DOUBLE PLATE FIXATION FOR PROXIMAL INTERPHALANGEAL JOINT INSTABILITY
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Double plate fixation has been reported in a small number of horses with comminuted fractures of the middle phalanx. There are no published reports using this technique in the management of other injuries that destabilise the proximal interphalangeal joint (PIJ), including biaxial palmar/plantar eminence fractures and disruption of the palmar/plantar soft tissue support structures of the PIJ. Furthermore, there is a paucity of information on the long-term prognosis for horses undergoing double plate fixation to manage destabilising injuries of the PIJ. The objectives of this study were to document further the clinical use of double plate fixation for management of injuries to the PIJ resulting in palmar/plantar instability and compare these results with other methods of management.
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The case records and radiographs of 30 horses with destabilising injuries to the PIJ treated by double plate fixation at Texas A&M University between 1987 and 2013 were analysed.
Long-term follow-up information was obtained by telephone interview with the client or referring veterinarian.
Thirty-one disruptive PIJ injuries were double plated in 30 cases.
Twenty-nine of 30 horses were discharged from the hospital.
The medial time for post operative external coaptation was 41 days. Long-term follow-up (>2 years) was available for 25 horses, of which 15 (60%) returned to useful function.
Radiographic evidence of fracture healing and arthrodesis of the PIJ was evident in 28 (90%) repairs at 6 months following repair.
The use of 2 abaxially placed dorsal plates for management of destabilising injuries to the PIJ results in a very good prognosis for survival and a reasonable prognosis for return to functional use.
Source: McCormick, J. D. and Watkins, J. P. (2017), Double plate fixation for the management of proximal interphalangeal joint instability in 30 horses (1987–2015). Equine Veterinary Journal, 49: 211–215. doi: 10.1111/evj.12578
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