Evaluation of transfixation casting for treatment of third metacarpal, third metatarsal, and phalangeal fractures in horses: 37 cases (1994-2004).

This research article studies the use of transfixation casting in treating certain kinds of fractures in horses, examining the success rate, related complications, and outcomes.

Study Overview

• The study is a retrospective review of 37 cases involving horses that suffered from third metacarpal, third metatarsal or phalangeal fractures and were treated with transfixation casting.
• The cases include 29 adult horses and 8 foals.

Methods

• The researchers reviewed medical records and collected follow-up information.
• Data collected include information about the survival of the horses, fracture healing, return to intended use, complications like pin loosening and pin hole lysis, and the complications associated with the pins.
• A logistic regression model was used to analyze the data.

Results

• The results show that the fractures healed and the horse survived in 77% of the cases (27 out of 35 horses). This includes 10 of the 15 cases involving third metacarpal or metatarsal bone fractures, 11 of the 12 cases involving proximal phalanx fractures, and 6 of the 8 involving middle phalanx fractures.
• However, there were complications. Four adult horses experienced a fracture through a pin hole, and one horse suffered from a pathological unicortical fracture as a result of a pin hole infection.
• Inability of the horses to return to their intended use was associated with factors such as increased body weight, fractures affecting two joints, non-diaphyseal fracture location, and an increased duration until radiographic union.
• Body weight was also associated with pin loosening, although this relationship is adjusted in the results. Pin hole lysis was associated with the number of days with a transfixation cast, and pin-related complications were associated with insertions done by hand.

Conclusions

• The researchers conclude that transfixation casting can successfully manage fractures distal to the carpus or tarsus in horses.
• Transfixation casting was found to be most suitable for comminuted fractures of the proximal phalanx, but can also be used for third metacarpal, third metatarsal, or middle phalanx fractures, with or without internal fixation.