< Home

Services

Your ECVS

< Back

33rd Annual Scientific Meeting proceedings


Stream:   |   Session: Orthopaedic Short Communications
Date/Time: 05-07-2024 (11:00 - 11:15)   |   Location: Auditorium 2
A novel transcoronal surgical technique for the treatment of cystic lesions of the distal phalanx: A cadaveric study
Frietman S*1, Rijkenhuizen A*2, Van Proosdij R3, Van Veggel E4
1Vet Clin Den Ham, Den Ham, Netherlands, 2European Equine Surgeon Consultant, Wijk bij Duurstede, Netherlands, 3De Klomp Dierenartsen, De Klomp, Netherlands, 4Sporthorse Medical Diagnostic Centre, Heesch, Netherlands.

Objectives:

Objective: To assess the feasibility of a novel transcoronal approach for the treatment of arthroscopically inaccessible midsagittal type 3 cysts of the palmar/plantar aspect of the distal phalanx (P3).

 

Methods:

All cadaveric specimens underwent radiographic guided drilling, followed by cortical screw placement. The cartilage was macroscopically assessed after disarticulation of the distal interphalangeal joint. Correct, i.e. midsagittal, entry at the extensor process and trajectory was subjectively evaluated via computed tomographic assessment. The minimal distance from the outer margin of the drill hole and the proximal border of the subchondral bone plate was measured using frontal computed tomographic slices.

 

Results:

Of all ten inserted screws, nine followed the aimed midsagittal course and only one showed an undesired abaxial trajectory. No evidence of iatrogenic damage to vital structures such as joint cartilage, flexor cortex and solar canal of P3 were noted. All cortical screws were placed in close proximity to the palmar/plantar articular cartilage of P3 (average of 5.6mm (range: 3.5mm – 6.2mm)).

 

Conclusions:

Accurate axial (i.e., midsagittal) drilling and screw placement, under radiographic guidance, was achieved in nine out of ten specimens.

Clinical Significance: This novel technique for the treatment of P3 cysts that are arthroscopically inaccessible, seems promising. Additional studies are required to investigate its feasibility in clinical cases, and to investigate the long-term outcome following transcystic screw placement of type 3 P3 cysts.

Back to the top of the page ^