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Alternative approach for fracture fixation following implant infection in a Salter-Harris type-II fracture of the proximal phalanx in a Warmblood foal.
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  • Andrey Kalinovskiy,
  • Anna Ehrle,
  • Eva Müller,
  • Christophorus Lischer
Andrey Kalinovskiy
Free University of Berlin

Corresponding Author:kalinovskiy333@gmail.com

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Anna Ehrle
Free University of Berlin
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Eva Müller
Free University of Berlin
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Christophorus Lischer
Free University of Berlin
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Abstract

A two-day-old female Warmblood foal (70 kg) presented with a closed, displaced Salter-Harris type-II fracture of the proximal physis of the left hind first phalanx. For fracture repair four 4.5 mm cortical screws and wire in a figure-of-8 pattern were applied on the lateral and medial aspect of the phalanx, respectively. A 4.5 mm cortical screw was additionally inserted in lag-fashion to engage the lateral metaphyseal spike. Three days postoperatively, medial axis deviation and implant infection were noted and revision surgery was performed. Previous implants were removed and two 4.5 mm transphyseal cortical lag-screws were placed in proximolateral-distomedial and dorsoproximal-plantarodistal direction. Postoperatively, the fracture healed rapidly and the implants were removed 6 weeks later. Nineteen months after implant removal the horse did not show any sign of lameness, despite a shortening of the proximal phalanx compared to the contralateral limb. In cases of postoperative implant instability and infection, implant removal often becomes necessary. However, new implants cannot be placed safely in the previous location. To avoid this problem, this report describes an alternative approach for screw positioning in case of previous implant infection in a Salter-Harris type-II fracture of the proximal physis of the first phalanx.
27 Dec 2022Submitted to Equine Veterinary Education
29 Dec 2022Submission Checks Completed
29 Dec 2022Assigned to Editor
06 Jan 2023Reviewer(s) Assigned
15 Feb 2023Review(s) Completed, Editorial Evaluation Pending
24 Feb 2023Editorial Decision: Revise Minor
28 Mar 20231st Revision Received
29 Mar 2023Submission Checks Completed
29 Mar 2023Assigned to Editor
09 Apr 2023Review(s) Completed, Editorial Evaluation Pending
20 Apr 2023Editorial Decision: Revise Minor
24 Apr 20232nd Revision Received
24 Apr 2023Submission Checks Completed
24 Apr 2023Assigned to Editor
29 Apr 2023Editorial Decision: Accept