Short‐ and long‐term results following standing fracture repair in 34 horses

Reasons for performing study: Standing fracture repair in the horse is a recently described surgical procedure and currently there are few follow‐up data. This case series contains 2 novel aspects in the standing horse: repair of incomplete sagittal fractures of the proximal phalanx and medial condylar repair from a lateral aspect. Objectives: To describe outcome in a case series of horses that had lower limb fractures repaired under standing sedation at Rossdales Equine Hospital. Method: Case records for all horses that had a fracture surgically repaired, by one surgeon at Rossdales Equine Hospital, under standing sedation and local anaesthesia up until June 2011, were retrieved. Hospital records, owner/trainer telephone questionnaire and the Racing Post website were used to evaluate follow‐up. Results: Thirty‐four horses satisfied the inclusion criteria. Fracture sites included the proximal phalanx (incomplete sagittal fracture, n = 14); the third metacarpal bone (lateral condyle, n = 12, and medial condyle, n = 7); and the third metatarsal bone (lateral condyle, n = 1). One horse required euthanasia due to caecal rupture 10 days post operatively. Twenty horses (66.7% of those with available follow‐up) have returned to racing. Where available, mean time from operation to return to racing was 226 days (range 143–433 days). Conclusions: Standing fracture repair produced similar results to fracture repair under general anaesthesia in terms of both the number of horses that returned to racing and the time between surgery and race. Potential relevance: Repair of lower limb fracture in the horse under standing sedation is a procedure that has the potential for tangible benefits, including avoidance of the inherent risks of general anaesthesia. The preliminary findings in this series of horses are encouraging and informative when discussing options available prior to fracture repair.     

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

Objective— To describe a lateral approach for screw fixation in lag fashion of simple spiral medial condylar fractures of the third metacarpus/metatarsus (MC3/MT3).
Study Design— Case series.
Animals— Thoroughbred racehorses (n=9).
Methods— Nondisplaced medial MC3/MT3 condylar fractures (3 thoracic, 6 pelvic limbs), with mean length 126 mm (range, 91–151 mm) were repaired by internal fixation, under general anesthesia, using multiple 4.5 mm cortical screws inserted in lag fashion from the lateral aspect of the limb, using radiographic or fluoroscopic guidance. Horses were recovered from anesthesia in half-limb casts; 7 unassisted and 2 using a rope-recovery system. Horses had 2 months box rest, 1 month in-hand walking, and follow-up radiographic examination at 3 months.
Results— Horses recovered uneventfully from anesthesia. Five horses raced; 1 returned to training, was persistently lame, and was retired to stud; 2 were retired directly to stud; and 1 horse was lost to follow-up.
Conclusions— MC3/MT3 medial condylar fractures were successfully repaired by screws inserted n lag fashion form the lateral aspect.
Clinical Relevance— 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.     

Transpalpebral enucleation using a chain écraseur

This study was undertaken to describe the technique, complications and outcome of the use of a chain écraseur for transpalpebral enucleation in horses under general anaesthesia. We report its use in 53 horses, reviewing the subject details, reasons for enucleation, surgical technique, intra‐ and post operative complications, and long‐term outcome. Intraoperative complications included mild to moderate bleeding in 4 horses. Post operative complications included mild periorbital post operative swelling in one horse, transient head tilt in one horse and severe enterocolitis, which resulted in euthanasia in one horse; another 2 horses were subjected to euthanasia after long bone fractures that occurred during recovery from general anaesthesia and 2 horses had the prosthesis removed as a result of inflammatory reaction or infection. Long‐term outcome was available for 38 horses, 25 of which returned to their previous activities and 13 were retired. Twelve horses were lost for follow‐up. Transpalpebral enucleation using a chain écraseur is a feasible alternative to traditional enucleation techniques that can provide adequate haemostasis during transection of the optic pedicle when used properly.     

Conservative management of minimally displaced radial fractures in three horses

Minimally displaced, spiral, radial fractures were diagnosed in three adult horses. Two horses had open fractures and in one horse the fracture was closed. A diagnosis was made on radiographs taken 24 h, 5, and 9 days after the fracture. There was minimal displacement of the fracture fragments despite the considerable time which had elapsed between fracture and diagnosis and an unfavourable prognosis with internal fixation, so conservative therapy was the preferred method of treatment. One horse developed a sequestrum and draining sinus, which was treated surgically under general anaesthesia 3 months after diagnosis of the fracture. Other complications were minimal and transient. Two horses were being used for pleasure riding 12 months after fracture and one horse was pasture sound at 8 months.     

