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Metacarpal fractures associated with pancarpal arthrodesis in dogs
R G Whitelock1, J Dyce, J E Houlton
1Department of Clinical Veterinary Medicine, University of Cambridge, UK.
Objective:
To report the prevalence of third metacarpal bone fractures after dorsal plating for pancarpal arthrodeses in dogs and to identify predisposing factors.
Study Design:
Retrospective clinical study.
Animals:
Fifty-four client-owned dogs.
Methods:
Pancarpal arthrodesis was performed using dorsally applied 2.7- or 3.5-mm bone plates. Medical records and radiographs were retrospectively evaluated to identify those dogs with metacarpal bone fractures after pancarpal arthrodesis and to determine the angle of arthrodesis, the percentage of the third metacarpal bone covered by the bone plate, and the percentage width of the bone occupied by the screw. Radiological evidence of arthrodesis at follow-up examination 6 weeks postoperatively was recorded. Long-term results were obtained by telephone follow-up with the owners. All lame dogs were evaluated clinically and radiographically.
Results:
Metacarpal fractures occurred in 6 of 54 dogs. One of these dogs had a stress fracture of the third metacarpal 10 months after implant removal and was not included in the statistical analysis. Fractures occurred through the distal screw hole in four dogs and involved two metacarpal bones (III and IV) in two dogs. The median ratio of bone screw diameter-to-metacarpal bone diameter was the same for dogs with metacarpal bone fractures and those with no fractures (44%), and the median angles of arthrodesis were 8 degrees and 7 degrees. These values were not statistically significant. The percentage length of the metacarpal bone covered by the plate was 53% (no fracture) compared with 46% (fracture), and this difference was statistically significant (P = .035).
Conclusions:
Screw diameter was not implicated as a predisposing factor for metacarpal bone fracture in dogs undergoing pancarpal arthrodesis using a dorsally applied dynamic compression plate. The length of the metacarpal bone covered by the bone plate did affect the frequency of metacarpal fracture, with fewer fractures occurring when greater than 53% of the bone length was covered by the dynamic compression plate.
Clinical Relevance:
When performing pancarpal arthrodesis with a dorsally applied bone plate, it is recommended that at least 50% of the length of the third metacarpal bone should be covered by the plate.