Arthrodesis Techniques for Equine Proximal Interphalangeal Joints
Summary
Arthrodesis of the proximal interphalangeal joint in the horse is a well‐established surgical intervention aimed at obliterating a painful or unstable joint by achieving bony fusion between the first and second phalanges. Indications encompass chronic osteoarthritis unresponsive to conservative management, acute articular fractures, and severe soft-tissue injury compromising joint integrity. Techniques vary from open joint debridement with cartilage removal and subchondral bone preparation to minimally invasive percutaneous drilling. Stabilisation methods include dynamic compression plates, locking compression plates and lag screws, often supplemented by external coaptation. The choice of implant and approach is influenced by lesion chronicity, limb conformation and desired postoperative load-bearing timeline. Meticulous cartilage excision and subchondral bone stimulation are essential to promote osteogenesis, while implant configuration must resist the substantial bending and torsional forces of the distal limb. Postoperative management typically involves extended stall rest, bandaging or casting to support fusion and regular radiographic monitoring. Advances in imaging and intraoperative guidance have refined implant placement, minimised soft-tissue trauma and reduced complication rates. Despite these improvements, potential adverse outcomes include implant failure, infection and contralateral limb laminitis, underscoring the importance of case selection and surgeon expertise. Globally, arthrodesis remains a critical technique to restore equine comfort and function where salvage is the primary goal.
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Arthrodesis Techniques for Equine Proximal Interphalangeal Joints publication trend
The graph below shows the total number of articles in arthrodesis techniques for equine proximal interphalangeal joints across all publications each year (not limited to Nature Index journals).
Technical terms
Arthrodesis: Surgical fusion of a joint by removal of articular cartilage and stabilisation of opposing bone surfaces to induce osteogenesis.
Proximal interphalangeal joint (PIPJ): The pastern joint between the first and second phalanges of the equine digit, critical for weight-bearing and locomotion.
Dynamic compression plate (DCP): A metallic plate that applies axial compression across bone segments via eccentrically placed screws.
Locking compression plate (LCP): A plate‐and‐screw system where threaded screw heads lock into the plate, creating a fixed‐angle construct.
Lag screw: A screw placed to draw two bone fragments together, converting shear forces into compressive forces at the fusion site.
Percutaneous drilling: A minimally invasive technique using small skin incisions and a drill to remove cartilage and prepare subchondral bone for arthrodesis.
References
- The Comparison of Latero-Medial versus Dorso-Palmar/Plantar Drilling for Cartilage Removal in the Proximal Interphalangeal Joint. Animals (2021).
- Proximal interphalangeal arthrodesis in seven horses: A retrospective study in Brazil (2011-2019). Ciência Rural (2021).
- Proximal interphalangeal joint arthrodesis in a case of chronic proliferative osteoarthritis in the horse – a case report. Acta Veterinaria Brno (2021).
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