Surgical repair of propagating condylar fractures of the third metacarpal/metatarsal bones with cortical screws placed in lag fashion in 26 racehorses (2007-2015).

This research paper assesses the effectiveness of surgical repair, using lag screw fixation, on propagating condylar fractures of the third metacarpal/metatarsal bones in racehorses. The study found no significant difference in the racing performances before and after surgery, suggesting this technique could be a viable alternative to the recommended plate fixation treatment.

Study Purpose and Methodology

In this retrospective case series, the researchers set out to evaluate both the short-term outcomes and long-term racing performance of horses that underwent lag screw fixation for long condylar fractures of the third metacarpal or third metatarsal bones.

• To do this, they reviewed medical records, post-surgical racing performance, and outcomes of 26 horses with these types of fractures.
• They looked at various details including the horse’s age, breed, sex, the circumstances surrounding the fracture, radiographic evaluation, anesthesia and recovery records, surgical and post-operative management, as well as any complications.

Study Findings

The researchers discovered that:

• The study involved 26 horses (9 Standardbreds and 17 Thoroughbreds), all of which has a long condylar fracture of the third metacarpal/metatarsal bones.
• Both fore- and hindlimbs were represented equally, with the left hindlimb being involved more frequently.
• A majority (76%) of the fractures had a spiraling component and 15% were comminuted, broken into several pieces.
• Of the 26 horses, 15 (58%) raced post-surgery, including all the nine Standardbreds and six Thoroughbreds (35%).
• Of those that raced post-surgery, 12 placed in at least one race and 11 won at least once.
• Only one horse experienced a severe complication during recovery.

Study Conclusions

Despite some limitations, such as the non-standardized follow-up method and duration, as well as the low number of cases with different surgeons involved, the researchers concluded that:

• Repairing long condylar fractures using the lag screw fixation technique, combined with a half-limb or full-limb tight cast for recovery, could be a good surgical alternative.
• This technique produced similar results to the traditionally recommended plate fixation, with over 50% of horses returning to racing post-recovery.
• The prognosis was even better for pacers.