Proximal phalanx: simple - Complications and results
1. Authors
Larry R. Bramlage
This text is taken from G.E. Fackelman, J.A. Auer, D.M. Nunamaker: AO Principles of Equine Osteosynthesis
2. Complications
With proper attention to detail, complications are rare. Common technique errors include: failure to properly locate the screws, thus reducing the quality of the fixation or endangering the joint or soft tissues; failure to adequately countersink the screw head, resulting in bending; failure to adequately engage the transcortex, with stripping of the threads from the bone; and failure to maintain aseptic technique resulting in postoperative infection. Even with a less than ideal technique, healing is often still attainable.
Degenerative arthritis is rare, but painful non-union of the articular surface of the fetlock can occur if adequate compression is not achieved.
3. Results
The prognosis for resumption of athletic activity after internal fixation of simple proximal phalanx fractures is excellent. More complicated fractures carry a more grave prognosis commensurate with their severity.
4. Bibliography
[1] Barr AR, Denny HR, Waterman AE, et al. (1988)
Proximal phalangeal fractures in the horse.
Vet Comp Ortho Trauma; 2:86.
[2] Ellis DR, Simpson OJ, Greenwood RE, et al. (1987)
Observations and management of fractures of the proximal phalanx in young Thoroughbreds.
Equine Vet J; 19:43--49.
[3] Fackelman GE (1973)
Sagittal fractures of the first phalanx (P1) in the horse; Fixation by the lag screw principle.
VM/SAC; 68:622.
[4] Gabel AA, Bukowiecki CF (1983)
Fractures of the phalanges.
Vet Clin North Am [Large Anim Pract]; 5:233- 260.
[5] Markel MD, Richardson DW (1985)
Non-comminuted fractures of the proximal phalanx in 69 horses.
J Am Vet Med Assoc; 186: 573.
