Internal fixation of proximal fractures of the 2nd and 4th metacarpal and metatarsal bones using bioabsorbable screws

• Published in: Australian veterinary journal 2018-03, Vol.96 (3), p.76-81
• Main Authors: Mageed, M, Steinberg, T, Drumm, N, Stubbs, N, Wegert, J, Koene, M
• Format: Article
• Language: English
• Subjects: Absorbable Implants; Animals; biodegradable implants; Biodegradable materials; Bone Screws; Bones; Complications; Female; Fracture Fixation, Internal - methods; Fracture Fixation, Internal - veterinary; Fractures; Fractures, Bone - diagnostic imaging; Fractures, Bone - surgery; Fractures, Bone - veterinary; Germany; Horses; Horses - injuries; Horses - surgery; Male; Medical records; Metacarpal; Metacarpal Bones - injuries; Metacarpal Bones - surgery; Metatarsal Bones - injuries; Metatarsal Bones - surgery; Metatarsus; osteosynthesis; Polylactic acid; Radiography; Retrospective Studies; Sclerosis; splint bones; Treatment Outcome
• ISSN: 0005-0423; 1751-0813
• DOI: 10.1111/avj.12673

Objective 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. Methods 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. Results 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. Conclusion 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.