;28(1):25-30. doi: 10.1053/jvet.1999.0025.
To report the prevalence of third metacarpal bone fractures after dorsal plating for pancarpal arthrodeses in dogs and to identify predisposing factors.
Retrospective clinical study.
Fifty-four client-owned dogs.
Pancarpal arthrodesis was performed using dorsally applied 2.7- or 3.5-mm bone plates. Medical records and radiographs were retrospectively evaluated to identify those dogs with metacarpal bone fractures after pancarpal arthrodesis and to determine the angle of arthrodesis, the percentage of the third metacarpal bone covered by the bone plate, and the percentage width of the bone occupied by the screw. Radiological evidence of arthrodesis at follow-up examination 6 weeks postoperatively was recorded. Long-term results were obtained by telephone follow-up with the owners. All lame dogs were evaluated clinically and radiographically.
Metacarpal fractures occurred in 6 of 54 dogs. One of these dogs had a stress fracture of the third metacarpal 10 months after implant removal and was not included in the statistical analysis. Fractures occurred through the distal screw hole in four dogs and involved two metacarpal bones (III and IV) in two dogs. The median ratio of bone screw diameter-to-metacarpal bone diameter was the same for dogs with metacarpal bone fractures and those with no fractures (44%), and the median angles of arthrodesis were 8 degrees and 7 degrees. These values were not statistically significant. The percentage length of the metacarpal bone covered by the plate was 53% (no fracture) compared with 46% (fracture), and this difference was statistically significant (P = .035).
Screw diameter was not implicated as a predisposing factor for metacarpal bone fracture in dogs undergoing pancarpal arthrodesis using a dorsally applied dynamic compression plate. The length of the metacarpal bone covered by the bone plate did affect the frequency of metacarpal fracture, with fewer fractures occurring when greater than 53% of the bone length was covered by the dynamic compression plate.
When performing pancarpal arthrodesis with a dorsally applied bone plate, it is recommended that at least 50% of the length of the third metacarpal bone should be covered by the plate.
报告犬全腕关节融合术采用背侧钢板固定后第三掌骨骨折的发生率,并确定诱发因素。
回顾性临床研究。
54只客户拥有的犬。
采用背侧应用的2.7或3.5毫米骨板进行全腕关节融合术。对病历和X光片进行回顾性评估,以确定全腕关节融合术后发生掌骨骨折的犬只,并确定融合角度、骨板覆盖第三掌骨的百分比以及螺钉占据骨宽度的百分比。记录术后6周随访检查时融合的放射学证据。通过与犬主电话随访获得长期结果。对所有跛行犬进行临床和放射学评估。
54只犬中有6只发生掌骨骨折。其中1只犬在取出植入物10个月后发生第三掌骨应力性骨折,未纳入统计分析。4只犬的骨折发生在远端螺钉孔处,2只犬的骨折累及两根掌骨(第三和第四掌骨)。发生掌骨骨折的犬和未发生骨折的犬,骨螺钉直径与掌骨直径的中位数比例相同(44%),融合的中位数角度分别为8度和7度。这些值无统计学意义。骨板覆盖掌骨的百分比,未骨折组为53%,骨折组为46%,差异有统计学意义(P = 0.035)。
对于采用背侧应用动力加压钢板进行全腕关节融合术的犬,螺钉直径并非掌骨骨折的诱发因素。骨板覆盖掌骨的长度确实影响掌骨骨折的发生率,当动力加压钢板覆盖骨长度超过53%时,骨折发生率较低。
采用背侧骨板进行全腕关节融合术时,建议骨板至少覆盖第三掌骨长度的50%。