Minimally invasive repair of a calcaneus fracture in a Standardbred foal.

The research paper discusses a successful minimally invasive surgical approach to the repair of a fracture in the calcaneus (heel) bone of a young Standardbred horse, providing an alternate option to traditional open reduction and plate fixation methods.

Presenting Issue

• The subject of this research was a four-month-old Standardbred colt that had suffered a fracture to its right calcaneus approximately eight days prior and was displaying significant lameness and swelling around the tarsal area (ankle joint).
• Despite medical management the lameness persisted and radiographic examination revealed a displaced oblique fracture in the body of the calcaneus. Additionally, the separation of the fractured bone pieces was gradually worsening. The researchers consequently recommended surgical repair.

Procedure

• The mentioned repair was performed under anesthesia and used a minimally invasive method of internal fixation. This means that instead of using open surgery to manually reposition the bone pieces and secure them with plates and screws, they instead placed two cortical screws in a lag fashion via small incisions made over the side of the foal’s calcaneus.
• Subsequent to the operation, the surgical area was wrapped in a Robert-Jones bandage, which is a type of thick, padded bandage, and the foal underwent a smooth recovery period.

Follow-up Observations

• At 8 weeks post-surgery, signs of tenosynovitis, or inflammation of the sheath(normally enclosing a tendon), began appearing due to the distal screw tip invading the sheath. In response, the research team removed the inserted screw under anesthesia, drained the tarsal sheath, and prescribed rest along with bandaging. Subsequent to the treatment, the inflammation resolved
• The foal was observed on a long-term basis and was found to be free of its prior lameness fourteen months post-surgery, demonstrating the successful outcome of the minimally invasive surgery.

Conclusions

• The researchers concluded that minimally invasive internal fixation for calcaneus fracture in horses is viable. Moreover, it could be associated with reduced morbidity in comparison to open reduction and plate fixation.