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DOI: 10.1055/s-0039-1694972
Ex Vivo Comparison of the Accuracy of a Clamped with a Hand-Held Drill Guide for Drilling Distal Third Metacarpals and Metatarsals in Equids
Funding None.Publication History
07 March 2019
30 June 2019
Publication Date:
09 September 2019 (online)
![](https://www.thieme-connect.de/media/10.1055-s-00035023/202001/lookinside/thumbnails/10-1055-s-0039-1694972_190021-1.jpg)
Abstract
Objectives The aim of this study was to determine whether a clamped drill guide can be used effectively to drill across equine distal third metacarpals and metatarsals and to compare accuracy and speed of a drilling with a hand-held drill guide.
Study Design Eighty equine cadaver limbs were divided between four surgeons with varying experience. The limbs were randomly allocated to clamped or hand-held drill guides and placed in a stand in an upright/standing position on a metal table. Drilling times from cis- to trans cortices were measured. Post-drilling computed tomography images were used to assess drilling deviations in the dorsopalmar and proximodistal directions.
Results Mean proximodistal deviation of the drill hole was distad for both guides and significantly (p = 0.01) less for the clamped drill guide +0.35° (range: –5.42°, +6.61°, standard deviation [SD] ± 3.18°) than the hand-held drill guide +2.05° (range: –5.24°, +9.81°, SD ± 3.69°). Mean dorsopalmar/plantar deviation was non-significantly (p = 0.17) less for the clamped drill guide −0.27° (range: −9.72°, +6.58°, SD ± 3.57°) than the hand-held drill guide +0.60° (range: −9.74°, + 12.33°, SD ± 4.51°). Mean time taken to drill from cis to trans cortex was significantly (p < 0.001) shorter with the clamped drill guide (41.2s) than the hand-held guide (56.6s).
Conclusion The clamped drill guide could be used successfully on the equine distal third metacarpals and metatarsals and resulted in some improved accuracy and reduced drilling time compared with the hand-held guide. The use of the clamped drill guide in vivo could be supported. This may be of benefit for certain fracture repairs in equids.
Authors' Contributions
O. James contributed to data collection, obtained the images and wrote the manuscript. Y. Elce contributed to data collection, conceived and designed the study with R. Reardon. E. Cillán-Garcia contributed to data collection and helped with manuscript preparation. R. Reardon contributed to data analyses, interpretation and wrote the results section in addition to conceiving and designing the study with Y. Elce. All authors approved the final version of the manuscript.
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References
- 1 Pinchbeck GL, Clegg PD, Proudman CJ, Stirk A, Morgan KL, French NP. Horse injuries and racing practices in National Hunt racehorses in the UK: the results of a prospective cohort study. Vet J 2004; 167 (01) 45-52
- 2 Wright I. Racecourse fracture management. Part 1: incidence and principles. Equine Vet Educ 2017; 29 (07) 391-400
- 3 Compston P, Payne R. Standing fracture repair – a new chapter. Equine Vet Educ 2013; 25 (08) 386-388
- 4 Payne RJ, Compston PC. Short- and long-term results following standing fracture repair in 34 horses. Equine Vet J 2012; 44 (06) 721-725
- 5 Matta JM. Fractures of the acetabulum: accuracy of reduction and clinical results in patients managed operatively within three weeks after the injury. J Bone Joint Surg Am 1996; 78 (11) 1632-1645
- 6 Schenker ML, Mauck RL, Ahn J, Mehta S. Pathogenesis and prevention of posttraumatic osteoarthritis after intra-articular fracture. J Am Acad Orthop Surg 2014; 22 (01) 20-28
- 7 Ilg P, Ellis III E. A comparison of two methods for inserting lag screws. J Oral Maxillofac Surg 1992; 50 (02) 119-123
- 8 Dandekeri SS, Sowmya MK, Bhandary S. Stereolithographic surgical template: a review. J Clin Diagn Res 2013; 7 (09) 2093-2095
- 9 Vercruyssen M, Jacobs R, Van Assche N, van Steenberghe D. The use of CT scan based planning for oral rehabilitation by means of implants and its transfer to the surgical field: a critical review on accuracy. J Oral Rehabil 2008; 35 (06) 454-474
- 10 Abebe ES, Moorman III CT, Dziedzic TS. , et al. Femoral tunnel placement during anterior cruciate ligament reconstruction: an in vivo imaging analysis comparing transtibial and 2-incision tibial tunnel-independent techniques. Am J Sports Med 2009; 37 (10) 1904-1911
- 11 Madron M, Caston S, Kersh K. Placement of bone screws in a standing horse for treatment of a fracture of the greater tubercle of the humerus. Equine Vet Educ 2013; 25 (08) 381-385
- 12 Tucker R, Hughes TK. Diagnosis and standing repair of a proximal metatarsal fracture in a racing Thoroughbred. Equine Vet Educ 2018; DOI: 10.1111/eve.12975.