Conservative management of minimally displaced radial fractures in three horses

Minimally displaced, spiral, radial fractures were diagnosed in three adult horses. Two horses had open fractures and in one horse the fracture was closed. A diagnosis was made on radiographs taken 24 h, 5, and 9 days after the fracture. There was minimal displacement of the fracture fragments despite the considerable time which had elapsed between fracture and diagnosis and an unfavourable prognosis with internal fixation, so conservative therapy was the preferred method of treatment. One horse developed a sequestrum and draining sinus, which was treated surgically under general anaesthesia 3 months after diagnosis of the fracture. Other complications were minimal and transient. Two horses were being used for pleasure riding 12 months after fracture and one horse was pasture sound at 8 months.     

Long incomplete longitudinal fractures of the third metacarpal and metatarsal bone in horses

Five horses with long incomplete longitudinal fractures of the third metacarpal bone and three horses with similar fractures of the third metatarsal bone were examined. In three of the metacarpal fractures a long incomplete fissure extended proximomedially, in association with the more common lateral condylar fracture of the third metacarpal bone, and in the other two cases the fracture originated from the medial aspect of the distal articular surface. In the three horses with fractures of the third metatarsal bone the fractures had a consistent spiral configuration.     

Minimally invasive plate fixation of lower limb injury in horses: 32 cases (1999-2003)

REASONS FOR PERFORMING STUDY: Complications of osteosynthesis including superficial and deep infections continue to affect adversely outcome in equine surgery of the lower limb. OBJECTIVE: To describe a technique for minimally invasive plate fixation in horses and evaluate clinical results of the technique. HYPOTHESIS: Lower complication rates would occur in horses treated with a minimally invasive approach compared with conventional techniques. METHODS: Cases of minimally invasive plate fixation from January 1999 to December 2003 were evaluated. Case records, radiographs and race records for horses that sustained distal third metacarpal/metatarsal (Mc/tIII) condylar fractures were assessed. Follow-up information was obtained and results analysed. In addition, results for horses that received arthrodesis by a conventional, open approach during the same period were evaluated and statistical analysis was performed. RESULTS: Thirty-two cases of minimally invasive plate fixation were identified (22 incomplete distal Mc/tIII condylar fractures with a spiralling or diaphyseal component, 10 metacarpophalangeal arthrodeses and 4 pastern arthrodeses). For both types of arthrodesis, surgery times and infection rates were lower and survival rates higher in the minimally invasive group, but no statistical difference was found. Spiralling condylar fractures were successfully managed, without catastrophic fracture. CONCLUSIONS AND POTENTIAL RELEVANCE: Minimally invasive percutaneous plate osteosynthesis (MIPPO) can be successfully used for select applications in horses, and may reduce morbidity and mortality in equine fracture repair.     

Factors associated with racing performance of Thoroughbreds undergoing lag screw repair of condylar fractures of the third metacarpal or metatarsal bone

OBJECTIVE: To evaluate effects of sex, fracture configuration, affected limb, and screw placement on outcome of Thoroughbreds with condylar fractures involving the third metacarpal or metatarsal bone. DESIGN: Cohort study. Animals-56 horses. PROCEDURE: Age, sex, affected limb, fracture configuration, fracture length, fracture fragment width, and distance of the most distal screw from the articular surface were analyzed in logistic regression models. RESULTS: Females were more likely to have displaced fractures and race in fewer races after surgery than males. Sex and fracture configuration were associated with number of postoperative races. Among horses that returned to racing, those with thicker fracture fragments were 11 times as likely as horses with thinner fracture fragments to win a race after surgery. Horses with longer fractures and older horses had fewer postoperative races. Horses in which the most distal screw had been placed further from the joint surface had more races. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that female horses with displaced condylar fractures and male horses with nondisplaced condylar fractures are more likely to be referred for treatment. The effect of sex on outcome for these horses cannot be clearly separated from the effect of fracture configuration. When adjusted for fracture configuration, males were 6 times as likely as females to race after surgery. When adjusted for sex, horses with nondisplaced fractures were 17 times as likely as horses with displaced fractures to race after surgery. Results suggest that the most distal screw should be placed above the epicondylar fossa.     

