NM Fitzpatrick, J O’Riordan, R Yeadon.
Fitzpatrick Referrals, Farnham, United Kingdom

ACVS Abstract 2007 

Secured Pin Intramedullary Dorsal Epoxy Resin (SPIDER) technique was applied for repair of metatarsal/metacarpal fractures, tarsometatarsal arthrodesis and metatarso-phalangeal luxation. We hypothesised that SPIDER technique could be applied via a limited approach adhering to the principles of biologic osteosynthesis and minimizing complications associated with conventional techniques. Clinical and radiographic records of dogs and cats treated by SPIDER were retrospectively reviewed. Intramedullary K-wires stabilized metatarsal/metacarpal injuries, exiting the metatarsi/metacarpi dorsally at the distal articular surface.

Distal wire ends were contoured dorsally and secured, along with one or two proximal transverse k-wires, within an epoxy resin bolus. Client function questionnaires, clinical and radiographic evaluation were performed one year post-operatively. Injuries included metatarsal fractures, metacarpal fractures, tarsometatarsal luxation and phalangeal luxation. 

Weightbearing occurred 0–5 days post-operatively. Radiographic union and frame removal occurred at 27–72 days for cats, 13–59 days for dogs. Complications included tarsal synostosis, valgus deformity, metatarsal deformity, and metatarsophalangeal subluxation. One year post-operative radiographic evaluation did not reveal osteoarthritis of metatarso- or metacarpo-phalangeal joints or associated discomfort. 1/16 patients exhibited mild lameness one year post-operatively.

Client perception of success was universally high. SPIDER provided reliable anatomical reconstruction for all injuries described in both juvenile and mature patients. Time to frame removal was affected by severity of injury and older patient age. Clinician and owner assessed outcomes were high. SPIDER frame is applicable for stabilization of a range of MT/MC injuries via a limited approach and provides a favourable functional outcome.