Page 55 - Manual of Equine Field Surgery
P. 55
l
Transphysea Bridging 51
-~+- Metaphysis
....,. n. 'ct+---P hys is
·7"--1--- Epiphysis I
f
r
r
l
"
'4lf'=~~-
Figure 7-2 Hypodermic needle in position to iden-
tify the distal radial physis. Two screws are placed per-
pendicular to the long axis of the bone approximately
1 to 2 cm proximal and distal to the physis.
Figure 7-1 A curvilinear incision ( dotted line) is
made over the medial aspect of the left distal radial
physis oriented along the long axis of the radius, begin-
ning at the level of the radiocarpal joint and extending
toward the diaphysis of the bone for exposure of the
epiphysis, the physis, and 2 to 3 cm of the metaphysis.
beginning at the level of the radiocarpal joint and
extending toward the diaphysis of the bone for
exposure of the epiphysis, the physis, and 2 to 3
cm of the metaphysis (Figure 7 -1). The soft tissues ~e~~·,.e.-~
are bluntly dissected and retracted. Then 22-gauge
Figure 7-3 A figure of eight wire (18-gauge ortho-
1.5-inch needles are placed into the radiocarpal pedic wire) is placed around tl1e heads of the screws and
joint space and the physis. A 1-cm incision is tightened using a wire twister or pliers.
made with a scalpel through the collateral liga-
men t midway between the needles for placement
of the epiphyseal screw (Figure 7-2). Using radi-
ographic guidance for screw placement and ori-
entation, a 3.2-mm pilot hole is drilled, measured,
and tapped for placement of a 4.5-mm screw. As 4i.9r>v.>t;:l~
a general rule, the epiphyseal screw is placed Figure 7-4 A second figure of eight wire is placed
roughly parallel to the physis, except in the distal and tightened as described and the wire twists are bent
tibial physis, where a shorter screw is used and the against the bone toward the adjacent joint.
screw must be angled from distal to proximal to
avoid entering the tibiotarsal joint. A 40-mm- metaphysis and tightened incompletely. A figure
length cortical screw is inserted into the epiphysis of eight wire (l8-ga11ge orthopedic wire) is placed
and incompletely tightened. A I-cm incision is around the heads of the screws and tightened
made in the periosteum over the metaphysis at a using a wire twister or pliers (Figure 7-3). A
site approximately 2 to 3 cm from the physis. The second figure of eight wire is placed and tightened
periosteum is elevated, and a 4.5-mm 40-mm- as described, and the wire twists are bent against
length cortical screw is similarly placed in the the bone toward the adjacent joint (Figure 7-4).
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