Use of a modified transfixation pin cast for treatment of comminuted phalangeal fractures in horses

Authors
Fabrice Rossignol, Amélie Vitte and Josef Boening
Date
January 2014
Journal
Veterinary Surgery
Volume
43
Number
1
Pages
66-72

Objectives

To (1) report a modified transfixation pin cast technique, using dorsal recumbency for fracture reduction, distal positioning of the pins in the epiphysis and distal metaphysis, and a hybrid cast, combining plaster of Paris (POP) and fiberglass casting, and (2) report outcome in 11 adult horses.
Study Design

Case series.
Animals

Adult horses (n = 11) with comminuted phalangeal fractures.
Methods

Horses were anesthetized and positioned in dorsal recumbency. The phalangeal fracture was reduced by limb traction using a cable attached to the hoof. Screw fixation in lag fashion of fracture fragments was performed when possible. Transfixation casting was performed using two 6.3 mm positive profile centrally threaded pins with the 1st pin placed in the epiphysis of the metacarpus/tarsus at the center of, or slightly proximal to, the condylar fossa and the 2nd one 3–4 cm proximal. A hybrid cast was applied.
Results

Forelimbs were involved in 9 horses and the hind limb in 2. Pins were maintained for a minimum of 6 weeks. No pin loosening was observed at the time of removal (6–8 weeks). A pony fractured the distal aspect of the metacarpus at the proximal pin. Nine horses survived (82%); none of the horses developed septic arthritis despite the distal location of the distal pin, close to the fetlock joint.
Conclusion

This modified transfixation pin casting technique was associated with good pin longevity and could reduce the risk of secondary pin hole fractures and pin loosening.