OBJECTIVE To compare the torsional mechanical properties of 2 external skeletal fixators (ESFs) placed with 2 intramedullary pin (IP) and transfixation pin (TP) size combinations in a model of raptor tibiotarsal bone fracture. SAMPLE 24 ESF-synthetic tibiotarsal bone model (polyoxymethylene) constructs. PROCEDURES Synthetic bone models were fabricated with an 8-mm (simulated fracture) gap. Four types of ESF-synthetic bone model constructs (6/group) were tested: a FESSA with a 1.6-mm IP and 1.6-mm TPs, a FESSA with a 2.0-mm IP and 1.1-mm TPs, an acrylic connecting bar with a 1.6-mm IP and 1.6-mm TPs, and an acrylic connecting bar with a 2.0-mm IP and 1.1-mm TPs. Models were rotated in torsion (5°/s) to failure or the machine angle limit (80°). Mechanical variables at yield and at failure were determined from load deformation curves. Effects of overall construct type, connecting bar type, and IP and TP size combination on mechanical properties were assessed with mixed-model ANOVAs. RESULTS Both FESSA constructs had significantly greater median stiffness and median torque at yield than both acrylic bar constructs; FESSA constructs with a 1.6-mm IP and 1.6-mm TPs had greatest stiffness of all tested constructs and lowest gap strain at yield. No FESSA constructs failed during testing; 7 of 12 acrylic bar constructs failed by fracture of the connecting bar at the interface with a TP. CONCLUSIONS AND CLINICAL RELEVANCE Although acrylic bar ESFs have been successfully used in avian patients, the FESSA constructs in this study were mechanically superior to acrylic bar constructs, with greatest benefit resulting from use with the larger TP configuration.

OBJECTIVE To compare heat generation and mechanical bone damage for tapered and cylindrical transfixation pins during drilling, tapping, and pin insertion in equine third metacarpal bones. SAMPLE 16 pairs of cadaveric equine third metacarpal bones. PROCEDURES For cylindrical pin insertion, a 6.2-mm hole was drilled and tapped with a cylindrical tap, and then a standard 6.3-mm pin was inserted. For tapered pin insertion, a 6.0-mm hole was drilled, reamed with a tapered reamer, and tapped with a tapered tap, and then a 6.3-mm tapered pin was inserted. Paired t tests and 1-way ANOVAs were used to compare heat generation (measured by use of thermocouples and thermography), macrodamage (assessed by use of stereomicroscopy), and microdamage (assessed by examination of basic fuchsin–stained histologic specimens) between cylindrical and tapered pins and between tapered pins inserted to various insertion torques. RESULTS Tapered pin insertion generated less heat but resulted in more bone damage than did cylindrical pin insertion when pins were inserted to the same insertion torque. Insertion of tapered pins to increasing insertion torques up to 16 N•m resulted in increased heat generation and bone damage. CONCLUSIONS AND CLINICAL RELEVANCE Tapered pin insertion resulted in lower heat production than did cylindrical pin insertion. However, tapered pin insertion resulted in greater bone damage, which likely was attributable to differences in the tapered and cylindrical taps. A tapered pin may be preferable to a cylindrical pin for insertion in equine cortical bone provided that improvements in tap design can reduce bone damage during insertion.

Objective: To determine the extent to which a hydroxyapatite coating promotes pin stability in the third metacarpal bone during transfixation casting in horses. Animals: 14 adult horses. Procedures: 7 horses each were assigned to either an uncoated or hydroxyapatite-coated pin group. Three transcortical pins were placed in the third metacarpal bone of each horse and incorporated into a cast for 8 weeks. Insertion and extraction torque were measured, and torque reduction was calculated. Radiography was performed at 0, 4, and 8 weeks. Lameness evaluation was performed at 2, 4, 6, and 8 weeks. Bacteriologic culture of pins and pin holes was performed at pin removal. Results: All horses used casts without major complication throughout the study. Insertion torque was higher in uncoated pins. There was no effect of group on extraction torque. Hydroxyapatite-coated pins had lower torque reduction. Five of 15 hydroxyapatite-coated pins maintained or increased stability, whereas all uncoated pins loosened. Pin hole radiolucency, lameness grades, and positive bacteriologic culture rates were not different between groups. Conclusions and Clinical Relevance: Hydroxyapatite coating increased pin stability within the third metacarpal bone of horses during 8 weeks of transfixation casting but did not improve pin performance on clinical assessments. Clinical use of hydroxyapatite-coated transfixation pins may result in greater pin stability; however, further research is necessary to improve the consistency of pin osteointegration and elucidate whether clinical benefits will ultimately result from this approach in horses.