- 13 Cillán-García E, Reardon R, Schiavo S, Fordham T, Elce Y. Standing repair of a proximal, incomplete, articular fracture of the third metatarsal bone. Equine Vet Educ 2018; DOI: 10.1111/eve.12939.
- 14 Hamilton-Bennett SE, Oxley B, Behr S. Accuracy of a patient-specific 3D printed drill guide for placement of cervical transpedicular screws. Vet Surg 2018; 47 (02) 236-242
- 15 Oxley B. A 3-dimensional-printed patient-specific guide system for minimally invasive plate osteosynthesis of a comminuted mid-diaphyseal humeral fracture in a cat. Vet Surg 2018; 47 (03) 445-453
- 16 Smith LCR, Greet TRC, Bathe AP. A lateral approach for screw repair in lag fashion of spiral third metacarpal and metatarsal medial condylar fractures in horses. Vet Surg 2009; 38 (06) 681-688
- 17 Gasiorowski JC, Richardson DW. Clinical use of computed tomography and surface markers to assist internal fixation within the equine hoof. Vet Surg 2015; 44 (02) 214-222
- 18 Fackelman GE. Metacarpal(-tarsal) condyles. In: Fackelman GE, Auer JA, Nunamaker DM, Bramlage L. , eds. AO Principles of Equine Osteosynthesis. Stuttgart, Germany: Thieme Medical Publishers; 2000: 77-79
- 19 Nunamaker DM. General techniques and biomechanics. In: Fackelman GE, Auer JA, Nunamaker DM, Bramlage L. eds. AO Principles of Equine Osteosynthesis. Stuttgart, Germany: Thieme Medical Publishers; 2000: 11-25
- 20 Richardson DW. Third Metacarpal and Metatarsal Bones. In: Auer JA, Stick JA. , eds. Equine Surgery. 4th ed. St Louis, MO: Elsevier Saunders; 2012: 1325-1338
- 21 Brioschi V, Cook J, Arthurs GI. Can a surgeon drill accurately at a specified angle?. Vet Rec Open 2016; 3 (01) e000172
- 22 Arisan V, Karabuda ZC, Özdemir T. Accuracy of two stereolithographic guide systems for computer-aided implant placement: a computed tomography-based clinical comparative study. J Periodontol 2010; 81 (01) 43-51
- 23 Ozan O, Turkyilmaz I, Ersoy AE, McGlumphy EA, Rosenstiel SF. Clinical accuracy of 3 different types of computed tomography-derived stereolithographic surgical guides in implant placement. J Oral Maxillofac Surg 2009; 67 (02) 394-401
- 24 Di Giacomo GA, Cury PR, de Araujo NS, Sendyk WR, Sendyk CL. Clinical application of stereolithographic surgical guides for implant placement: preliminary results. J Periodontol 2005; 76 (04) 503-507
- 25 Shimokawa N, Takami T. Surgical safety of cervical pedicle screw placement with computer navigation system. Neurosurg Rev 2017; 40 (02) 251-258
- 26 Zekas LJ, Bramlage LR, Embertson RM, Hance SR. Results of treatment of 145 fractures of the third metacarpal/metatarsal condyles in 135 horses (1986-1994). Equine Vet J 1999; 31 (04) 309-313
- 27 Rick MC, O'Brien TR, Pool RR, Meagher D. Condylar fractures of the third metacarpal bone and third metatarsal bone in 75 horses: radiographic features, treatments, and outcome. J Am Vet Med Assoc 1983; 183 (03) 287-296
- 28 Dechant JE, Baxter GM, Southwood LL. , et al. Use of a three-drill-tract technique for arthrodesis of the distal tarsal joints in horses with distal tarsal osteoarthritis: 54 cases (1990-1999). J Am Vet Med Assoc 2003; 223 (12) 1800-1805
- 29 Kuemmerle JM, Berchtold S. Area of cartilage accessible to curettage for subsequent arthrodesis of the equine proximal interphalangeal joint. Comparison of conventional and collateral ligament sparing approaches. Vet Comp Orthop Traumatol 2013; 26 (06) 489-492
- 30 Koop R, Vercruyssen M, Vermeulen K, Quirynen M. Tolerance within the sleeve inserts of different surgical guides for guided implant surgery. Clin Oral Implants Res 2013; 24 (06) 630-634