Jeremy D. Hubert

In vitro biomechanical comparison of locking compression plate fixation and limited-contact dynamic compression plate fixation of osteotomized equine third metacarpal bones.

OBJECTIVE To compare monotonic biomechanical properties and fatigue life of a broad locking compression plate (LCP) fixation with a broad limited contact dynamic compression plate (LC-DCP) fixation to repair osteotomized equine third metacarpal (MC3) bones. STUDY DESIGN In vitro biomechanical testing of paired cadaveric equine MC3 with a mid-diaphyseal osteotomy, stabilized by 1 of 2 methods for fracture fixation. ANIMAL POPULATION Cadaveric adult equine MC3 bones (n=12 pairs). METHODS MC3 were divided into 3 groups (4 pairs each) for: (1) 4-point bending single cycle to failure testing; (2) 4-point bending cyclic fatigue testing; and (3) torsional single cycle to failure testing. The 8-hole, 4.5 mm LCP was applied to the dorsal surface of 1 randomly selected bone from each pair. One 8-hole, 4.5 mm LC-DCP) was applied dorsally to the contralateral bone from each pair. All plates and screws were applied using standard ASIF techniques. All MC3 bones had mid-diaphyseal osteotomies. Mean test variable values for each method were compared using a paired t-test within each group. Significance was set at P<.05. RESULTS Mean yield load, yield bending moment, composite rigidity, failure load and failure bending moment, under 4-point bending, single cycle to failure, of the LCP fixation were significantly greater than those of the LC-DCP fixation. Mean cycles to failure for 4-point bending was significantly greater for the LCP fixation compared with LC-DCP fixation. Mean yield load, mean composite rigidity, and mean failure load under torsional testing, single cycle to failure was significantly greater for the broad LCP fixation compared with the LC-DCP fixation. CONCLUSION The 4.5 mm LCP was superior to the 4.5 mm LC-DCP in resisting the static overload forces (palmarodorsal 4-point bending and torsional) and in resisting cyclic fatigue under palmarodorsal 4-point bending. CLINICAL RELEVANCE The results of this in vitro study may provide information to aid in the selection of a biological plate for the repair of equine long bone fractures.

Effects of Extracorporeal Shock Wave Therapy on Desmitis of the Accessory Ligament of the Deep Digital Flexor Tendon in the Horse

OBJECTIVE To evaluate the effects of extracorporeal shock wave therapy (ESWT) on collagenase-induced lesions in the accessory ligament of the deep digital flexor tendon (ALDDFT) of horses. STUDY DESIGN Paired, blinded controlled study. ANIMALS Eight Thoroughbred horses (3 mares, 5 geldings; mean ± SD weight, 464 ± 26 kg, mean age, 8 ± 1.7 years). METHODS Lesions were created in both ALDDFTs of all horses by injection of 2 × 10(3) IU of collagenase type I. Percent lesion and structure (fiber alignment and echogenicity) were quantified with ultrasonographic imaging 3, 6, and 9 weeks after collagenase injection. After ultrasound examinations, ESWT (1000 shocks at 0.15 mJ/mm2) was applied to 1 ALDDFT in each horse. ALDDFT were harvested 15 weeks after collagenase injection and the microstructure, mRNA levels of collagen types I and III, and collagen and glycosaminoglycan content were evaluated. RESULTS There were no differences in percent lesion, echogenicity, or fiber alignment between control- and ESWT-treated ligaments at each evaluation time; however, compared with 3-week values, there was a significant increase in percent lesion and echogenicity for EWST treated ligaments at 6 weeks and significant decrease in both variables for treated and control ligaments at 12 weeks. Fiber alignment improved significantly at 9 weeks in controls and at 12 weeks in treated and control ligaments. Collagen type I mRNA levels were significantly higher in the ESWT treatment group compared with the control group 15 weeks after collagenase injection though differences in other mRNA levels, microstructure, and composition were not significant. CONCLUSIONS Our results do not support an effect of ESWT on collagenase-induced lesions in the equine ALDDFT.

