Mageed M, Steinberg T, Drumm N, Stubbs N, Wegert J, Koene M
Tierklinik Lüsche GmbH, 49456, Bakum-Lüsche, Germany.
Aust Vet J. 2018 Mar;96(3):76-81. doi: 10.1111/avj.12673.
Fractures involving the proximal one-third of the splint bone are relatively rare and are challenging to treat. A variety of management techniques have been reported in the literature. The aim of this retrospective case series was to describe the clinical presentation and evaluate the efficacy of bioabsorbable polylactic acid screws in internal fixation of proximal fractures of the 2nd and 4th metacarpal and metatarsal bones in horses.
The medical records, diagnostic images and outcome of all horses diagnosed with a proximal fracture of the splint bones and treated with partial resection and internal fixation of the proximal stump using bioabsorbable polylactic acid screws between 2014 and 2015 were reviewed.
Eight horses met the inclusion criteria. The results showed that there were no complications encountered during screw placement or postoperatively. Six horses returned to full work 3 months after the operation and two horses remained mildly lame. On follow-up radiographs 12 months postoperatively (n = 2) the screws were not completely absorbed. The screws resulted in a cone-shaped radiolucency, which was progressively replaced from the outer margins by bone sclerosis.
The use of bioabsorbable screws for fixation of proximal fractures of the splint bone appears to be a safe and feasible technique and may offer several advantages over the use of traditional metallic implants.
涉及掌骨近端三分之一的骨折相对少见，治疗颇具挑战性。文献中已报道了多种治疗技术。本回顾性病例系列的目的是描述临床表现，并评估生物可吸收聚乳酸螺钉在马的第二和第四掌骨及跖骨近端骨折内固定中的疗效。
回顾了2014年至2015年间所有被诊断为掌骨近端骨折并采用生物可吸收聚乳酸螺钉对近端残端进行部分切除和内固定治疗的马的病历、诊断影像及治疗结果。
八匹马符合纳入标准。结果显示，在螺钉置入过程中及术后均未出现并发症。六匹马在术后3个月恢复了全部工作，两匹马仍有轻度跛行。术后12个月的随访X线片（n = 2）显示螺钉未完全吸收。螺钉导致了锥形的透亮区，其从外缘开始逐渐被骨硬化所替代。
使用生物可吸收螺钉固定掌骨近端骨折似乎是一种安全可行的技术，与使用传统金属植入物相比可能具有若干优势。
