Equine ulnar fracture repair with locking compression plates can be associated with inadvertent penetration of the lateral cortex of the radius

Authors
Jan M. Kuemmerle, Karolin Kühn, Marco Bryner and Anton E. Fürst
Date
October 2013
Journal
Veterinary Surgery
Volume
42
Number
7
Pages
790-794

Abstract
Objective

To evaluate if the use of locking head screws (LHS) in the distal holes of a locking compression plate (LCP) applied to the caudal aspect of the ulna to treat equine ulnar fractures is associated with a risk of injury to the lateral cortex of the radius.
Study Design

Controlled laboratory study.
Sample Population

Cadaveric equine forelimbs (n = 8 pair).
Methods

After transverse ulnar osteotomy, osteosynthesis was performed with a narrow 10–13 hole 4.5/5.0 LCP applied to the caudal aspect of each ulna. The distal 3 holes were filled with 4.5 mm cortex screws (CS) in 1 limb (group 1) and with 5.0 mm LHS contralaterally (group 2). CS were inserted in an angle deemed appropriate by the surgeon and LHS were inserted perpendicular to the plate. Implant position and injury to the lateral cortex of the radius were assessed by radiography, CT, and limb dissection.
Results

In group 1, injury of the lateral radius cortex did not occur. In group 2, 4 limbs and 6/24 LHS were associated with injury of the lateral radius cortex by penetration of a LHS. This difference was statistically significant. CS were inserted with a mean angle of 17.6° from the sagittal plane in a caudolateral–craniomedial direction.
Conclusions

Use of LHS in the distal part of a LCP applied to the caudal aspect of the ulna is associated with a risk of inadvertent injury to the lateral cortex of the radius.