Surgical repair of mid-body proximal sesamoid bone fractures in 25 horses.

This research article investigates the effectiveness of surgical procedures on horses with mid-body proximal sesamoid bone (PSB) fractures. The results suggest that using screws for fixation in lag fashion, combined with external coaptation, demonstrates a greater likelihood for the horse to return to athletic activity.

Research Methodology

• The research is a retrospective case study, examining 25 horses that had unilateral mid-body PSB fractures.
• It covers a ten-year period, from 1996 to 2006, using records, radiographs, and arthroscopic videos of horses with surgically repaired fractures.
• Data collected include the affected limb and PSB, fracture characteristics, and the surgical technique followed.
• Outcomes were determined based on radiographic assessment of healing and race records.
• The researchers used Fisher’s Exact test for analyzing the categorical data.

Findings

• The medial forelimb PSBs were found to be the part most commonly affected with PSB fractures, accounting for 80% of the studied cases.
• The study found that the surgical technique and degree of fracture reduction were significant factors in influencing the outcome for the horses.
• Of the horses with screw repair, 44% returned to racing post-surgery. However, none of the horses treated with wire fixation managed to do so.
• The possible factors that could have influenced this outcome includes differences in fracture reduction (with improved reduction noted in 88% of screw repairs against 22% in wire repairs) and the use of external coaptation (employed in 88% of screw repair cases and 22% of wire repair cases).
• The study found that none of the horses with unimproved reduction raced following their surgeries.

Conclusions

• Only 28% of horses with mid-body PSB fractures were able to race after surgery, demonstrating a relatively low success rate for treatment of these types of fractures.
• The report suggests screw fixation in a lag fashion as a superior repair technique compared to wire fixation.
• The research concludes that for mid-body PSB fractures, arthroscopically assisted screw fixation in lag fashion, coupled with external coaptation for post-anesthesia recovery and initial support, offers the best chances for the horses to return to athletic use.