Management of a severely comminuted fracture of the third metacarpal bone in a horse.

This research article describes a case where a young Standardbred stallion suffered a severely comminuted fracture of multiple metacarpal bones and the subsequent process of the horse’s treatment and repair. Despite suffering multiple complications in the postoperative period, including a bacterial infection and further health issues, successful resolution of these complications allowed the horse to return to breeding use.

Treatment of Comminuted Fracture

• The horse in the study suffered from a severely comminuted, or shattered, fracture involving the second, third, and fourth metacarpal bones, also known as the long bones in the horse’s leg.
• The repair of such complex fracture involved the use of two 14-hole broad dynamic compression plates. Fixation plates are metal plates used to stabilize and secure the bone fragments. These plates were positioned at 90 degrees to one another, which was designed to provide support and prevent bending.
• An autologous cancellous bone graft was then added to the fracture site. This involved taking sponge-like bone tissue from the horse itself (specifically from the tuber coxae, or hip bone) and using it to fill in the bone defect in the third metacarpal bone.

Postoperative Complications

• The horse experienced several complications following the surgery. Just 5 months post-operation, the treated bone developed a Staphylococcus aureus infection, a common type of bacteria that can lead to serious infections in the bone.
• The horse also developed laminitis in the opposite forelimb six months after the fracture. Laminitis is a painful condition affecting horses’ feet, often caused by inflammation.
• Septic tenosynovitis, a bacterial infection in the tendon sheath, occurred in the horse’s contralateral hind limb. This complication led to extended hospitalization for the horse, as the total time spent in postoperative care reached 20 months.
• Despite these complications, both the infection and laminitis were successfully resolved by the time the horse returned to its breeding use.