A clinical evaluation of a headless, titanium, variable-pitched, tapered, compression screw for repair of nondisplaced lateral condylar fractures in thoroughbred racehorses

OBJECTIVE: To report clinical evaluation of headless compression screws for repair of metacarpal/metatarsal (MC/MT3) condylar fractures in horses. STUDY DESIGN: Retrospective case study. SAMPLE POPULATION: Racing Thoroughbreds (n=16) with nondisplaced lateral condylar fractures of MC/MT 3. METHODS: Medical records (1999-2004) of horses with nondisplaced longitudinal fractures of the lateral condyle of MC/MT3 were reviewed. Pre-operative variables retrieved were: patient age, gender, limb involvement, injury occurrence, fracture length, and width, evidence of palmar comminution and degenerative joint disease, number of pre-injury starts, and pre-injury earnings. Post-operative variables retrieved were: surgical complications, surgical time, number of race starts, and post-operative earnings. RESULTS: MC3 (n=11) and MT3 (5) nondisplaced longitudinal fractures of the lateral condyle were repaired with Acutrak Equine (AE) screws. Left front limb fractures were most common (8) followed by left hind (5) and right front (3). Nine fractures occurred during training and 7 during racing; 4 fractures had palmar comminution. No surgical complications occurred. Of 15 horses that returned to training, 11 (73%) raced 306+/-67 days after injury and had greater mean (+/-SD) post-injury earnings/start ($5290.00+/-$8124.00) than pre-injury ($4971.00+/-$2842.00). Screw removal was not required in any horse. CONCLUSION: The AE screw is a viable option for repair of nondisplaced lateral condylar MC/MT3 fractures in Thoroughbred racehorses. CLINICAL RELEVANCE: Adequate stability of nondisplaced lateral condylar fractures can be achieved with a headless tapered compression screw while avoiding impingement on the collateral ligaments and joint capsule of the fetlock joint.     

A Lateral Approach to the Repair of Propagating Fractures of the Medial Condyle of the Third Metacarpal and Metatarsal Bone in 18 Racehorses

Objectives— To report the technique, observations on fracture configurations and results of treatment by fixation lag screw following the fracture plane determined by an approach to the third metacarpal/metatarsal bone (MC3/MT3) that begins laterally over the metacarpo(metatarso)phalangeal joint and extends dorsally over the diaphysis of the bone.
Study Design— Case series.
Animals— Thoroughbred horses (n=18) with propagating fractures of the medial condyle of MC3/MT3.
Methods— Retrospective analysis of case records of horses with fractures of the medial condyle of MC3/MT3 that propagated sagittaly or in a spiral configuration into the diaphysis, repaired surgically under general anesthesia by screw fixation in lag fashion through a lateral approach with periosteal reflection.
Results— Fractures were readily identified at surgery, enabling screw fixation in lag fashion following the fracture plane. Fracture configurations varied and could be classified as sagittal and spiral fractures with fractures within each group generally following a similar course. All horses recovered relatively uneventfully from general anesthesia and surgery, and all fractures healed well. Thirteen horses returned to training; 5 subsequently raced.
Conclusions— Repair of propagating sagittal and spiral fractures of the medial condyle of MC3/MT3 with diaphyseal involvement, through a lateral approach with periosteal reflection permits stable fixation with minimal complications. In this series there were no catastrophic failures.
Clinical relevance— Fractures of the medial condyle of MC3/MT3 that propagate either sagittaly or in a spiral configuration into the diaphysis can be successfully repaired with screw fixation in lag fashion using a lateral approach with periosteal reflection.     

Macroscopic changes in the distal ends of the third metacarpal and metatarsal bones of Thoroughbred racehorses with condylar fractures

OBJECTIVE: To determine changes in the distal ends of the third metacarpal and metatarsal bones (MCIII and MTIII) of Thoroughbred racehorses that had sustained a catastrophic condylar fracture during high-speed exercise. SAMPLE POPULATION: Fractured and contralateral MCIIIs and MTIIIs from 11 Thoroughbred racehorses that sustained a displaced condylar fracture during racing, both MCIIIs from 5 Thoroughbred racehorses euthanatized because of a catastrophic injury other than a condylar fracture, and both MCIIIs from 5 horses of other breeds that had not been professionally trained or raced. PROCEDURE: Macroscopic observations were made of the distal ends of the bones before and after digestion of the articular cartilage with NaOH. RESULTS: In all 11 racehorses with a displaced condylar fracture, the fracture was associated with a branching array of cracks in the condylar groove. In this region, fracture margins were smooth, and there was loss of subchondral bone. Comminution of the dorsal cortex was also seen. Parasagittal linear wear lines in the articular cartilage, erosions in the articular cartilage of the condyles, loss of the underlying subchondral bone, and cracking of condylar grooves were all more severe in the Thoroughbred racehorses than in the horses that had not been professionally trained or raced. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that condylar fractures in horses are pathologic fatigue or stress fractures that arise from a preexisting, branching array of cracks in the condylar groove of the distal end of MCIII or MTIII.     

