DIAG IM3 - Page 113

Tel +44 0845114 130258 9596 8530info@vetinst.com info@vetinst.com Dental Equipment & Instrumentation Internal Fixation15 3 Pantarsal Arthrodesis by Dorsal Hybrid Plate Canine Dorsal Pantarsal Arthrodesis Plate The concept of a dorsal plate is not new. Contoured DCPs have been used with success for pantarsal arthrodesis for some time. However, there is a fundamental problem with the use of DCPs. The plate loading takes place across the weakest plane of the plate on the compression side of the joint resulting in a relatively weak construct which leads to cycling and plate failure usually at the hole closest to the bend. In addition use of the same diameter screw in both metatarsals and the tibia can result in a mismatch. A large screw in the distal metatarsal makes the metatarsal involved very vulnerable to fracture. Although requiring more initial dissection than the medial approach, the dorsal plate makes alignment easier and does not involve screwing metatarsals to each other. Stability across the talocrural joint is achieved by a screw which passes through the plate and crosses the joint into the calcaneus.  he Canine Dorsal Pantarsal Range developed by Noel Fitzpatrick T currently comprises two hybrid plates which covers the typical patient range. Each plate has the following features: • Plate is much stronger around the bend to tranfer stress away from vulnerable areas. Noel Fitzpatrick and VI have revisted the dorsal plate and developed a range plates which allow the surgeon to benefit from the advantages of dorsal plating whilst minimising the risks of failure. The Plates are hybrid in nature and taper distally to reduce the stress riser at the end of the plate. The vulnerable area on either side of the bend is substantially thicker and stronger than the plate proximally and distally to reduce stress at the joint. For maximum stability it is essential that a screw is placed across the talocrural joint. To facilitate this the holes on either side of the bend are extended into slots to increase the range of screw angles possible. • Plate tapers distally to minimise stress riser on metatarsal at the end of the plate. • Full hybrid. Metatarsal holes smaller than tibia holes. • Slots above and below the bend to maximise screw angle options. Canine Dorsal Pantarsal Arthrodesis MIPO An aiming device is available to assist the surgeon in placing these vital screws. The shape of the cranial plate lends itself to being placed by minimally invasive plate osteosynthesis (MIPO) to preserve as much soft tissue as possible. Feline Dorsal Pantarsal Arthrodesis Plate Case: Noel Fitzpatrick During MIPO application the distal end of the plate is fed from the joint down through the distal keyhole. The proximal half of the plate is pushed through and retrograded back up the tibia. All screw holes may be accessed through keyholes. Case: Noel Fitzpatrick Developed in Feline Cranial Pantarsal collaboration with Noel Fitzpatrick we Arthrodesis MIPO offer a dedicated dorsal plate with holes placed in exactly the correct positions and machined to allow appropriate screw angulation to secure the talus. The Plate is a hybrid having smaller holes distally in a range of sizes. The Plate tapers Case: Noel Fitzpatrick distally to reduce the stress riser effect on the metatarsals. Plate profile shown on page 370. CANINE DORSAL PANTARSAL ARTHRODESIS PLATE FELINE DORSAL PANTARSAL PLATE 152941 152946 Feline Dorsal Pantarsal Arthrodesis Plate 2.0/2.0mm Calcaneal Holes accept 2.0 or 2.4mm Screws £118.45 Canine Dorsal Pantarsal Arthrodesis Plate 2.4/2.7/3.5mm £149.35 Plate profile shown on page 370. 97