Objective—To compare the bone temperature and final hole dimensions associated with sequential overdrilling (SO) and single 6.2-mm drill bit (S6.2DB) methods used to create transcortical holes in the third metacarpal bones (MCIIIs) of horse cadavers. Sample—60 MCIIIs from 30 horse cadavers. Procedures—In phase 1, hole diameter, tap insertion torque, peak bone temperature, and postdrilling bit temperature for 6.2-mm-diameter holes drilled in the lateral or medial cortical region of 12 MCIIIs via each of three 2-bit SO methods with a single pilot hole (diameter, 3.2, 4.5, or 5.5 mm) and the S6.2DB method were compared. In phase 2, 6.2-mm-diameter transcortical holes were drilled via a 2-bit SO method (selected from phase 1), a 4-bit SO method, or a S6.2DB method at 1 of 3 locations in 48 MCIIIs; peak bone temperature during drilling, drill bit temperature immediately following drilling, and total drilling time were recorded for comparison. Results—Hole diameter or tap insertion torque did not differ among phase 1 groups. Mean ± SD maximum bone temperature increases at the cis and trans cortices were significantly less for the 4-bit SO method (3.64 ± 2.01°C and 8.58 ± 3.82°C, respectively), compared with the S6.2DB method (12.00 ± 7.07°C and 13.19 ± 7.41°C, respectively). Mean drilling time was significantly longer (142.9 ± 37.8 seconds) for the 4-bit SO method, compared with the S6.2DB method (49.7 ± 24.3 seconds). Conclusions and Clinical Relevance—Compared with a S6.2DB method, use of a 4-bit SO method to drill transcortical holes in cadaveric equine MCIIIs resulted in smaller bone temperature increases without affecting hole accuracy.

Objective-To compare variables for screw insertion, pushout strength, and failure modes for a headless tapered compression screw inserted in standard and oversize holes in a simulated lateral condylar fracture model. Sample Population-6 pairs of third metacarpal bones from horse cadavers. Procedure-Simulated lateral condylar fractures were created, reduced, and stabilized with a headless tapered compression screw by use of a standard or oversize hole. Torque, work, and time for drilling, tapping, and screw insertion were measured during site preparation and screw implantation. Axial load and displacement were measured during screw pushout. Effects of drill hole size on variables for screw insertion and screw pushout were assessed by use of Wilcoxon tests. Results-Drill time was 59% greater for oversize holes than for standard holes. Variables for tapping (mean maximum torque, total work, positive work, and time) were 42%, 70%, 73%, and 58% less, respectively, for oversize holes, compared with standard holes. Variables for screw pushout testing (mean yield load, failure load, failure displacement, and failure energy) were 40%, 40%, 47%, and 71% less, respectively, for oversize holes, compared with standard holes. Screws could not be completely inserted in 1 standard and 2 oversize holes. Conclusions and Clinical Relevance-Enlarging the diameter of the drill hole facilitated tapping but decreased overall holding strength of screws. Therefore, holes with a standard diameter are recommended for implantation of variable pitch screws whenever possible. During implantation, care should be taken to ensure that screw threads follow tapped bone threads.

Objective-To develop a model for measuring rotary stability of the canine elbow joint and to evaluate the relative contribution of the anconeal process (AN), lateral collateral ligament (LCL), and medial collateral ligament (MCL). Sample Population-18 forelimbs from 12 canine cadavers. Procedure-Forelimbs were allocated to 3 experimental groups (6 forelimbs/group). Each intact forelimb was placed in extension at an angle of 135° and cycled 50 times from -16° (pronation) to +28° (supination) in a continuous manner at 2.0 Hz. Cycling was repeated following sectioning of the structure of interest (group 1, AN; group 2, LCL; and group 3, MCL). Torque at -12° (pronation) and +18° (supination) was measured for each intact and experimentally sectioned limb. A Student t test was performed to compare torque values obtained from intact verses experimentally sectioned limbs and for comparison with established criteria for differentiation of primary (≥ 33%), secondary (10 to 33%), and tertiary rotational stabilizers (< 10%). Results-In pronation, the AN was the only primary stabilizer (65%). For supination, the LCL was a primary stabilizer (48%), AN was a secondary stabilizer (24%), and MCL was a tertiary stabilizer (7%). Conclusions and Clinical Relevance-With the elbow joint in extension at an angle of 135°, the AN is a primary rotational stabilizer in pronation, and the LCL is a primary stabilizer in supination. Disruption of the AN or LCL may affect rotary range of motion or compromise stability of the elbow joint in dogs.

OBJECTIVE To perform 3-D inverse dynamics analysis of the entire forelimb of healthy dogs during a walk and trot. ANIMALS 5 healthy adult Beagles. PROCEDURES The left forelimb of each dog was instrumented with 19 anatomic markers. X-ray fluoroscopy was used to optimize marker positions and perform scientific rotoscoping for 1 dog. Inverse dynamics were computed for each dog during a walk and trot on the basis of data obtained from an infrared motion-capture system and instrumented quad-band treadmill. Morphometric data were obtained from a virtual reconstruction of the left forelimb generated from a CT scan of the same dog that underwent scientific rotoscoping. RESULTS Segmental angles, torque, and power patterns were described for the scapula, humerus, ulna, and carpus segments in body frame. For the scapula and humerus, the kinematics and dynamics determined from fluoroscopy-based data varied substantially from those determined from the marker-based data. The dominant action of scapular rotation for forelimb kinematics was confirmed. Directional changes in the torque and power patterns for each segment were fairly consistent between the 2 gaits, but the amplitude of those changes was often greater at a trot than at a walk. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that control of the forelimb joints of dogs is similar for both a walk and trot. Rotation of the forelimb around its longitudinal axis and motion of the scapula should be reconsidered in the evaluation of musculoskeletal diseases, especially before and after treatment or rehabilitation.