The effects of Strongylus vulgaris parasitism on eosinophil distribution and accumulation in equine large intestinal mucosa

REASONS FOR PERFORMING STUDY Eosinophilic granulocytes have been associated with parasite or immune-mediated diseases, but their functions in other disease processes remain unclear. Cause and timing of eosinophil migration into the equine gastrointestinal mucosa are also unknown. OBJECTIVE To determine the effects of intestinal parasitism on eosinophils in equine large intestinal mucosa. METHODS Large intestinal mucosal samples were collected from horses and ponies (n = 16) from the general veterinary hospital population, ponies (n = 3) raised in a parasite-free environment, ponies experimentally infected with 500 infective Strongylus vulgaris larvae and treated with a proprietary anthelmintic drug (n = 14), and a similar group of ponies (n = 7) that received no anthelmintic treatment. Total eosinophil counts and eosinophil distribution in the mucosa were determined by histological examination. A mixed model analysis was performed and appropriate Bonferroni adjusted P values used for each family of comparisons. P<0.05 was considered significant. RESULTS There was no difference in large intestinal mucosal eosinophil counts and eosinophil distribution between ponies infected with S. vulgaris and those raised in a parasite-free environment. Experimental infection with S. vulgaris, with or without subsequent anthelmintic treatment, did not change eosinophil counts, and counts were similar to those for horses from the general population. CONCLUSIONS Migration of eosinophils to the equine large intestinal mucosa appears to be independent of exposure to parasites. Large intestinal mucosal eosinophils may have more functions in addition to their role in defence against parasites.

An in vitro biomechanical comparison of a 5.5 mm limited-contact dynamic compression plate fixation with a 4.5 mm limited-contact dynamic compression plate fixation of osteotomized equine third metacarpal bones.

OBJECTIVES To compare monotonic biomechanical properties and fatigue life of a 5.5 mm broad limited-contact dynamic compression plate (5.5-LC-DCP) fixation with a 4.5 mm broad LC-DCP (4.5-LC-DCP) fixation to repair osteotomized equine third metacarpal (MC3) bones. STUDY DESIGN In vitro biomechanical testing of paired cadaveric equine MC3 with a mid-diaphyseal osteotomy, stabilized by 1 of 2 methods for fracture fixation. SAMPLE POPULATION Adult equine cadaveric MC3 bones (n=18 pair). METHODS MC3 were divided into 3 test groups (6 pairs each) for: (1) 4-point bending single cycle to failure testing; (2) 4-point bending cyclic fatigue testing; and (3) torsional single cycle to failure testing. The 8-hole, 5.5 mm broad LC-DCP (5.5-LC-DCP) was applied to the dorsal surface of 1 randomly selected bone from each pair. One 8-hole, 4.5 mm broad LC-DCP (4.5-LC-DCP) was applied dorsally to the contralateral bone from each pair. Plates and screws were applied using standard ASIF techniques. All MC3 bones had mid-diaphyseal osteotomies. Mean test variable values for each method were compared using a paired t-test within each group. Significance was set at P<.05. RESULTS Mean yield load, yield bending moment, composite rigidity, failure load and failure bending moment under 4-point bending, single cycle to failure, of the 5.5-LC-DCP fixation were significantly greater (P<.024) than those of the 4.5-LC-DCP fixation. Mean cycles to failure for 4-point bending was significantly (P<.05) greater for the 4.5-LC-DCP fixation compared with the 5.5-LC-DCP fixation. Mean yield load, mean composite rigidity, and mean failure load in torsion for the 5.5-LC-DCP fixation was not significantly different (P>.05) than those with the 4.5-LC-DCP fixation. CONCLUSION 5.5-LC-DCP fixation was superior to 4.5-LC-DCP fixation in resisting the static overload forces under palmarodorsal 4-point bending. There was no significant difference between 5.5-LC-DCP fixation and 4.5-LC-DCP fixation in resisting static overload forces under torsion; however, the 5.5-LC-DCP offers significantly less stability (80% of that of the 4.5-LC-DCP) in cyclic fatigue testing. CLINICAL RELEVANCE The results of this in vitro study may provide information to aid in the selection of a biological plate for long bone fracture repair in horses.

