In Vitro Pullout Strength of Screws Inserted in Adult Equine Third Metacarpal Bone After Overdrilling a 4.5-mm Threaded Insertion Hole

Objective—To determine and compare the in vitro pullout strength of 5.5-mm cortical versus 6.5-mm cancellous bone screws inserted in the diaphysis and metaphysis of adult equine third metacarpal (MCIII) bones, in threaded 4.5-mm cortical bone screw insertion holes that were then overdrilled with a 4.5-mm drill bit to provide information relevant to the selection of a replacement screw if a 4.5-mm cortical screw is stripped. Study Design—In vitro pullout tests of 5.5-mm cortical and 6.5-mm cancellous screws in equine MCIII bones. Sample Population—Two independent cadaver studies each consisting of 14 adult equine MCIII bones. Methods—Two 4.5-mm cortical screws were placed either in the middiaphysis (study 1) or distal metaphysis (study 2) of MCIII bones. The holes were then overdrilled with a 4.5-mm drill bit and had either a 5.5-mm cortical or a 6.5-mm cancellous screw inserted; screw pullout tests were performed at a rate of 0.04 mm/second until screw or bone failure occurred. Results—In diaphyseal bone, the screws failed in all tests. Tensile breaking strength for 5.5-mm cortical screws (997.5 ± 49.3 kg) and 6.5-mm cancellous screws (931.6 ± 19.5 kg) was not significantly different. In metaphyseal bone, the bone failed in all tests. The holding power for 6.5-mm cancellous screws (39.1 ± 4.9 kg/mm) was significantly greater than 5.5-mm cortical screws (23.5 ± 3.5 kg/mm) in the metaphysis. There was no difference in the tensile breaking strength of screws in the diaphysis between proximal and distal screw holes; however, the holding power was significantly greater in the distal, compared with the proximal, metaphyseal holes. Conclusions—Although tensile breaking strength was not different between 5.5-mm cortical and 6.5-mm cancellous screws in middiaphyseal cortical bone, holding power of 6.5-mm cancellous screws was greater than 5.5-mm cortical screws in metaphyseal bone of adult horses. Clinical Relevance—If a 4.5-mm cortical bone screw strips in MCIII diaphyseal bone of adult horses, either a 5.5-mm cortical or 6.5-mm cancellous screw, however, would have equivalent pullout strengths. A 6.5-mm cancellous screw, however, would provide greater holding power than a 5.5-mm cortical screw in metaphyseal bone.     

Effect of diameter of the drill hole on torque of screw insertion and pushout strength for headless tapered compression screws in simulated fractures of the lateral condyle of the equine third metacarpal bone

OBJECTIVE: To compare variables for screw insertion, pushout strength, and failure modes for a headless tapered compression screw inserted in standard and oversize holes in a simulated lateral condylar fracture model. SAMPLE POPULATION: 6 pairs of third metacarpal bones from horse cadavers. PROCEDURE: Simulated lateral condylar fractures were created, reduced, and stabilized with a headless tapered compression screw by use of a standard or oversize hole. Torque, work, and time for drilling, tapping, and screw insertion were measured during site preparation and screw implantation. Axial load and displacement were measured during screw pushout. Effects of drill hole size on variables for screw insertion and screw pushout were assessed by use of Wilcoxon tests. RESULTS: Drill time was 59% greater for oversize holes than for standard holes. Variables for tapping (mean maximum torque, total work, positive work, and time) were 42%, 70%, 73%, and 58% less, respectively, for oversize holes, compared with standard holes. Variables for screw pushout testing (mean yield load, failure load, failure displacement, and failure energy) were 40%, 40%, 47%, and 71% less, respectively, for oversize holes, compared with standard holes. Screws could not be completely inserted in 1 standard and 2 oversize holes. CONCLUSIONS AND CLINICAL RELEVANCE: Enlarging the diameter of the drill hole facilitated tapping but decreased overall holding strength of screws. Therefore, holes with a standard diameter are recommended for implantation of variable pitch screws whenever possible. During implantation, care should be taken to ensure that screw threads follow tapped bone threads.     

