Surgical repair of propagating condylar fractures of the third metacarpal/metatarsal bones with cortical screws placed in lag fashion in 26 racehorses (2007–2015). (12th February 2018)

• Record Type: Journal Article
• Authors: Moulin, N.; François, I.; Coté, N.; Alford, C.; Cleary, O.; Desjardins, M. R.
• Is Part Of: Equine veterinary journal. Volume 50:Number 5(2018)
• Page Start: 629
• Page End: 635
• Publication Date: 2018-02-12
• Subjects: horse -- fracture -- metacarpus -- metatarsus -- lag screw -- propagating; Horses -- Diseases -- Periodicals; 636.108905
• DOI: 10.1111/evj.12811
• Languages: English
• ISSNs: 0425-1644

Abstract

Summary: Background: Despite the recommendation of plate fixation for propagating condylar fractures of the third metacarpal (McIII) or third metatarsal bone (MtIII), lag screw fixation can be a viable surgical option. Objectives: To evaluate short‐term outcome and long‐term racing performance of horses that underwent lag screw fixation of long condylar fractures of the McIII/MtIII. Study design: Retrospective case series. Methods: Medical records, post‐surgical racing performance and outcome of 26 horses with propagating fractures of the medial and/or lateral condyle of McIII/MtIII were reviewed. Medical information included were age, breed, sex, physical examination at admission, circumstances of fracture, radiographic evaluation, anaesthesia and recovery records, surgical and post‐operative management, as well as complications. Outcome included racing data and information from telephone interviews. Results: Twenty‐six horses (9 Standardbreds and 17 Thoroughbreds) were admitted with a long condylar fracture of the McIII/MtIII. Fore‐ and hindlimbs were equally represented with the left hindlimb being more frequently involved. Most of the fractures had a spiralling component (76%) and four (15%) were comminuted. Fifteen (58%) horses raced post‐surgery including nine Standardbreds (100%) and six Thoroughbreds (35%). Twelve of them were placed in at least one race and 11 won at least once. One horse sustained a severe complication in recovery. No significant difference was observed in the racing performances before and after surgery. Main limitations: Follow‐up method and duration were not standardised and there is a low number of cases with six surgeons. Conclusions: Long condylar fractures can be repaired using lag fashion technique combined with a half‐limb or full‐limb tight cast for recovery as a good surgical alternative. Similar results to plate fixation can be expected, with a return to racing of more than 50%, and the prognosis being even better for pacers.