An In Vitro Biomechanical Comparison of Equine Proximal Interphalangeal Joint Arthrodesis Techniques: An Axial Positioned Dynamic Compression Plate and Two Abaxial Transarticular Cortical Screws Inserted in Lag Fashion Versus Three Parallel Transarticular Cortical Screws Inserted in Lag Fashion

OBJECTIVES To compare in vitro monotonic biomechanical properties of an axial 3-hole, 4.5 mm narrow dynamic compression plate (DCP) using 5.5 mm cortical screws in conjunction with 2 abaxial transarticular 5.5 mm cortical screws inserted in lag fashion (DCP-TLS) with 3 parallel transarticular 5.5 mm cortical screws inserted in lag fashion (3-TLS) for the equine proximal interphalangeal (PIP) joint arthrodesis. STUDY DESIGN Paired in vitro biomechanical testing of 2 methods of stabilizing cadaveric adult equine forelimb PIP joints. SAMPLE POPULATION Cadaveric adult equine forelimbs (n=15 pairs). METHODS For each forelimb pair, 1 PIP joint was stabilized with an axial 3-hole narrow DCP (4.5 mm) using 5.5 mm cortical screws in conjunction with 2 abaxial transarticular 5.5 mm cortical screws inserted in lag fashion and 1 with 3 parallel transarticular 5.5 mm cortical screws inserted in lag fashion. Five matching pairs of constructs were tested in single cycle to failure under axial compression, 5 construct pairs were tested for cyclic fatigue under axial compression, and 5 construct pairs were tested in single cycle to failure under torsional loading. Mean values for each fixation method were compared using a paired t-test within each group with statistical significance set at P<.05. RESULTS Mean yield load, yield stiffness, and failure load under axial compression and torsion, single cycle to failure, of the DCP-TLS fixation were significantly greater than those of the 3-TLS fixation. Mean cycles to failure in axial compression of the DCP-TLS fixation was significantly greater than that of the 3-TLS fixation. CONCLUSION The DCP-TLS was superior to the 3-TLS in resisting the static overload forces and in resisting cyclic fatigue. CLINICAL RELEVANCE The results of this in vitro study may provide information to aid in the selection of a treatment modality for arthrodesis of the equine PIP joint.

Quantitative analysis of scintigraphic findings in tibial stress fractures in Thoroughbred racehorses

OBJECTIVE To develop a quantitative method of interpreting tibial scintigrams of Thoroughbred racehorses with tibial stress fractures that may facilitate diagnosis of fractures and to provide prognostic information regarding future performance of affected horses. ANIMALS 35 Thoroughbred racehorses. PROCEDURES Static bone-phase scintigrams of tibial stress fractures were quantitatively analyzed by use of ratios of the mean radionuclide counts per pixel in a region of interest (ROI) drawn around the area of increased uptake of radiopharmaceutical to mean counts per pixel in a second ROI drawn around an apparently normal area of the tibial diaphysis. In horses with unilateral fractures, ratios for the contralateral tibia were determined by use of 2 ROIs drawn at the same positions as the ROIs in the fractured tibia. Ratios were compared between fractured versus apparently normal tibias, between horses that returned to racing versus those that did not, and among horses with various grades of lameness. The association between ratios for fractured tibias and intervals between diagnosis and return to racing was also assessed. RESULTS Mean ratio of ROIs in apparently normal tibias was 1.35 (95% confidence interval [CI], 1.21 to 1.50); that in tibias with stress fractures was 3.55 (95% CI, 2.50 to 4.60). These ratios were significantly different. None of the associations between ratios for fractured tibias and grades of lameness or performance outcomes were significant. CONCLUSIONS AND CLINICAL RELEVANCE Tibial stress fracture scintigrams can be quantitatively analyzed. A prospective study with a controlled rehabilitation period is necessary to evaluate the possible applications of this method.