Holding power of cortical screws after power tapping and hand tapping.

Paired equine third metacarpal bones were drilled and tapped for 4.5 mm and 5.5 mm cortical screws. Tapping was done by hand or with an air-driven reversible orthopedic drill. Screws were inserted and subjected to extraction forces to failure of the osseous threads or the screws. There was no difference in holding power of either screw size between hand-tapped and power-tapped holes.     

Osteostixis for Incomplete Cortical Fracture of the Third Metacarpal Bone: Results in 11 Horses

Eleven horses with acute or chronic incomplete cortical fractures of the left or right third metacarpal bone (McIII) were treated with surgical puncture (osteostixis). The fractures were diagnosed by physical examination and radiography. Four to eight holes, 2.7 or 3.5 mm in diameter, were drilled in the fractured bone. Radiographically, the fractures were healed by month 3, and the drill holes were inapparent by month 7. Nine horses (82%) returned to race competition, and two horses were retired, one the result of a surgical complication. The mean time between surgery and the first race was 9.4 months. None of the bones refractured within 24 months of surgery. Osteostixis was not technically difficult and a second operation for implant removal was not necessary.     

Biomechanical comparison of cortical radial graft versus ulnar transposition graft limb-sparing techniques for the distal radial site in dogs

OBJECTIVE: To compare the biomechanical properties of radial graft (RG) versus ulnar transposition graft (UTG) limb-sparing techniques in the dog. STUDY DESIGN: Cadaveric study. ANIMALS: Six pairs of normal canine thoracic limbs. METHODS: In each pair of limbs, 1 limb was subjected to the RG technique and the other to the UTG technique. Limbs were tested in axial loading until failure. Modes of failure and biomechanical properties were compared between the 2 groups. Percent coverage of the metacarpal bone by the plate was retrospectively compared between the limbs that failed by fracture of the metacarpal bones and those that did not. RESULTS: RG limbs had significantly greater stiffness, yield load, maximum load, maximum energy, and post-yield energy. All UTG limbs failed by cranial bending of the plate. Half of the RG limbs failed by caudal bending of the plate and half by fracture of the third metacarpal bone at the distal end of the plate. Limbs with <80% plate coverage of the metacarpal bone were significantly more likely to fail by metacarpal fracture. CONCLUSIONS: The RG technique was biomechanically superior to the UTG technique under the conditions studied. At least 80% plate coverage of the metacarpal bone should be achieved. CLINICAL RELEVANCE: Exercise restriction and coaptation bandages should be considered for patients undergoing the UTG technique to minimize potential biomechanical complications.     

Effect of subchondral drilling on repair of partial-thickness cartilage defects of third carpal bones in horses

Arthrotomies of middle carpal joints were done on 13 horses, and a 1-cm partial thickness, round defect was made on the radial facet of both third carpal bones. In one joint, 1-mm diameter 1-cm deep holes were drilled within the defect, and one joint was used as a control. horses were assigned to 2 groups--group 1 (n = 6 horses), 5 drill holes; group 2 (n = 7 horses), 11 drill holes. At 1 and 3 weeks after surgery, differences between joints in synovial fluid total protein values, WBC counts, or results of mucin precipitate tests were not significant (P = 0.005). Physically and radiographically, horses were the same during the 12 initial weeks they were housed in stalls and the 9 weeks they were kept in paddocks. Twenty-one weeks after surgery, horses were euthanatized. Joints with drill holes had a significantly greater area (P less than 0.05) of healthy fibrocartilage new tissue: group 1-33 to 68% new tissue, compared with 0 to 23% new tissue in controls; and group 2-22 to 64% new tissue, compared with 0 to 37% new tissue in controls. Differences between healing of defects with drill holes in groups 1 and 2 were not significant. Thickness of new tissue over drill holes was 33 to 61% of thickness of cartilage adjacent to the defect, and thickness of tissue between drill holes was 11 to 43% (group 1) and 8 to 79% (group 2) of the thickness of cartilage adjacent to the defect.(ABSTRACT TRUNCATED AT 250 WORDS)     

