Executive Editor: Jörg Auer

Authors: Lawrence Bramlage, Alan Ruggles

Phalanges Proximal phalanx, Multifragmentary

back to skeleton

Glossary

Screw fixation
Main indication Skill Equipment
Fractures with one intact strut of bone. Highly experienced and skilled surgeon Simple surgical and imaging resources


Comminuted fractures, which have an intact strut of bone extending from the fetlock to the pastern joint, are amendable to reconstruction using cortex screws in lag fashion and supported with a half-limb cast during convalescence. Repair of such fractures is aimed at pasture soundness.

Those fractures without an intact strut of bone extending from the fetlock to the pastern joint are not amendable to complete reconstruction by means of cortex screws. Surgical options for these fractures include limited reconstruction with cortex screws and support with a transfixation cast, an external skeletal fixation device, or in selected cases double-plate fixation of the proximal and middle phalanx – the latter serves as “distal fragment” – in conjunction with a pastern arthrodesis.

Cast application alone is contraindicated because of fracture collapse, lameness and contralateral laminitis.

*Skill
Basic surgical experience, no specialized skills Basic surgical experience, no specialized skills
Some specialized surgical experience Some specialized surgical experience
Highly experienced and skilled surgeon Highly experienced and skilled surgeon
*Equipment
Basic equipment only Basic equipment only
Simple surgical and imaging resources Simple surgical and imaging resources
Full specialized surgical and imaging resources Full specialized surgical and imaging resources

v1.3 2013-11-20