Nonsurgical management of type II fractures of the distal phalanx in 48 Standardbred horses

Abstract

The prognosis for type II fractures of the distal phalanx is guarded. It is advisable to fit a bar shoe on the horse during convalescence. Horses returning to training and racing with a bar shoe appear less likely to refracture the distal phalanx. Those horses that return to racing can perform at a level similar to that prior to fracture.

Conservative treatment of intra-articular distal phalanx fractures in horses not used for racing

“…Previous studies that included conservatively treated horses, and in which all or most of the horses were racehorses, revealed success rates between approximately 50 and 85%. 2,[4][5][6]10 Due to the relatively few cases of surgical treatment of intra-articular fractures of the distal phalanx that have been reported, 7,10,11 comparison between the success rates of surgical and conservative treatment is difficult. However, a study which compared nine surgically treated with seven conservatively treated Standardbreds showed no significant difference between the two groups: seven and six horses, respectively, returned to athletic activity.…”

“…1 Studies have shown incidences of 0.38 to 0.43% of all patients referred to a university clinic. 2,3 Several authors claim that racehorses are more commonly affected than other breeds 1,[4][5][6] and that forelimbs are more commonly involved. 2,3,5 These fractures are caused by acute trauma, 3,7 and can be divided into seven different types based on configuration.…”

“…2 A study on conservative treatment of intra-articular fractures of the distal phalanx in 48 Standardbreds showed that 63% returned to racing. 6 Relatively few cases of distal phalanx fractures in horses not used for racing have been reported in the literature. 2,8,9 The lack of studies documenting the results of conservative treatment of intra-articular fractures of the distal phalanx in a significant number of horses not used for racing prompted the present study.…”

Changes in shape of the Standardbred distal phalanx and hoof capsule in response to exercise

“…The distal phalanx has been investigated from a clinical perspective 10,11 and there are few studies of the normal bone 12,13 . Linford et al 12 examined the normal distal phalanx in racing Thoroughbreds using radiographs.…”

Biaxial plantar process fractures of the distal phalanx in a horse

“…The duration of bar shoe placement is a topic of much debate. Bar shoes have been shown to cause contraction of the hoof and distortion of the heels, therefore removal at some time is desirable (Yovich 1989, O'Sullivan and others 1999, Rijkenhuizen and others 2012). Some authors believe that removal of the shoe may alter the forces on the fracture site and predispose the horses to re-fracture at the site of previous injury.…”