A Lateral Approach for Screw Repair in Lag Fashion of Spiral Third Metacarpal and Metatarsal Medial Condylar Fractures in Horses

Abstract

Use of a lateral approach to medial condylar MC3/MT3 fractures allows screw insertion perpendicular to the fracture plane without interference with palmar/plantar soft tissue structures or from the splint bones. Although repair was performed under general anesthesia, the technique should be adaptable to application in standing horses.

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

“…Overall return to racing, in the current study is similar to other studies which report return to racing between 25 and 62% . In one report evaluating a lag fashion fixation of propagating condylar fractures under general anaesthesia associated with a long open approach, 14 out of 18 horses returned to training, of which 5 raced .…”

“…Despite the low number of cases, this proportion is slightly higher than previously reported . Mean time to first start was also comparable with other studies reporting a return in 11.6–14.5 months .…”

“…Cast was removed within 24 h after recovery in 21 cases (81%). Horses were hospitalised for an average of 6 days after fracture fixation. The mean time between fracture repair and screw removal was 14 weeks [10–36].…”

“…The technique used here, does not seem to be a disadvantage for the return to racing when compared with the outcome after plate fixation. The use of cortical screws placed in lag fashion is easier, faster and seems to carry the same success rate as repair using plate fixation .…”

Metacarpus/metatarsus

“…57 Given the recognized risks of catastrophic fracture in these cases during recovery from general anesthesia some surgeons opt to perform surgery with the horse standing under local anesthesia. [58][59][60] Care should be taken not to unnecessarily traumatize the splint bones, suspensory ligament or other soft tissues during drilling and tapping. Screw length and position should be monitored radiographically or fluoroscopically to ensure that they do not engage soft tissues or the splint bones.…”