OBJECTIVE To assess effects of vertebral distraction-fusion techniques at a treated segment (C5-C6) and an adjacent segment (C4-C5) of canine cervical vertebrae. SAMPLE Cervical vertebrae harvested from cadavers of 10 skeletally mature Beagles. PROCEDURES Three models (intact, titanium plate, and polymethylmethacrylate [PM MA]) for stabilization of the caudal region of the cervical vertebrae (C4 through C7) were applied to the C5-C6 vertebral segment sequentially on the same specimens. Biomechanical assessments with flexion-extension, lateral bending, and axial rotational tests were conducted after each procedure. Range of motion (ROM) for a torque load applied with a 6-axis material tester was measured at C4-5 and C5-6 and calculated by use of a 3-D video measurement system. RESULTS In both the plate and PMMA models, ROM significantly increased at C4-5 and significantly decreased at C5-6, compared with results for the intact model. The ROM at C5-6 was significantly lower for the plate model versus the PMMA model in lateral bending and for the PMMA model versus the plate model in axial rotation. Conversely, ROM at C4-5 was significantly higher in axial rotation for the PMMA model versus the plate model. No significant differences were identified in flexion-extension between the PMMA and plate models at either site. CONCLUSIONS AND CLINICAL RELEVANCE Results of this study suggested that vertebral distraction and fusion of canine vertebrae can change the mechanical environment at, and may cause disorders in, the adjacent segment. Additionally, findings suggested that effects on the adjacent segment differed on the basis of the fusion method used.

Objective—To evaluate the effects of pilot hole diameter and tapping on insertion torque and axial pullout strength of 4.0-mm cancellous bone screws in a synthetic canine cancellous bone substitute. Sample—75 synthetic cancellous bone blocks (15 blocks/group). Procedures—For groups 1 through 5, screw size-pilot hole diameter combinations were 3.5–2.5 mm (cortical screws), 4.0–2.5 mm, 4.0–2.5 mm, 4.0–2.0 mm, and 4.0–2.0 mm, respectively. Holes were tapped in groups 1, 2, and 4 only (tap diameter, 3.5, 4.0, and 4.0 mm, respectively). One 70-mm-long screw was inserted into each block; in a servohydraulic materials testing machine, the screw was extracted (rate, 5 mm/min) until failure. Mean group values of maximum insertion torque, axial pullout strength, yield strength, and stiffness were determined. Results—Mean maximum insertion torque differed significantly among the 5 groups; the group 5 value was greatest, followed by group 3, 4, 2, and 1 values. Group 3, 4, and 5 axial pullout strengths were similar and significantly greater than the group 2 value; all values were significantly greater than that for group 1. Group 5 and 4 yield strengths were similar and significantly greater than the group 3, 2, and 1 values. Stiffness in group 3 was similar to group 4 and 2 values but significantly greater than the group 5 value; all values were significantly greater than that for group 1. Conclusions and Clinical Relevance—These synthetic cancellous bone model findings suggested that tapping a 2.0-mm-diameter pilot hole when placing a 4.0-mm screw is the optimal insertion technique.

OBJECTIVE To evaluate the ability of novel legwear designed to limit extension of the metacarpophalangeal joint (MCPJ) to redirect loading forces from the flexor apparatus during walk, trot, and canter on a treadmill and during unrestrained and restrained activity in a stall. ANIMALS 6 adult horses without musculoskeletal disease. PROCEDURES Legwear-derived force data were recorded under 4 conditions: inactive state (unlimited legwear extension) and 3 active (restrictive) states (mild, 30° extension; moderate, 20° extension; or maximum, 10° extension). Associations between peak legwear loads and torques among legwear states and treadmill gaits and stall activities were assessed. The hair coat and skin of the forelimbs were examined for any legwear-induced adverse effects after testing. RESULTS During the treadmill exercises, moderate restriction of legwear extension resulted in significantly higher peak load and torque than mild restriction, and faster speeds (canter vs walk or trot and trot vs walk) yielded significantly higher peak load and torque. During in-stall activity, maximum restriction of legwear extension yielded significantly higher peak load and torque than moderate restriction. Unrestrained in-stall activity resulted in significantly higher peak load and torque than restrained activity. The legwear caused minimal adverse effects on the hair coat and skin of the forelimbs. CONCLUSIONS AND CLINICAL RELEVANCE Findings suggested that the legwear variably reduced peak loads on the flexor apparatus. Extension of the MCPJ may be incrementally adjusted through the legwear such that return to activity may be controlled, and controlled return to activity is crucial for rehabilitating flexor apparatus injuries.