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In vitro comparison of linear vs triangular screw configuration to stabilize complete uniarticular parasagittal fractures of the proximal phalanx in horses


Citation

Labens, Raphael and Khairuddin, Nurul Hayah and Jermyn, Kieri and Syed Waseem Ahmad, Sharifah Roohi (2019) In vitro comparison of linear vs triangular screw configuration to stabilize complete uniarticular parasagittal fractures of the proximal phalanx in horses. Veterinary Surgery, 48 (1). pp. 96-104. ISSN 0161-3499; ESSN: 1532-950X

Abstract

Objective To assess fracture gap reduction and stability of linear vs triangular 4.5‐mm lag screw repair of experimental, uniarticular, and complete forelimb proximal phalanx (P1) fractures. Study design Experimental. Sample population Fourteen equine cadaver limbs/horses. Methods Simulated fractures were repaired with 2 lag screws under 4‐Nm insertion torque (linear repair). Computed tomography (CT) imaging was performed with the leg unloaded and loaded to forces generated while walking. The fracture repair was revised to include 3 lag screws placed with the same insertion torque (triangular repair) prior to CT. The width of the fracture gap was assessed qualitatively by 2 observers and graded on the basis of gap measurements relative to the average voxel size at dorsal, mid, and palmar P1 sites. Interobserver agreement was assessed with Cohen's κ. The effect of repair type, loading condition, and measurement site on fracture gap grades was evaluated by using Kendall's τ‐b correlation coefficients and paired nonparametric tests. Significance was set at P ≤ .05. Results Agreement between loading and fracture gap widening was fair in triangular (κ = 0.53) and excellent in linear (κ = 0.81) repairs. Loading resulted in fracture gap distraction in linear repairs (Plinear = .008). Triangular repairs reduced fractures better irrespective of loading (Punloaded = .003; Ploaded < .001). The type of repair was not correlated with fracture gap grades at unloaded mid and loaded dorsal P1 sites. Conclusion Repair of uniarticular complete parasagittal fractures with a triangular screw configuration improved in vitro fracture gap reduction and stability. Clinical significance Triangular lag screw repair likely improves biomechanical conditions during postoperative weight bearing.


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Additional Metadata

Item Type: Article
Divisions: Faculty of Medicine and Health Science
Faculty of Veterinary Medicine
DOI Number: https://doi.org/10.1111/vsu.13123
Publisher: Wiley-Blackwell Publishing
Keywords: Linear; Triangular screw
Depositing User: Azhar Abdul Rahman
Date Deposited: 02 Oct 2020 08:41
Last Modified: 02 Oct 2020 08:41
Altmetrics: http://altmetrics.com-details.php?domain=psair.upm.edu.my&doi=10.1111/vsu.13123
URI: http://psasir.upm.edu.my/id/eprint/80221
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