Metacarpal fractures associated with pancarpal arthrodesis in dogs

OBJECTIVE: To report the prevalence of third metacarpal bone fractures after dorsal plating for pancarpal arthrodeses in dogs and to identify predisposing factors. STUDY DESIGN: Retrospective clinical study. ANIMALS: Fifty-four client-owned dogs. METHODS: 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. RESULTS: 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). CONCLUSIONS: 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. CLINICAL RELEVANCE: 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.     

A Comparison of the Synthes 4.5-mm Cannulated Screw and the Synthes 4.5-mm Standard Cortex Screw Systems in Equine Bone

Objective —To determine risk of failure of the Synthes 4.5-mm cannulated screw system instrumentation in equine bone and to compare its application with the Synthes 4.5-mm standard cortex screw system.
Study Design —The maximum insertion torque of the cannulated and standard cortex screw systems were compared with the ultimate torsional strengths of the equipment. Pullout strength and ultimate tensile load of cannulated and standard cortex screws were also determined.
Sample Population—Paired equine cadaver third metacarpal and third carpal bones.
Methods —Maximum insertion torque and ultimate torsional strengths were determined by using an axial-torsional, servohydraulic materials testing system and a hand-held torquometer. Pullout tests were performed by using a servohydraulic materials testing system.
Results —Maximum insertion torque of all cannulated instrumentation was less than ultimate torsional strength at all locations ( P < .05). Maximum insertion torques of cannulated taps and screws were greater than for standard taps and screws in the third carpal bone ( P < .002). Pullout strength of the cannulated screws was less than the standard cortex screws at all sites ( P < .001). Cannulated screws broke before bone failure in all but one bone specimen. Conclusions—The risk of cannulated instrument or screw failure during insertion into bone is theoretically low. The relatively low pullout strength of the cannulated screws implies that the interfragmentary compression achievable is likely to be less than with standard cortex screws. Clinical Relevance—The relatively low pullout strength of the cannulated screw suggests that its risk of failure during fracture repair is greater than with the standard cortex screw.     

The effect of training on equine metacarpal bone breaking strength

Right third metacarpal bones (n=24) from Thoroughbreds, 24 to 48 months old and in race training, were tested to failure in 3 point bending. The neutral load axis was estimated and the distance from the axis to the outer dorsal cortical surface measured. Mid-diaphyseal dorsopalmar and lateromedial outer cortical and medullary diameters were measured. Breaking strength, cortical area and area moment of inertia were also calculated. Significant correlations were demonstrated between months in training and dorsopalmar bone diameter, cortical area and area moment of inertia. Significant linear models were illustrated between the same 3 variables and number of months in training. It was concluded that increased duration of training significantly enlarges dorsopalmar bone diameter, cortical area and area moment of inertia. Training did not affect metacarpal bone breaking strength as determined by 3 point bending.     

In vitro comparison of metaphyseal and diaphyseal placement of centrally threaded, positive-profile transfixation pins in the equine third metacarpal bone

