Fixation of supraglenoid tubercle fractures using distal femoral locking plates in three Warmblood horses

Sina Frei; Anton E. Fürst; Murielle Sacks; Andrea S. Bischofberger

doi:10.3415/VCOT-15-10-0164

Veterinary and Comparative Orthopaedics and Traumatology, Table of Contents

Vet Comp Orthop Traumatol 2016; 29(03): 246-252
DOI: 10.3415/VCOT-15-10-0164

Case Report

Schattauer GmbH

Fixation of supraglenoid tubercle fractures using distal femoral locking plates in three Warmblood horses

Authors

Sina Frei

¹Equine Hospital, Equine Department, Vetsuisse-Faculty, University of Zürich, Zürich, Switzerland
Anton E. Fürst

¹Equine Hospital, Equine Department, Vetsuisse-Faculty, University of Zürich, Zürich, Switzerland
Murielle Sacks

²Section of Anesthesiology, Equine Department, Vetsuisse-Faculty, University of Zürich, Zürich, Switzerland
Andrea S. Bischofberger

¹Equine Hospital, Equine Department, Vetsuisse-Faculty, University of Zürich, Zürich, Switzerland

Abstract

Summary

Three horses that were presented with supraglenoid tubercle fractures were treated with open reduction and internal fixation using distal femoral locking plates (DFLP). Placing the DFLP caudal to the scapular spine in order to preserve the suprascapular nerve led to a stable fixation, however, it resulted in infraspinatus muscle atrophy and mild scapulohumeral joint instability (case 1). Placing the DFLP cranial to the scapular spine and under the suprascapular nerve resulted in a stable fixation, however, it resulted in severe atrophy of the supraspinatus and infraspinatus muscles and scapulohumeral joint instability (case 2). Placing the DFLP cranial to the scapular spine and slightly overbending it at the suprascapular nerve passage site resulted in the best outcome (case 3). Only a mild degree of supraspinatus and infraspinatus muscle atrophy was apparent, which resolved quickly and with no effect on scapulohumeral joint stability. In all cases, fixation of supraglenoid tubercle fractures using DFLP in slightly different techniques led to stable fixations with good long-term outcome. One case suffered from a mild incisional infection and plates were removed in two horses. Placement of the DFLP cranial to the scapular spine and slightly overbending it at the suprascapular nerve passage prevented major nerve damage. Further cases investigating the degree of muscle atrophy following the use of the DFLP placed in the above-described technique are justified to improve patient outcome.

Keywords

Scapula - supraglenoid tubercle - fracture - distal femoral locking plate - suprascapular nerve

Full Text

References

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