Management of fractures and exostosis of the metacarpals and metatarsals II and IV in 25 horses.

This research paper analyses 25 cases of horses suffering from fractures and growth abnormalities in their second and fourth metacarpal and metatarsal bones. The fractures either occurred in the horse’s chest or pelvic limbs. The investigated treatments include surgical excision of the damaged bone fragment and the growth abnormality at the fracture site, and closure of the surgical wound.

Types of Fractures Reviewed

• The paper examines 25 cases of horses suffering from fractures in their second and fourth metacarpal and metatarsal bones, collectively referred to as splint bones.
• These fractures presented in one of two forms: closed fractures, which do not communicate with the external environment and open fractures, which have a permanent or intermittent draining sinus that can expose the fracture site to the risk of infection.
• Out of the 25 cases, 14 fractures occurred in a thoracic limb (chest limb), and 11 in a pelvic limb.

Treatment of Closed Fractures

• Closed fractures were treated by surgically removing the distal, or furthest away, fragment of the broken bone and any abnormal bony growths (exostosis) at the fracture site.
• Following the surgery, primary wound closure was performed on all horses with closed fractures. This involves directly suturing the wound edges together to speed up the healing process.
• In three cases, a lag screw fixation was used to secure the remaining, proximal bone fragment. This involves inserting a screw across the fracture to provide compression and stability.
• All of the treated closed fractures healed naturally without complications, and 10 out of the 13 horses were free from lameness a year after the surgery.

Treatment of Open Fractures

• The open fractures were also managed surgically, but with the additional step of debridement, or cleaning of the fracture site to remove dirt, foreign objects, and damaged tissue.
• Like the closed fractures, the abnormal distal splint fragment was excised, or cut out, during the surgery.
• Primary wound closure was used in 11 of the 12 horses with open fractures. The remaining horse’s wound was left to heal on its own through granulation (the formation of new connective tissue and tiny blood vessels), scar contraction, and epithelialisation (the growth of skin across the wound).
• Eight of these horses were deemed sound or healthy after a year, while the rest were lost to follow-up, meaning further information about their recovery could not be obtained.