Repair of an open radial fracture in an adult horse.

This research paper presents a case study of an open radial fracture in an adult horse that was treated by internal fixation using dynamic compression plates and bone screws. Although the fracture healed fully, the horse displayed lameness due to the irritation caused by the bone plates, which was resolved by their removal.

Case Description

• The research paper starts by detailing a case of an adult horse weighing 450 kg that suffered an open radial fracture. This is a type of broken bone that extends to the surface of the skin, making it exceptionally delicate due to the increased risk of infection.
• The treating veterinarians opted for an approach known as internal fixation, which entailed surgically applying hardware like plates and screws to hold the broken pieces of the bone together while it healed.

Treatment and Healing Process

• The treatment strategy involved the use of two 18-hole 4.5-mm broad dynamic compression plates and bone screws of 5.5 and 4.5 mm. These materials were applied to the horse’s radial fracture for supportive and healing purposes.
• The report states that the fracture healed entirely, demonstrating that the therapeutic approach was successful in promoting bone growth and recovery.

Complications After Healing

• Despite the successful bone recovery, the horse was found to be lame on the treated limb when assessed 9 months after the surgery. This revealed an emerging problem despite initial treatment success.
• Upon careful investigation, it was discovered that the lameness was not directly due to the healed fracture itself, but a reaction to the bone plates. The plates appeared to be irritating the soft tissues and extensor tendons along the cranial and lateral aspects of the horse’s antebrachium.

Further Intervention

• Following the identification of the source of irritation, the affected tissues were anesthetized locally along the distal half of the bone plates, which significantly alleviated the horse’s lameness. The authors suggested that the lameness was a tissue response to the implanted bone plates.
• As a final resolution, both bone plates were surgically removed simultaneously. This operation was carried out without complications, and the horse returned to sound health and normal movement after the plates’ removal.

Conclusions

• This case report provides significant insight into the management of open radial fractures in larger animals like horses. Notably, it underlines the importance of considering possible irritant after-effects of therapeutic materials employed in such treatments.
• The paper suggests that while internal fixation using dynamic compression plates and bone screws can effectively heal an open radial fracture, considerations for long-term comfort and functionality must also be taken into account.