Outcome following lag screw fixation of non-C3 carpal slab fractures in horses.

Overview

• This study describes the clinical features and outcomes of horses that underwent lag screw fixation surgery for specific types of carpal slab fractures (non-C3) in various carpal bones.
• The research retrospectively reviews cases to evaluate survival, return to athletic performance, and owner satisfaction following surgery.

Study Purpose and Scope

• The objective was to analyze horses treated with lag screw fixation for slab fractures in the radial carpal (Cr), intermediate carpal (Ci), ulnar carpal (Cu), second (C2), or fourth (C4) carpal bones.
• This excludes C3 carpal bone fractures, which have been studied previously, to focus on other types of slab fractures in the carpus area.
• The study aimed to describe clinical presentation, surgical approaches, and both short- and long-term outcomes for these horses.

Methods

• Retrospective case study including 19 horses treated between January 2008 and January 2026.
• Medical records were reviewed to identify cases involving internal fixation of slab fractures in the specified carpal bones.
• Data on clinical presentation, surgical technique, and follow-up outcomes were collected.
• Long-term outcomes were determined using a standardized owner questionnaire to assess survival, return to athletic activity, and satisfaction.
• Surgical approaches included arthroscopic guidance in 5 cases and computed tomography (CT) guidance in 14 cases, reflecting advanced imaging use to assist in accurate screw placement.

Results

• Breed distribution among the 19 horses included 7 Thoroughbreds and 7 Warmbloods, indicating a focus on performance breeds.
• In 10/19 cases, fractures were caused by traumatic falls; notably, six occurred during recovery from general anesthesia, highlighting a potential risk factor.
• The survival rate beyond one year post-surgery was high at 88%, suggesting good overall prognosis.
• 53% of horses returned to their previous level of athletic function, demonstrating that over half could resume prior performance abilities after surgery.
• Owner satisfaction was reported at 71%, indicating that the majority were pleased with their horse’s recovery and function.

Conclusions and Clinical Implications

• The prognosis for horses with non-C3 carpal slab fractures treated with lag screw fixation is favorable.
• Outcomes in survival, return to previous work activity, and owner satisfaction were comparable to those reported for C3 slab fractures, which have historically received more attention.
• Lag screw fixation, supported by advanced imaging guidance, is an effective surgical treatment option for slab fractures in the Cr, Ci, Cu, C2, and C4 carpal bones.
• Animal practitioners can consider this technique a reliable intervention for these types of fractures, potentially improving return to sport and welfare of affected horses.