Equis ISSN 2398-2977

Proximal sesamoid bone: fracture repair - lag screw

Contributor(s): Stephen Adams, Jessica A Kidd-Millar, Vetstream Ltd, Chris Whitton

Introduction

  • Midbody fractures of the sesamoids   Proximal sesamoid: fracture  require internal fixation to ensure sufficient bone strength is present for function of the suspensory apparatus and fetlock.
  • Tension from the suspensory apparatus prevents adequate healing without internal fixation for compression of fragment to parent bone.

Uses

  • Proximal sesamoid bone fractures   Proximal sesamoid: fracture  that are not amenable to fragment removal, usually large apical fractures or midbody fractures.

Advantages

  • Rigid fixation of fracture with restoration of sesamoid bone continuity.

Disadvantages

  • Technically difficult.
  • Sesamoid heals poorly and is under constant tension.

Requirements

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Preparation

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Procedure

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Outcomes

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Prognosis

  • Fair - for return to athletic use; healing is prolonged.

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Busschers E et al (2008) Surgical repair of mid-body proximal sesamoid bone fractures in 25 horses. Vet Surg 37 (8), 771-780 PubMed.
  • Eddy A L et al (2004) A biomechanical comparison of headless tapered pitch compression and AO cortical bone screws for fixation of a simulated midbody transverse fracture of the proximal sesamoid bone in horses. Vet Surg 33 (3), 253-262 PubMed.
  • Woodie J B, Ruggles A J & Litsky A S (2000) In vitro biomechanical properties of 2 compression fixation methods for midbody proximal sesamoid bone fractures in horses. Vet Surg 29 (4), 358-363 PubMed.
  • Henninger R W et al (1991) Lagscrew and cancelluos bone graft fixation of transverse proximal sesamoid bone fractures in horses - 25 cases (1983-1989). JAVMA 199, 606-612 PubMed.

Other sources of information

  • Bertone A L (1996)Fractures of the proximal sesamoid bones.In:Equine Fracture Repair.Ed: Nixon A J. W B Saunders, Philadelphia.


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