Use of Locking Compression Plates as an External Fixator for Facilitated Ankylosis of an Infected Metacarpophalangeal Joint in a Foal

Stabilization of an infected joint necessitating joint fusion is a challenging situation with limited ideal surgical options. In this case, a Quarter Horse colt was born severely premature at 285 days of gestation. He was referred at 4.5 months of age for management of significant orthopaedic concerns. Custom orthotics were placed on all limbs. Unfortunately, the colt rapidly developed pressure sores due to the extreme nature of the support the braces were providing. The colt developed a fever, and a right front fetlock region pressure sore/granulation bed was found to communicate with the metacarpophalangeal joint (MCPJ). The infected right MCPJ was arthroscopically debrided. There was minimal to no normal cartilage covering the bony surfaces of the joint. The following day, the colt underwent surgery for facilitated ankylosis of the right MCPJ. A 17-hole 3.5 mm Locking Compression Plate (LCP) with 3.5 mm locking screws was contoured to the limb and placed along the medial aspect of the limb extending from the carpus to the proximal interphalangeal joint, and a nine-hole 3.5 mm Locking Compression Plate (LCP) with 4 3.5 mm locking screws in the two most proximal and distal plate holes were placed along the lateral aspect of the MCPJ. The shorter lateral plate and four screws from the medial plate were removed 48 days following surgery. The medial plate was fully removed 63 days from surgery with excellent fusion of the joint. The use of LCPs allowed for early limb loading, wound management care, patient comfort, and successful joint fusion.

Acknowledgment

Many thanks to the dedicated owner in this challenging case.

 

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Publication History

Article published online:
15 July 2025