OBJECTIVE: To evaluate in vitro holding power and associated microstructural and thermal damage from placement of positive-profile transfixation pins in the diaphysis and metaphysis of the equine third metacarpal bone. SAMPLE POPULATION: Third metacarpal bones from 30 pairs of adult equine cadavers. PROCEDURE: Centrally threaded positive-profile transfixation pins were placed in the diaphysis of 1 metacarpal bone and the metaphysis of the opposite metacarpal bone of 15 pairs of bones. Tensile force at failure for axial extraction was measured with a materials testing system. An additional 15 pairs of metacarpal bones were tested similarly following cyclic loading. Microstructural damage was evaluated via scanning electron microscopy in another 6 pairs of metacarpal bones, 2 pairs in each of the following 3 groups: metacarpal bones with tapped holes and without transfixation pin placement, metacarpal bones following transfixation pin placement, and metacarpal bones following transfixation pin placement and cyclic loading. Temperature of the hardware was measured with a surface thermocouple in 12 additional metacarpal bones warmed to 38 C. RESULTS: The diaphysis provided significantly greater resistance to axial extraction than the metaphysis. There were no significant temperature differences between diaphyseal and metaphyseal placement. Microstructural damage was limited to occasional microfractures seen only in cortical bone of diaphyseal and metaphyseal locations. Microfractures originated during drilling and tapping but did not worsen following transfixation pin placement or cyclic loading. CONCLUSIONS AND CLINICAL RELEVANCE: Centrally threaded, positive-profile transfixation pins have greater resistance to axial extraction in the diaphysis than in the metaphysis of equine third metacarpal bone in vitro. This information may be used to create more stable external skeletal fixation in horses with fractures.     

Effects of age and diet on the development of mechanical strength by the third metacarpal and metatarsal bones of young horses

The application of transmission ultrasonics to the equine cannon holds promise as a method of monitoring metacarpal and metatarsal development, quality and integrity under a variety of experimental and field conditions. The validity of relating the velocities of sound pulses transmitted through the cannon to the mechanical breaking strengths of these bones was tested in two studies. Breaking strengths calculated from the sound velocities through sections of the metacarpal bones from 14 yearling ponies and 12 yearling horses were highly correlated with the mechanical breaking strengths of those sections (r = .907 and .927, respectively; P less than .01). Sound velocities through the cannons of the horses before sacrifice ranged from 2,453 to 3,130 m/s and were correlated with their mechanically determined breaking strengths (193 to 262 X 10(6) N/M2; r = .673; P less than .01). The correlation coefficient increased to .912 when the sound velocities were adjusted for the sound-delaying effects of the overlying soft tissues. In a third study, 13 horses were weaned at 2 to 4 mo of age and were fed diets providing either 100 or 130% of National Research Council (NRC) energy and protein recommendations. Metacarpal and metatarsal development was monitored monthly for 15 mo via transmission ultrasonics. Sound velocities, breaking strengths calculated from velocities adjusted for estimated soft tissue cover, measured bone mediolateral diameters and cannon diameters minus estimated soft tissue increased as quadratic functions of chronologic age (r greater than .840; P less than .0001). None of these variables was significantly affected by diet, leg or sex. These studies have demonstrated that the use of transmission ultrasonics to estimate and monitor metacarpal and metatarsal breaking strengths in the live horse is reliable, reproducible, simple, accurate and valid. They also suggest that NRC energy and protein recommendations meet the requirements for maximum bone growth and development in well-managed young equines.     

Holding Power of Orthopedic Screws in Equine Third Metacarpal and Metatarsal Bones: Part II. Adult Horse Bone

Comparison was made of the holding power of 5.5 and 4.5 mm cortical orthopedic screws inserted into third metacarpal and metatarsal cadaver bones from 3- and 8-year-old horses. The tensile strength of these screws was tested mechanically. In nine comparative trials of these screws, 5.5 mm screws pulled out of bone in five trials at an average of 116.0 kg tensile force and broke in four trials at an average of 1383.2 kg. A 4.5 mm screw pulled out of bone at 834.5 kg in one trial, and screws broke at an average of 849.2 kg in eight trials. The larger 5.5 mm screw required a significantly greater (p = 0.022) pullout force than the mean force at 4.5 mm screw breakage. Fixation failure was due to screw breakage or bone shear, with 5.5 mm screws occasionally creating bone fragmentation during pullout. The average tensile breaking strengths of the 5.5 mm screws (1391.4 kg) and 4.5 mm screws (832.7 kg) determined mechanically were similar to forces at screw breakage during pullout testing in bone. Since the 5.5 mm screws have greater holding power and tensile strength than 4.5 mm screws, the use of the 5.5 mm screw in fracture repair in adult horses is recommended.     

