Management of comminuted fractures of the proximal phalanx in horses: 64 cases (1983-2001).

The research article presents a retrospective examination of 64 horse cases where surgical treatments were applied to resolve comminuted fractures of the proximal phalanx. The study found that moderately comminuted fractures had a high success rate of repair, while severely comminuted fractures offered a less optimistic prognosis due to the complexity of reconstructing the fractured parts.

Study Design and Data Collection

• The research employs a retrospective design involving a total of 64 horses.
• This study is based on a review of medical records and radiographs to gather requisite details on the horses’ signalment, fracture classification, and the treatment rendered.
• The researchers also obtained follow-up information about the horses through telephone conversations or through a review of production records.

Study Findings

• Thirty-eight horses were identified to have moderately comminuted fractures of the proximal phalanx. Two of these animals were immediately euthanized. The remaining 36 horses underwent an open reduction and internal fixation procedure for their fractures. Of this number, the procedure was successful in 33 horses, indicating a 92% success rate.
• The fractures in majority of these horses were repaired using a unique surgical method involving a long curved incision, the transection of the collateral ligament of the metacarpophalangeal or metatarsophalangeal joint, and open exposure of the proximal articular surface of the proximal phalanx.
• Twenty-six horses had severe comminuted fractures of the proximal phalanx. Six were immediately euthanized, while one horse was euthanatized after 9 days of treatment using a cast alone. The remaining 19 severely fractured horse cases were divided and separately treated with either an external skeletal fixation device (13 horses) with an overall success rate of about 62%, or transfixation pins incorporated into a fiberglass cast (6 horses) with a success rate of about 67%.

Conclusions

• The research concludes that the success of treating comminuted fractures in the proximal phalanx of horses depends partially on the severity of the fracture. While moderately comminuted fractures can be successfully repaired, severely comminuted fractures are a greater challenge because of the difficulty in accurately reconstructing the fragments.
• The prognoses in cases of severe fractures are less promising for horse survival compared to those with moderate fractures.