title: A tapered-sleeve transcortical pin external skeletal fixation device for use in horses: development, application, and experience.
abstract: OBJECTIVE
  To report development, configuration, application, and results of a tapered-sleeve transcortical pin external skeletal fixation device (TSP ESFD) for use on fractures of the distal aspect of the equine limb.
  
  
  METHODS
  Optimization analysis of a TSP ESFD was carried out with mechanical testing and review of clinical case outcomes.
  
  
  METHODS
  Cadaveric adult third metacarpal bones (MC3) for mechanical testing; horses (n=7) with severely comminuted proximal (6; P1) or second (1) phalanx fractures.
  
  
  METHODS
  Mechanical testing of methods for attachment of TSP to the sidebars were tested as well as optimization of pin diameters. Outcome of clinical cases managed with the TSP ESFD were compared with outcomes of horses treated with previous ESFD.
  
  
  RESULTS
  A TSP ESFD using 7.94 mm diameter pins was used. Survival rate was 71%. One horse with an infected P1 fracture and contralateral laminitis subsequently fractured MC3 through the distal pin hole while wearing the TSP ESFD. One mare with contralateral laminitis was euthanatized. Three horses had open fractures.
  
  
  CONCLUSIONS
  Design improvements incorporated into the TSP ESFD should increase treatment success.
  
  
  CONCLUSIONS
  External skeletal fixation continues to be a viable treatment alternative for severe injuries of the distal aspect of the equine limb. TSP ESFD should improve on the success of treatment by decreasing complications of bone fracture at the pin interface.
authors.affiliation: Richard S. Reynolds, Jr. Comparative Orthopedic Research Laboratory, Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19348, USA. dmn@vet.upenn.edu
authors.forename: David M
authors.initials: DM
authors.lastname: Nunamaker
authors.forename: Ronald A
authors.initials: RA
authors.lastname: Nash
mesh_terms: D000818:Animals; D001696:Biomechanical Phenomena; D001858:Bone Nails / Q000662:veterinary*; D005121:Extremities / Q000601:surgery; D005260:Female; D005592:Fracture Fixation / Q000295:instrumentation / Q000379:methods / Q000662:veterinary*; D017102:Fracture Healing; D050723:Fractures, Bone / Q000601:surgery / Q000662:veterinary*; D005597:Fractures, Open / Q000601:surgery / Q000662:veterinary; D006736:Horses / Q000293:injuries* / Q000601:surgery*; D008297:Male; D008422:Materials Testing / Q000662:veterinary; D050279:Metacarpal Bones / Q000293:injuries / Q000601:surgery; D016019:Survival Analysis; D050277:Toe Phalanges / Q000293:injuries / Q000601:surgery; D016896:Treatment Outcome