Comparison of two grafting methods in 4.0-mm drill defects in the third metacarpal bone of horses.

In 6 horses, bilateral metacarpal vertical series of three 4.0-mm unicortical drill holes were made. At random, one of each series of 3 holes was filled using a sternal 4.0-mm cancellous bone cylinder or a slurry of cancellous bone injected into the hole or left as an empty control. All horses had lateral metacarpal xeroradiographs at monthly intervals. Three horses (6 metacarpi) were examined post mortem after 4 months and 3 others after 6 months. Immediate through 4-month post-operative xeroradiographs demonstrated increased density in the holes with cancellous cylinders and no difference could be seen between the untreated controls and holes injected with slurry. From 5 months, no radiographic difference could be seen between the treatment groups. No consistent histological difference between treatment groups could be detected. In conclusion, no justification for clinical grafting of 4.0-mm unicortical dorsal metacarpal drill holes could be found.     

Metacarpal and metatarsal fractures in dogs

Metacarpal fractures were more common than metatarsal fractures in this retrospective study of 37 dogs. Fractures of one metacarpal or metatarsal bone occurred In 24 per cent of the dogs, two metacarpal bones in 16 per cent, three metacarpal or metatarsal bones in 19 per cent, and four metacarpal or metatarsal bones in 41 per cent. Eighty-seven per cent of the dogs with fractures of four bones had fracture displacement or malalignment of at least one digit. Progressive fracture healing usually occurred Irrespective of stabilisation method. For malaligned fractures, however, external coaptation did not consistently improve alignment. Fracture alignment was consistently Improved by open reduction and internal fixation of acute fractures with bone plates. Fractures of four bones occurred most often In the distal metacarpus as opposed to the proximal metatarsus. Therefore, open reduction and internal fixation may be more commonly indicated for severe metacarpal fractures, because fracture displacement or axial1 malalignment was significantly associated with fractures of the mid or distal regions of the metacarpus or metatarsus (P=0.052).     

High-intensity exercise of short duration alters bovine bone density and shape

The ability of short-duration high-intensity exercise to stimulate bone formation in confinement was investigated using immature Holstein bull calves as a model. Eighteen bull calves, 8 wk of age, were assigned to one of three treatment groups: 1) group-housed (GR, which served as a control), 2) confined with no exercise (CF), or 3) confined with exercise (EX). The exercise protocol consisted of running 50 m on a concrete surface once daily, 5 d/wk. Confined calves remained stalled for the 42-d duration of the trial. Blood samples were taken to analyze concentrations of osteocalcin and deoxypyridinoline, markers of bone formation and resorption. At the completion of the trial, calves were humanely killed, and both forelegs were collected. The fused third and fourth metacarpal bone was scanned using computed tomography for determination of cross-sectional geometry and bone mineral density. Three-point bending tests to failure were performed on metacarpal bones. The exercise protocol resulted in the formation of a rounder bone in EX as well as in increased dorsal cortex thickness compared with those in the GR and CF. The exercised calves had a significantly smaller medullary cavity than CF and GR (P < 0.01) and a larger percentage of cortical bone area than CF (P < 0.01). Dorsal, palmar, and total bone mineral density was greater in EX than in CF (P < 0.05), and palmar and total bone mineral densities were greater (P < 0.05) in EX than in GR. There was a trend for the bones of EX to have a higher fracture force than CF (P < 0.10). Osteocalcin concentrations normalized from d 0 were higher in EX than CF (P < 0.05). Therefore, the exercise protocol altered bone shape and seemed to increase bone formation comparison with the stalled and group-housed calves.     

