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In vitro comparison of linear vs triangular screw configuration to stabilize complete uniarticular parasagittal fractures of the proximal phalanx in horses

Objective To assess fracture gap reduction and stability of linear vs triangular 4.5‐mm lag screw repair of experimental, uniarticular, and complete forelimb proximal phalanx (P1) fractures. Study design Experimental. Sample population Fourteen equine cadaver limbs/horses. Methods Simulated fracture...

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Main Authors: Labens, Raphael, Khairuddin, Nurul Hayah, Jermyn, Kieri, Syed Waseem Ahmad, Sharifah Roohi
Format: Article
Language:English
Published: Wiley-Blackwell Publishing 2019
Online Access:http://psasir.upm.edu.my/id/eprint/80221/1/In%20vitro%20comparison%20of%20linear%20vs%20triangular%20screw%20configuration%20to%20stabilize%20complete%20uniarticular%20parasagittal%20fractures%20of%20the%20proximal%20phalanx%20in%20horses.pdf
http://psasir.upm.edu.my/id/eprint/80221/
https://onlinelibrary.wiley.com/doi/full/10.1111/vsu.13123
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spelling my.upm.eprints.802212020-10-02T08:41:44Z http://psasir.upm.edu.my/id/eprint/80221/ In vitro comparison of linear vs triangular screw configuration to stabilize complete uniarticular parasagittal fractures of the proximal phalanx in horses Labens, Raphael Khairuddin, Nurul Hayah Jermyn, Kieri Syed Waseem Ahmad, Sharifah Roohi Objective To assess fracture gap reduction and stability of linear vs triangular 4.5‐mm lag screw repair of experimental, uniarticular, and complete forelimb proximal phalanx (P1) fractures. Study design Experimental. Sample population Fourteen equine cadaver limbs/horses. Methods Simulated fractures were repaired with 2 lag screws under 4‐Nm insertion torque (linear repair). Computed tomography (CT) imaging was performed with the leg unloaded and loaded to forces generated while walking. The fracture repair was revised to include 3 lag screws placed with the same insertion torque (triangular repair) prior to CT. The width of the fracture gap was assessed qualitatively by 2 observers and graded on the basis of gap measurements relative to the average voxel size at dorsal, mid, and palmar P1 sites. Interobserver agreement was assessed with Cohen's κ. The effect of repair type, loading condition, and measurement site on fracture gap grades was evaluated by using Kendall's τ‐b correlation coefficients and paired nonparametric tests. Significance was set at P ≤ .05. Results Agreement between loading and fracture gap widening was fair in triangular (κ = 0.53) and excellent in linear (κ = 0.81) repairs. Loading resulted in fracture gap distraction in linear repairs (Plinear = .008). Triangular repairs reduced fractures better irrespective of loading (Punloaded = .003; Ploaded < .001). The type of repair was not correlated with fracture gap grades at unloaded mid and loaded dorsal P1 sites. Conclusion Repair of uniarticular complete parasagittal fractures with a triangular screw configuration improved in vitro fracture gap reduction and stability. Clinical significance Triangular lag screw repair likely improves biomechanical conditions during postoperative weight bearing. Wiley-Blackwell Publishing 2019 Article PeerReviewed text en http://psasir.upm.edu.my/id/eprint/80221/1/In%20vitro%20comparison%20of%20linear%20vs%20triangular%20screw%20configuration%20to%20stabilize%20complete%20uniarticular%20parasagittal%20fractures%20of%20the%20proximal%20phalanx%20in%20horses.pdf Labens, Raphael and Khairuddin, Nurul Hayah and Jermyn, Kieri and Syed Waseem Ahmad, Sharifah Roohi (2019) In vitro comparison of linear vs triangular screw configuration to stabilize complete uniarticular parasagittal fractures of the proximal phalanx in horses. Veterinary Surgery, 48 (1). pp. 96-104. ISSN 0161-3499; ESSN: 1532-950X https://onlinelibrary.wiley.com/doi/full/10.1111/vsu.13123 10.1111/vsu.13123
institution Universiti Putra Malaysia
