Authors of section

Author

Anton Fürst

Executive Editor

Jörg Auer

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Plate fixation

1. Principles/General considerations

There are few reports describing surgical treatment of sacral fractures in horses.

In most horses the fractures are closed, but open fractures can occur.

coccygeal

2. Preparation and approach

This procedure is performed with the patient standing through the dorsal midline approach to the coccygeal region.

plate fixation

3. Reduction

Pointed reduction forceps can be used for realignment of the fragments.

plate fixation

4. Fixation

Plate selection

Plates and pins can be used. The use of the locking compression plate (LCP) is preferred for fracture fixation of the vertebrae. According to the size of the patient, a small or broad 3.5/4.0 or 4.5/5.0mm LCP is used.

plate fixation with atlantoaxial arthrodesis

Plate preparation

Only minimal plate contouring is needed to fit the anatomical shape of the vertebra.

Accurate contouring of locking compression plates is not necessary, but it improves the closure of the soft tissue over the plate.

plate fixation

Plate application

With the reduction forceps in position, the appropriately sized plate is applied on the dorsal spinous process.

plate fixation

Locking-head screws are inserted into the dorsal cortex of the involved coccygeal vertebrae.

coccygeal

5. Closure

The subcutaneous tissues and skin are closed.

A stent bandage is applied and covered with an adhesive barrier drape to keep the incision clean and dry during recovery.

plate fixation

6. Aftercare

Following surgery, antibiotics and NSAIDs are routinely administered for 3 days. If indicated, they need to be continued.

Routinely follow up radiographs are taken immediately after surgery and after 2 and 4 months.

The rehabilitation protocol includes 2 months of stall confinement, followed by 1 month of hand-walking, and 2 months of progressive exercise.

Only when the ataxia has completely disappeared, the horse can return to training or other activities.

plate fixation with atlantoaxial arthrodesis

Implant removal

There is no need for implant removal, except in cases of implant loosening or surgical site infection.