The Effect of Hole Diameter on the Torsional Mechanical Properties of the Equine Third Metacarpal Bone

The torsional monotonic structural material properties of equine metacarpi with or without, either a 5/16 inch or 3/8 inch diameter bicortical lateromedial middiaphyseal hole were assessed to determine the effect of a hole on metacarpal strength. Torsional stiffness was not significantly effected by the presence of a bicortical hole, whereas yield and failure angles, torques and energies of metacarpi with a hole were 51% to 97% of those of intact bones. Significant differences were not apparent for yield and failure mechanical properties between metacarpi with a 5/16 inch diameter hole and metacarpi with a 3/8 inch diameter hole; however, postyield mechanical properties were lower for metacarpi with a 3/8 inch hole. Whereas some metacarpi with a 5/16 inch hole were capable of plastic deformation before failure, metacarpi with a 3/8 inch diameter hole appeared to have sufficient stress concentration to propagate complete fracture on structural yield.     

Core decompression of the equine navicular bone: an in vitro biomechanical study

Objective: To determine the effect of core decompression surgery and bone mineral density (BMD) on the mechanical properties of equine navicular bones. Study Design: Experimental, in vitro study. Sample Population: Fore limb navicular bones (n=36 pairs) from sound 2–5‐year‐old horses with no radiographic abnormalities of the distal aspect of the forelimbs. Methods: Navicular BMD was measured using dual energy X‐ray absorptiometry. One randomly assigned navicular bone from each pair served as control. The contralateral test specimen was allocated to 1 of 6 treatment groups defined by drill bit size (3.2 versus 2.5 mm diameter) and by the number of drill channels (1, 2, or 3) created in the proximal border of the bone. Bones were then tested until failure in 3‐point bending. Data were statistically analyzed using ANOVA and regression analysis. Results: There were significant (P<.001) positive correlations between BMD and biomechanical data. A significant (P<.001) reduction in breaking strength was noted between intact and drilled bone pairs; however, the diameter and number of decompression channels did not significantly (P>.05) influence the extent of the reduction in mechanical strength. Conclusion: In vitro core decompression significantly decreases the breaking strength of the equine navicular bone.     

An in vitro biomechanical comparison between prototype tapered shaft cortical bone screws and AO cortical bone screws for an equine metacarpal dynamic compression plate fixation of osteotomized equine third metacarpal bones

OBJECTIVES: To compare biomechanical properties of a prototype 5.5 mm tapered shaft cortical screw (TSS) and 5.5 mm AO cortical screw for an equine third metacarpal dynamic compression plate (EM-DCP) fixation to repair osteotomized equine third metacarpal (MC3) bones. STUDY DESIGN: Paired in vitro biomechanical testing of cadaveric equine MC3 with a mid-diaphyseal osteotomy, stabilized by 1 of 2 methods for fracture fixation. ANIMAL POPULATION: Adult equine cadaveric MC3 bones (n=12 pairs). METHODS: Twelve pairs of equine MC3 were divided into 3 groups (4 pairs each) for (1) 4-point bending single cycle to failure testing, (2) 4-point bending cyclic fatigue testing, and (3) torsional single cycle to failure testing. An EM-DCP (10-hole, 4.5 mm) was applied to the dorsal surface of each, mid-diaphyseal osteotomized, MC3 pair. For each MC3 bone pair, 1 was randomly chosen to have the EM-DCP secured with four 5.5 mm TSS (2 screws proximal and distal to the osteotomy; TSS construct), two 5.5 mm AO cortical screws (most proximal and distal holes in the plate) and four 4.5 mm AO cortical screws in the remaining holes. The control construct (AO construct) had four 5.5 mm AO cortical screws to secure the EM-DCP in the 2 holes proximal and distal to the osteotomy in the contralateral bone from each pair. The remaining holes of the EM-DCP were filled with two 5.5 mm AO cortical screws (most proximal and distal holes in the plate) and four 4.5 mm AO cortical screws. All plates and screws were applied using standard AO/ASIF techniques. Mean test variable values for each method were compared using a paired t-test within each group. Significance was set at P<.05. RESULTS: Mean 4-point bending yield load, yield bending moment, bending composite rigidity, failure load and failure bending moment of the TSS construct were significantly greater (P<.00004 for yield and P<.00001 for failure loads) than those of the AO construct. Mean cycles to failure in 4-point bending of the TSS construct was significantly greater (P<.0002) than that of the AO construct. The mean yield load and composite rigidity in torsion of the TSS construct were significantly greater (P<.0039 and P<.00003, respectively) than that of the AO construct. CONCLUSION: The TSS construct provides increased stability in both static overload testing and cyclic fatigue testing. CLINICAL RELEVANCE: The results of this in vitro study support the conclusion that the EM-DCP fixation using the prototype 5.5 mm TSS is biomechanically superior to the EM-DCP fixation using 5.5 mm AO cortical screws for the stabilization of osteotomized equine MC3.     

