title: Proximal interphalangeal joint arthrodesis using a combination plate-screw technique in 53 horses (1994-2003).
abstract: BACKGROUND
  A method for proximal interphalangeal joint (PIP joint) arthrodesis that provides a stable fixation and minimal duration of cast support is evaluated retrospectively.
  
  
  OBJECTIVE
  Evaluate the clinical use of a combined plate-screw method for PIP joint arthrodesis in a large number of horses.
  
  
  METHODS
  The records of 53 horses undergoing PIP joint arthrodesis were reviewed. Arthrodesis was performed with a dorsally placed 3-, 4- or 5-hole narrow dynamic compression plate (DCP) with 2 transarticular cortex screws placed in lag fashion either side of the plate. Subject details, clinical presentation, radiographic findings, surgical technique, post operative treatment and complications were recorded. Long-term follow up (mean 3 years) was obtained for 46 horses.
  
  
  RESULTS
  Arthrodesis procedures (n = 58) were performed on 53 horses with a DCP in combination with transarticular cortex screws placed in lag fashion. Conditions treated were osteoarthritis (OA) of the PIP joint, fracture of middle phalanx, PIP joint subluxation, subchondral cystic lesions and degenerative joint disease secondary to sepsis. Time of post operative cast application was 14 days. Overall 40/46 (87%) horses could be used as intended including 20/25 (81%) forelimb and 20/21 (95%) hindlimb arthrodeses. Twenty-three of 27 (85%) horses used for performance had successful outcomes. Complications included implant infection, cast sores and partial implant failure.
  
  
  CONCLUSIONS
  PIP joint arthrodesis using a DCP and transarticular cortex screws placed in lag fashion provides a stable construct and short casting period with minimal complications. The prognosis for return to performance was excellent for horses treated with hindlimb PIP joint arthrodesis and good for forelimb arthrodesis.
  
  
  CONCLUSIONS
  Use of a combination technique for PIP joint arthrodesis allows a high proportion of horses with pastern joint disease to be returned to their athletic potential.
authors.affiliation: Department of Large Animal Medicine and Surgery, College of Veterinary Medicine, Texas A&M University, College Station, Texas 77843, USA.
authors.forename: P M
authors.initials: PM
authors.lastname: Knox
authors.forename: J P
authors.initials: JP
authors.lastname: Watkins
mesh_terms: D000818:Animals; D001174:Arthrodesis / Q000379:methods / Q000662:veterinary*; D001860:Bone Plates / Q000662:veterinary; D001863:Bone Screws / Q000662:veterinary; D002370:Casts, Surgical / Q000662:veterinary; D005260:Female; D005552:Forelimb; D006614:Hindlimb; D006734:Horse Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D006736:Horses; D007592:Joint Diseases / Q000000981:diagnostic imaging / Q000601:surgery / Q000662:veterinary*; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology / Q000662:veterinary*; D011379:Prognosis; D011859:Radiography; D012189:Retrospective Studies; D014033:Toe Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome