Minimally invasive plate fixation of lower limb injury in horses: 32 cases (1999-2003)

Reasons for performing study: Complications of osteosynthesis including superficial and deep infections continue to affect adversely outcome in equine surgery of the lower limb. Objective: To describe a technique for minimally invasive plate fixation in horses and evaluate clinical results of the technique. Hypothesis: Lower complication rates would occur in horses treated with a minimally invasive approach compared with conventional techniques. Methods: Cases of minimally invasive plate fixation from January 1999 to December 2003 were evaluated. Case records, radiographs and race records for horses that sustained distal third metacarpal/metatarsal (Me/tIII) condylar fractures were assessed. Follow-up information was obtained and results analysed. In addition, results for horses that received arthrodesis by a conventional, open approach during the same period were evaluated and statistical analysis was performed. Results: Thirty-two cases of minimally invasive plate fixation were identified (22 incomplete distal Mc/tIII condyllar fractures with a spiralling or diaphyseal component, 10 metacarpophallangeal arthrodeses and 4 pastern arthrodeses). For both types of arthrodesis, surgery times and infection rates were lower and survival rates higher in the minimally invasive group, but no statistical difference was found. Spiralling condyllar fractures were successfully managed, without catastrophic fracture. Conclusions and potential relevance: Minimally invasive percutaneous plate osteosynthesis (MIPPO) can be successfully used for select applications in horses, and may reduce morbidity and mortality in equine fracture repair.