Magnetic resonance imaging findings in the carpus and proximal metacarpal region of 50 lame horses

Reasons for performing study: There is limited information on magnetic resonance imaging (MRI) findings in the carpus and proximal metacarpal region of lame horses. Objectives: To document MRI findings in horses with lameness localised to the carpus and/or proximal metacarpal region. Methods: Clinical records of horses that underwent MRI of the carpus and/or proximal metacarpal region at the Animal Health Trust between January 2003 and September 2010 were reviewed. Magnetic resonance images of all horses and available radiographs, ultrasonographic and scintigraphic images were assessed. When possible, MRI findings were related to the results of other diagnostic imaging techniques. Results: Seventy‐two MR studies of 58 lame limbs in 50 horses from a broad range of work disciplines and ages were reviewed. The most commonly detected primary abnormality was decreased signal intensity in T1‐ and T2‐weighted images in the medial aspect of the carpal bones and/or the proximomedial aspect of the metacarpal bones (n = 29). Nine horses had syndesmopathy between the second and third metacarpal bones. In 6 horses the primary abnormalities were identified in the palmar cortex of the third metacarpal bone (McIII). Significant abnormalities of the suspensory ligament (SL) with associated lesions in the adjacent palmar cortex of the McIII were seen in 4 limbs. Ligament and associated osseous abnormalities between the second and third carpal bones and second and third metacarpal bones were detected in 4 limbs. Conclusions and potential relevance: Magnetic resonance imaging enabled diagnosis of a variety of lesions not detected by conventional imaging in horses from a wide range of work disciplines. The distribution of injury types differed considerably from previous studies.     

A Biomechanical Comparison of Headless Tapered Variable Pitch and AO Cortical Bone Screws for Fixation of a Simulated Lateral Condylar Fracture in Equine Third Metacarpal Bones

OBJECTIVE: To compare drilling, tapping, and screw-insertion torque, force, and time for the 4.5-mm AO and 6.5-mm Acutrak Plus (AP) bone screws, and to compare the mechanical shear strength and stiffness of a simulated complete lateral condylar fracture of the equine third metacarpal bone (MC3) stabilized with either an AO or AP screw. STUDY DESIGN: In vitro biomechanical assessment of screw-insertion variables, and shear failure tests of a bone-screw-stabilized simulated lateral condylar fracture. SAMPLE POPULATION: Eight pairs of cadaveric equine MC3s METHODS: Metacarpi were placed in a fixture and centered on a biaxial load cell in a materials-testing system to measure torque, compressive force, and time for drilling, tapping, and screw insertion. Standardized simulated lateral condylar fractures were stabilized by either an AO or AP screw and tested in shear until failure. A paired t test was used to assess differences between screws, with significance set at P < .05. RESULTS: Insertion and mechanical shear testing variables were comparable for AO and AP insertion equipment and screws. CONCLUSION: The 6.5-mm tapered AP screw can be inserted in equine third metacarpal condyles and is mechanically comparable with the 4.5-mm AO screw for fixation of a simulated lateral condylar fracture. CLINICAL RELEVANCE: Considering the comparable mechanical behavior, the potential for less-persistent soft-tissue irritation with the headless design, and the ability to achieve interfragmentary compression by inserting the screw in one hole drilled perpendicular to the fracture plane, the 6.5-mm tapered AP screw may be an attractive alternative for repair of incomplete lateral condylar fractures in horses.