A lateral approach to the repair of propagating fractures of the medial condyle of the third metacarpal and metatarsal bone in 18 racehorses.
Abstract: To report the technique, observations on fracture configurations and results of treatment by fixation lag screw following the fracture plane determined by an approach to the third metacarpal/metatarsal bone (MC3/MT3) that begins laterally over the metacarpo(metatarso)phalangeal joint and extends dorsally over the diaphysis of the bone. Methods: Case series. Methods: Thoroughbred horses (n=18) with propagating fractures of the medial condyle of MC3/MT3. Methods: Retrospective analysis of case records of horses with fractures of the medial condyle of MC3/MT3 that propagated sagittaly or in a spiral configuration into the diaphysis, repaired surgically under general anesthesia by screw fixation in lag fashion through a lateral approach with periosteal reflection. Results: Fractures were readily identified at surgery, enabling screw fixation in lag fashion following the fracture plane. Fracture configurations varied and could be classified as sagittal and spiral fractures with fractures within each group generally following a similar course. All horses recovered relatively uneventfully from general anesthesia and surgery, and all fractures healed well. Thirteen horses returned to training; 5 subsequently raced. Conclusions: Repair of propagating sagittal and spiral fractures of the medial condyle of MC3/MT3 with diaphyseal involvement, through a lateral approach with periosteal reflection permits stable fixation with minimal complications. In this series there were no catastrophic failures. Conclusions: Fractures of the medial condyle of MC3/MT3 that propagate either sagittaly or in a spiral configuration into the diaphysis can be successfully repaired with screw fixation in lag fashion using a lateral approach with periosteal reflection.
Publication Date: 2009-08-14 PubMed ID: 19674412DOI: 10.1111/j.1532-950X.2009.00562.xGoogle Scholar: Lookup
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- Journal Article
Summary
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This research investigated a new surgical technique to repair propagating fractures in a specific bone (medial condyle of the third metacarpal and metatarsal bone) in thoroughbred racehorses. The study noted that the fractures could be fixed successfully with a minimal complication rate.
Methods
- Eighteen thoroughbred racehorses suffering from propagating fractures of the medial condyle of the third metacarpal/metatarsal bone (MC3/MT3) were studied. These fractures were either continuing (‘propagating’) in a straight (‘sagittal’) line or in a spiral configuration into the main shaft (‘diaphysis’) of the bone.
- The research involved a retrospective analysis of the case records of these horses, all of which underwent surgery under general anesthesia. The surgical intervention involved fixation of the fracture using screws through a novel lateral (from the side) approach, which involved reflecting (pulling back) the outer, bone-forming layer (periosteum).
Results
- During surgery, the fractures were readily identified and could be classified into two categories – sagittal and spiral fractures, with fractures within each group following a similar course.
- Screw fixation following the fracture plane proved to be successful, and all horses recovered relatively uneventfully from both surgery and anesthesia.
- The study reported that all fractures healed well and that no catastrophic failures occurred. Furthermore, thirteen horses were returned to training, and five ended up racing subsequently.
Conclusions
- As per the conclusions drawn from this case series, lateral approach through periosteal reflection permits stable fixation of these types of fractures with minimal complications. The fractures that follow a straight or a spiral path into the main shaft of the bone can be repaired successfully using this screw fixation technique.
- This research contributes valuable knowledge to veterinary medicine, particularly for equine practitioners who frequently encounter these types of injuries in racehorses. This minimally invasive surgical technique could significantly improve the prognosis and rehabilitation prospects of horses suffering these fractures.
Cite This Article
APA
Wright IM, Smith MR.
(2009).
A lateral approach to the repair of propagating fractures of the medial condyle of the third metacarpal and metatarsal bone in 18 racehorses.
Vet Surg, 38(6), 689-695.
https://doi.org/10.1111/j.1532-950X.2009.00562.x Publication
Researcher Affiliations
- Newmarket Equine Hospital, Newmarket, Suffolk CB8 0FG, UK. referrals@neh.uk.com
MeSH Terms
- Animals
- Bone Screws / veterinary
- Female
- Fracture Fixation, Internal / methods
- Fracture Fixation, Internal / veterinary
- Fractures, Bone / surgery
- Fractures, Bone / veterinary
- Horses / injuries
- Horses / surgery
- Male
- Metacarpal Bones / injuries
- Metacarpal Bones / surgery
- Metatarsal Bones / injuries
- Metatarsal Bones / surgery
- Postoperative Care / veterinary
- Retrospective Studies
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