Comparison of Three Drilling Techniques for Carpometacarpal Joint Arthrodesis in Horses

Authors: 
HAYLEY M. LANG 1 , LUCA PANIZZI, Dr Med Vet 1 , ANDREW L. ALLEN, DVM, MVetSc, PhD 1 , MURRAY R. WOODBURY, DVM, MSc 1 , and SPENCER M. BARBER, DVM, Diplomate ACVS 1
Volume: 
38
Number: 
8
Pages: 
990 - 997
Journal: 
Veterinary Surgery
Date: 
December 2009

Objective: To evaluate 3 drilling techniques for arthrodesis of the equine carpometacarpal (CMC) joint.

Study Design: Experimental study.

Sample Population: Cadaveric equine forelimbs (n=15).

Methods: Limbs were divided into 3 groups (5 limbs each) to evaluate 3 drilling techniques: (1) use of a 4.5 mm drill bit inserted into the joint through 4 entry points and moved in a fanning motion; (2) a 5.5 mm drill bit inserted through 2 entry points to create 3 nonfanned drill tracts (3 drill technique); and (3) a 4.5 mm drill bit used in a 3 drill technique. The CMC joint was disarticulated after drilling, and cartilage and subchondral bone damage evaluated visually and by gross and microradiographic examination using planimetry.

Results: Technique 1 produced significantly more damage of the proximal surface, but significantly less to the subchondral bone of the distal surface. Technique 1 produced the most damage to both the articular cartilage and subchondral bone of the total CMC joint than either of the 3 drill tract techniques; however, the difference between techniques 1 and 2 was not significant. Damage from technique 3 was significantly less than that with techniques 1 or 2.

Conclusions: Techniques 1 and 2 produced the most cartilage and subchondral bone damage with technique 2 changes more equally distributed between proximal and distal joint surfaces.

Clinical Relevance: Technique 1 (fanning) and 2 (5.5 mm 3 drill tracts) may be preferable to achieve arthrodesis of the CMC joint. Morbidity and efficacy of these arthrodesis techniques need to be evaluated in vivo.

Large animal: