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使用锁定加压远端股骨钢板进行双关节固定术治疗有近端指间关节半脱位风险的纯种赛马悬韧带外伤性断裂。

Treatment of traumatic disruption of the suspensory apparatus in Thoroughbred racehorses at risk of proximal interphalangeal joint subluxation using a locking compression-distal femur plate for double arthrodesis.

作者信息

Orozco Lopez David, Garcia-Lopez Jose M, Carpenter Ryan, Bras Jose J, Richardson Dean W, Ortved Kyla F

机构信息

New Bolton Center, Department of Clinical Studies, University of Pennsylvania, Kennett Square, Pennsylvania, USA.

William R. Prichard Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California-Davis, Davis, California, USA.

出版信息

Vet Surg. 2025 Apr;54(3):439-452. doi: 10.1111/vsu.14219. Epub 2025 Feb 3.

Abstract

OBJECTIVE

To describe the outcome of metacarpophalangeal (MCPJ) and proximal interphalangeal joint (PIPJ) arthrodesis using a locking compression-distal femur plate (LCP-DFP) in Thoroughbred racehorses with traumatic disruption of the suspensory apparatus (TDSA) at risk of PIPJ subluxation.

STUDY DESIGN

Multicenter retrospective study.

ANIMALS

Twenty-six Thoroughbred racehorses.

METHODS

Records of Thoroughbred racehorses with TDSA that had undergone MCPJ and PIPJ arthrodesis using an LCP-DFP at three referral hospitals between 2020 and 2024 were reviewed for inclusion. The preoperative data collected included signalment, affected limb, and type of injury. All postoperative complications were recorded. Long-term outcomes were obtained from medical records and telephone interviews.

RESULTS

Nine females, 14 geldings, and three intact males with TDSA were treated via double arthrodesis using an LCP-DFP. The most common postoperative complications included support limb laminitis, incisional drainage, implant infection with osteomyelitis, and distal interphalangeal joint subluxation. No horses developed PIPJ subluxation. Twenty (76.9%) horses developed short-term complications. Thirteen (50%) horses survived long term (>6 months, range 6-32 months) and were reported to be pasture sound without receiving any analgesic or antiinflammatory medication.

CONCLUSION

Metacarpophalangeal and PIPJ arthrodesis using an LCP-DFP in racehorses resulted in a stable construct with no horses developing subluxation of the PIPJ joint postoperatively. Arthrodesis using an LCP-DFP was associated with a fair prognosis for pasture soundness.

CLINICAL SIGNIFICANCE

Application of an LCP-DFP may prevent subluxation of the PIPJ; however, the prognosis is still affected by the high prevalence of other complications and associated mortality among horses that suffer TDSA.

摘要

目的

描述在有近端指间关节(PIPJ)半脱位风险的患有悬韧带装置创伤性断裂(TDSA)的纯种赛马中,使用锁定加压股骨远端钢板(LCP-DFP)进行掌指关节(MCPJ)和近端指间关节融合术的结果。

研究设计

多中心回顾性研究。

动物

26匹纯种赛马。

方法

回顾2020年至2024年间在三家转诊医院接受使用LCP-DFP进行MCPJ和PIPJ融合术的患有TDSA的纯种赛马的记录以纳入研究。收集的术前数据包括特征、患侧肢体和损伤类型。记录所有术后并发症。通过病历和电话访谈获得长期结果。

结果

9匹母马、14匹去势公马和3匹未去势公马患有TDSA,通过使用LCP-DFP进行双关节融合术治疗。最常见的术后并发症包括支持肢蹄叶炎、切口引流、植入物感染伴骨髓炎和远端指间关节半脱位。没有马匹发生PIPJ半脱位。20匹(76.9%)马匹出现短期并发症。13匹(50%)马匹长期存活(>6个月,范围6 - 32个月),据报告在牧场状况良好,无需接受任何镇痛或抗炎药物治疗。

结论

在赛马中使用LCP-DFP进行掌指关节和PIPJ融合术可形成稳定结构,术后没有马匹发生PIPJ关节半脱位。使用LCP-DFP进行关节融合术对牧场健康状况的预后尚可。

临床意义

应用LCP-DFP可能预防PIPJ半脱位;然而,预后仍受其他并发症的高发生率以及患有TDSA的马匹相关死亡率的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1091/11947293/72ec1722b650/VSU-54-439-g004.jpg

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