Introduction

• The proximal interphalangeal joint is a low-motion joint amenable to fusion to overcome lameness and pain associated with degenerative joint disease   Musculoskeletal: osteoarthritis (joint disease)  .
• Arthrodesis provides a rapid resolution of the problem affording an earlier return to exercise.

Uses

• Degenerative joint disease of the pastern joint   Musculoskeletal: osteoarthritis (joint disease)  .
• Fractures of the proximal phalanx   Proximal phalanx: fracture  .
• Fractures of the middle phalanx   Middle phalanx: fracture  .
• Luxation of the proximal interphalangeal joint.

Advantages

• Choice of lag screw   Bone: internal fixation - screws  and/or plate   Bone: internal fixation - plates  fixation.

Disadvantages

• Change in biomechanics following surgery, particularly in the forelimb, may predispose to osteoarthritis in the distal interphalangeal joint.

Requirements

Preparation

Procedure

Aftercare

Outcomes

Prognosis

• Good - for athletic use if performed in the hindlimbs.
• Guarded - for forelimbs.
• Horse may be only useful for breeding.

Further Reading

Publications

Refereed papers

• Recent references from PubMed and VetMedResource.
• Levine D G & Richardson D W (2007) Clinical use of the locking compression plate (LCP) in horses: a retrospective study of 31 cases (2004-2006). Equine Vet J 39 (5), 401-406 PubMed.
• Watts A E, Fortier L A & Caldwell F J (2007) Proximal interphalangeal joint arthrodesis in a one-mouth-old foal for superficial digital flexor tendon and straight sesamoidean ligament disruption. Equine Vet Educ 19 (8), 407-412 WileyOnline.
• Knox P M & Watkins J P (2006) Proximal interphalangeal joint arthrodesis using a combination plate-screw technique in 53 horses (1994-2003). Equine Vet J 38 (6), 538-542 PubMed.
• Galuppo L D, Stover S M & Willits N H (2000) A biomechanical comparison of double-plate and Y-plate fixation for comminuted equine second phalangeal fractures. Vet Surgery 29, 152-162 PubMed.
• Crabill M R et al (1995) Double-plate fixation of comminuted fractures of the 2nd phalanx in horses - 10 cases (1985-1993). JAVMA 207 (11), 1458 PubMed.
• Caron J P et al (1990) Proximal interphalangeal arthrodesis in the horse. A retrospective study and a modified screw technique. Vet Surg 19 (3), 196-202 PubMed.
• Shiroma J T et al (1989) Dorsal subluxation of the proximal interphalangeal joint in the pelvic limb of three horses. JAVMA 195 (6), 777-779 PubMed.

Other sources of information

• Watkins J P (1996) Fractures of the middle phalanx. In: Equine Fracture Repair. Ed: A J Nixon. W B Saunders, USA.