building UPM Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider Universiti Putra Malaysia
content_source UPM Institutional Repository
url_provider http://psasir.upm.edu.my/
language English
description Objective To assess fracture gap reduction and stability of linear vs triangular 4.5‐mm lag screw repair of experimental, uniarticular, and complete forelimb proximal phalanx (P1) fractures. Study design Experimental. Sample population Fourteen equine cadaver limbs/horses. Methods Simulated fractures were repaired with 2 lag screws under 4‐Nm insertion torque (linear repair). Computed tomography (CT) imaging was performed with the leg unloaded and loaded to forces generated while walking. The fracture repair was revised to include 3 lag screws placed with the same insertion torque (triangular repair) prior to CT. The width of the fracture gap was assessed qualitatively by 2 observers and graded on the basis of gap measurements relative to the average voxel size at dorsal, mid, and palmar P1 sites. Interobserver agreement was assessed with Cohen's κ. The effect of repair type, loading condition, and measurement site on fracture gap grades was evaluated by using Kendall's τ‐b correlation coefficients and paired nonparametric tests. Significance was set at P ≤ .05. Results Agreement between loading and fracture gap widening was fair in triangular (κ = 0.53) and excellent in linear (κ = 0.81) repairs. Loading resulted in fracture gap distraction in linear repairs (Plinear = .008). Triangular repairs reduced fractures better irrespective of loading (Punloaded = .003; Ploaded < .001). The type of repair was not correlated with fracture gap grades at unloaded mid and loaded dorsal P1 sites. Conclusion Repair of uniarticular complete parasagittal fractures with a triangular screw configuration improved in vitro fracture gap reduction and stability. Clinical significance Triangular lag screw repair likely improves biomechanical conditions during postoperative weight bearing.
format Article
author Labens, Raphael
Khairuddin, Nurul Hayah
Jermyn, Kieri
Syed Waseem Ahmad, Sharifah Roohi
spellingShingle Labens, Raphael
Khairuddin, Nurul Hayah
Jermyn, Kieri
Syed Waseem Ahmad, Sharifah Roohi
In vitro comparison of linear vs triangular screw configuration to stabilize complete uniarticular parasagittal fractures of the proximal phalanx in horses
author_facet Labens, Raphael
Khairuddin, Nurul Hayah
Jermyn, Kieri
Syed Waseem Ahmad, Sharifah Roohi
author_sort Labens, Raphael
title In vitro comparison of linear vs triangular screw configuration to stabilize complete uniarticular parasagittal fractures of the proximal phalanx in horses
title_short In vitro comparison of linear vs triangular screw configuration to stabilize complete uniarticular parasagittal fractures of the proximal phalanx in horses
title_full In vitro comparison of linear vs triangular screw configuration to stabilize complete uniarticular parasagittal fractures of the proximal phalanx in horses
title_fullStr In vitro comparison of linear vs triangular screw configuration to stabilize complete uniarticular parasagittal fractures of the proximal phalanx in horses
title_full_unstemmed In vitro comparison of linear vs triangular screw configuration to stabilize complete uniarticular parasagittal fractures of the proximal phalanx in horses
title_sort in vitro comparison of linear vs triangular screw configuration to stabilize complete uniarticular parasagittal fractures of the proximal phalanx in horses
publisher Wiley-Blackwell Publishing
publishDate 2019
url http://psasir.upm.edu.my/id/eprint/80221/1/In%20vitro%20comparison%20of%20linear%20vs%20triangular%20screw%20configuration%20to%20stabilize%20complete%20uniarticular%20parasagittal%20fractures%20of%20the%20proximal%20phalanx%20in%20horses.pdf
http://psasir.upm.edu.my/id/eprint/80221/
https://onlinelibrary.wiley.com/doi/full/10.1111/vsu.13123
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score 13.211869

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