A lateral approach for screw repair in lag fashion of spiral third metacarpal and metatarsal medial condylar fractures in horses.

This research discusses a surgical method for repairing specific types of bone fractures (medial condylar fractures of the third metacarpus/metatarsus) in horses. The approach involves the use of screws inserted from the side of the limb to secure the fracture, and has been successfully implemented in a small sample of thoroughbred racehorses.

Objectives and Methodology

• The study aims to present a laterally applied screw fixation method for repairing simple spiral medial condylar fractures of the third metacarpus/metatarsus (MC3/MT3), a common injury in racehorses.
• The case series consisted of nine Thoroughbred racehorses suffering from these specific fractures, with varying lengths that ranged from 91 to 151 mm on average.
• The treatment included internal fixation performed under general anesthesia, with multiple 4.5 mm cortical screws inserted from the side (lateral aspect) of the limb using radiographic or fluoroscopic guidance.
• Following surgery, horses were brought back from anesthesia in half-limb casts, seven without assistance and two using a rope-recovery system. A recovery plan in line with general equine treatment practices was set, including two months of box rest, a month of supervised walking, and a radiographic examination at three months for follow-up.

Results

• All horses recovered without complications from anesthesia.
• Out of all participants, five horses were able to return to racing, one horse returned to training but had to retire due to persistent lameness, two horses were sent directly to stud, and one was lost to follow-up.
• The MC3/MT3 medial condylar fractures were effectively fixed using the screws inserted from the lateral aspect.

Conclusions

• The study proves that a lateral approach for these specific fractures can allow screwing perpendicular to the fracture plane, without complications related to interfering with palmar/plantar soft tissue structures or from the splint bones.
• Despite the research being conducted under general anesthesia, the researchers suggest that with some adaptation, the method could apply to horses in a standing position.