Short incomplete sagittal fractures of the proximal phalanx in ten horses not used for racing.

The research discusses the treatment and outcomes of incomplete fractures of the proximal phalanx (referred to as type Ia P1 fractures) in horses, comparing surgical and conservative treatment options and suggesting that surgical therapy tends to result in better outcomes.

Study Design and Objective

• The objective of this research was to provide a descriptive study of incomplete, or short sagittal, fractures of the proximal phalanx (the bone in the foot of the horse) in horses not used for racing and to report the outcome of different treatment methods.
• The methods involved were retrospective in nature, investigating previous cases where horses (10 in total) suffered from such fractures.

Methodology

• Data was collected from these cases including the horse’s general information, history, and results from orthopedic examinations.
• The team re-evaluated radiographs taken of the affected region in each horse, looking for details such as the position and length of the fracture, presence of osteoarthritis or cystic lesions, formation of new bone, and subchondral sclerosis (hardening of the bone on the surface of a joint).
• The horses were treated either conservatively (4 horses), which involved two months of confinement followed by one month of monitored walking, or surgically (6 horses), which included insertion of screws in a lag fashion and, in some cases, debridement of concurrent subchondral cystic lesions (SCL).

Results and Conclusion

• The horses were followed up several months later (mean time of 27 months), and all horses that were treated with internal fixation (screws) were sound, meaning in good health, and showed radiographic evidence of fracture healing.
• In contrast, out of the 4 horses managed conservatively, 3 remained lame and only 1 showed radiographic signs of fracture healing. Furthermore, 2 horses that were not treated with internal fixation experienced catastrophic fracture propagation 20 and 30 months post-diagnosis, respectively.
• The study concludes that horses with a type Ia P1 fracture treated surgically tend to have better outcomes compared to those managed conservatively, indicating that lack of fracture healing may increase the risk of subsequent severe fractures.
• Based on these results, the study recommends surgical repair for optimal healing and return to athletic use in cases of type Ia P1 fractures in horses.