Use of preoperative computed tomography (CT) to plan repair of comminuted fractures of the middle phalanx in six Warmblood horses: Configuration, treatment and long-term outcome.
Abstract: To describe the additional information provided by computed tomography (CT) in planning and assisting repair of comminuted fractures of the middle phalanx (MP) in Warmblood horses. Methods: Case series. Methods: Six adult Warmblood horses. Methods: The case records of horses undergoing CT examination prior to internal fixation of comminuted MP fractures were reviewed. All horses underwent radiographic and preoperative CT examination. A standardized fast protocol (SFP) to assess CT images was used. Surgical repair consisted of fracture repair and proximal interphalangeal joint arthrodesis using two dorsally located plates under general anesthesia. Long-term follow-up was obtained from the clinical records and/or referring veterinary surgeons. Results: In all cases, CT provided information that could not have been obtained from radiographic examination. Four horses were alive at >6 months follow up and presented with a mild 3/5 AAEP lameness. Conclusions: The SFP provided additional information regarding fracture configuration that could not have been obtained during radiographic examination in all cases. In two cases it allowed identification of a small navicular bone fracture at the level of its dorsal cortex within the distal interphalangeal joint. In one case it allowed identification of deep digital flexor tendon (DDFT) rupture. Preoperative CT scans helped in planning the positioning of two or more independent 4.5/5.5 mm cortical lag screws to improve construct stability. Conclusions: The use of the CT SFP provides surgeons with precise fracture configuration, enables identification of concurrent pathology and optimizes surgical planning, thereby improving construct stability.
© 2025 American College of Veterinary Surgeons.
Publication Date: 2025-10-15 PubMed ID: 41097877DOI: 10.1111/vsu.70039Google Scholar: Lookup
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
- Case Reports
- Journal Article
Cite This Article
APA
Marcatili M, Kalinovskiy A, Christoph L.
(2025).
Use of preoperative computed tomography (CT) to plan repair of comminuted fractures of the middle phalanx in six Warmblood horses: Configuration, treatment and long-term outcome.
Vet Surg, 54(8), 1698-1710.
https://doi.org/10.1111/vsu.70039 Publication
Researcher Affiliations
- Pool House Equine Hospital, Lichfield, UK.
- Equine ClinicVeterinary Faculty, Freie Universität Berlin, Berlin, Germany.
- Equine ClinicVeterinary Faculty, Freie Universität Berlin, Berlin, Germany.
MeSH Terms
- Animals
- Forelimb / surgery
- Fracture Fixation, Internal / veterinary
- Fracture Fixation, Internal / methods
- Fractures, Bone / veterinary
- Fractures, Bone / surgery
- Fractures, Bone / diagnostic imaging
- Fractures, Comminuted / veterinary
- Fractures, Comminuted / surgery
- Fractures, Comminuted / diagnostic imaging
- Horses / injuries
- Horses / surgery
- Retrospective Studies
- Tomography, X-Ray Computed / veterinary
- Treatment Outcome
References
This article includes 19 references
- Colahan PT, Wheat JD, Meagher DM. Treatment of middle phalangeal fractures in the horse. JAVMA. 1981;178:1182‐1185.
- McCormick JD, Watkins JP. Double plate fixation for the management of proximal interphalangeal joint instability in 30 horses (1987–2015). EVJ. 2017;49:211‐215.
- Doran RE, White NA, Allen D. Use of bone plate for treatment of middle phalangeal fractures in horses: 7 cases. JAVMA. 1987;191:575‐578.
- Martin GS, McIlwraith CW, Turner AS, Nixon AJ, Stashak TS. Long‐term results and complications of proximal interphalangeal arthrodesis in horses. JAVMA. 1984;184:1136‐1140.
- Crabill MR, Watkins JP, Schneider RK, Auer JA. Double plate fixation of comminuted middle phalangeal fractures in horses (1985–1993). JAVMA. 1995;207(11):1458‐1461.
- Watkins J, Glass K. Chapter 18 ‐ fractures of the middle phalanx. Wright: Fractures in the Horse. John Wiley & Sons Ltd; 2022:365‐387.
- Buckwalter KA, Rydberg J, Kopecky KK, Crow K, Yang EL. Musculoskeletal imaging with multislice CT. AJR. 2001;176:979‐986.
- Rose PL, Seeherman H, O'Callaghan M. Computed tomographic evaluation of comminuted middle phalangeal fractures in the horse. VRU. 1997;38:424‐429.
- Perrin RAR, Launois MT, Brogniez L, et al. The use of computed tomography to assist orthopaedic surgery in 86 horses (2002–2010). Theory Event. 2011;23:306‐313.
- Gasiorowski JC, Richardson DW. Clinical use of computed tomography and surface markers to assist internal fixation within the equine hoof. VS. 2015;44:214‐222.
- Gunst S, Del Chicca F, Fürst AE, Kuemmerle JM. Central tarsal bone fractures in horses not used for racing: computed tomographic configuration and long‐term outcome of lag screw fixation. EVJ. 2016;48:585‐589.
- Taylor CJ, Peter VG, Coleridge MOD, Bathe AP. Immediate pre‐operative computed tomography for surgical planning of equine fracture repair: a retrospective review of 55 cases. PLoS One. 2022;17(12):e0278748. doi:10.1371/journal.pone.0278748
- Auer J. Chapter 77: principles of fracture treatment. Equine surgery. Fifth ed. Elsevier; 2019:1277‐1314.
- Denoix JM. The equine foot. The Equine Distal Limb. Manson Publishing Ltd; 2000:1‐127.
- Vishal K, Vishnu B, Sandeep P, Siddhartha S, Raju V. Does the use of intraoperative CT scan improve outcomes in Orthopaedic surgery? A systematic review and meta‐analysis of 871 cases. JCOT. 2022;18:216‐223.
- Mageed M. Standing computed tomography of the equine limb usinga multi‐slice helical scanner: technique and feasibility study. Theory Event. 2022;34(2):77‐83. doi:10.1111/eve.13388
- Mair T, Fairburn A, Giorio E, Bolas N. Cone‐beam computed tomography of the distal limb in 49 standing sedated horses. BEVA Abstract. 2021;53:31‐32.
- Genton M, Vila T, Olive J, Rossignol F. Standing MRI for surgical planning of equine fracture repair. Vet Surg. 2019;48(8):1372‐1381. doi:10.1111/vsu.13272
- Jones ARE, Ragle CA, Mattoon JS, Sanz MG. Use of non–contrast‐enhanced computed tomography to identify deep digital flexor tendinopathy in horses with lameness: 28 cases (2014–2016). JAVMA. 2019;254(7):852‐858. doi:10.2460/javma.254.7.852
Citations
This article has been cited 0 times.Use Nutrition Calculator
Check if your horse's diet meets their nutrition requirements with our easy-to-use tool Check your horse's diet with our easy-to-use tool
Talk to a Nutritionist
Discuss your horse's feeding plan with our experts over a free phone consultation Discuss your horse's diet over a phone consultation
Submit Diet Evaluation
Get a customized feeding plan for your horse formulated by our equine nutritionists Get a custom feeding plan formulated by our nutritionists