Risk factors for fatal lateral condylar fracture of the third metacarpus/metatarsus in UK racing

REASONS FOR PERFORMING STUDY: Lateral condylar fractures of the third metacarpus/metatarsus are the most common cause of equine fatality on UK racecourses. Identification of risk factors for such injuries and the subsequent implementation of intervention strategies could significantly reduce the total number of racecourse fatalities. OBJECTIVES: To identify horse-, race- and course-level risk factors for fatal lateral condylar fracture in Thoroughbreds on UK racecourses. METHODS: Case-control study designs were used. Case horses were defined as those that were subjected to euthanasia having sustained an irreparable lateral condylar fracture while racing at any of the 59 UK racecourses. Case races were defined as those in which one or more horses sustained a fatal lateral condylar fracture. Three controls for each case horse were selected at random from the race in which the case was running. Three controls for each case race were selected at random from all races of the same type held in the same year. Ninety-eight cases were included in the study. Conditional logistic regression was used to identify the relationship between a number of independent variables and the likelihood of fracture. RESULTS: Horses doing no gallop work during training and those in their first year of racing were at significantly increased risk of fracture on the racecourse. Case horses were also more likely to have started racing as 3- or 4-year-olds. Fractures were found to be more likely in longer races with a larger number of runners, races in which professional jockeys were not permitted to ride and races in which the going was described as firm or hard. CONCLUSIONS AND POTENTIAL RELEVANCE: Modifications to training schedules, specifically within the first year of racing, may have a large impact on the risk of fatal lateral condylar fracture on the racecourse. Horses should do some gallop work in training and our results suggest that the minimum distance galloped should be between 201 m (1 furlong) and 1609 m (8 furlongs) per week. The association with age at first race requires further investigation for flat and National Hunt racing separately. A reduction in the number of races taking place on very firm going could have an impact on the number of lateral condylar fractures.     

Standing oral extraction of cheek teeth in 100 horses (1998--2003)

REASONS FOR PERFORMING STUDY: Extraction of cheek teeth (CT) by the conventional repulsion technique requires general anaesthesia and carries a high rate of post operative complications. Consequently, an alternative method of extraction, i.e. orally in standing horses, was evaluated. HYPOTHESIS: The need for and risks of general anaesthesia could be avoided and post extraction sequelae reduced by performing extractions orally in standing horses. METHODS: One hundred mainly younger horses (median age 8, range 2-18 years) with firmly attached CT that required extraction because of apical infections, displacements, diastemata, idiopathic fractures and the presence of supernumerary CT had the affected teeth (n = 111) extracted orally under standing sedation. Follow-up information was obtained for all cases, a median of 16 months later. RESULTS: Oral extraction was successful in 89 horses and unsuccessful in 11 due to damage to the CT clinical crown (n = 9) during extraction, for behavioural reasons (n = 1) and because the apex of a partly extracted CT fell back into the alveolus following sectioning (n = 1). Predispositions to extraction-related CT fractures were present in 5 of the 9 cases, i.e. advanced dental caries (n = 2) and pre-existing 'idiopathic' fractures (n = 3). The iatrogenically fractured CT were later repulsed under standing sedation (n = 3) and under general anaesthesia (n = 6). Eighty-one of the remaining 89 horses had successful oral CT extraction with no or minimal intra- or post operative complications occurring. Post operative complications in the other 8 cases included post extraction alveolar sequestration (n = 3), alveolar sequestration and localised osteomyelitis (n = 1), localised osteomyelitis (n = 1), incorporation of alveolar packing material into alveolar granulation tissue (n = 1), and nasal discharge due to continued intranasal presence of purulent food material (n = 1) and to ongoing sinusitis (n = 1). The above sequelae were treated successfully in all cases, with general anaesthesia required in just one case. Following oral extraction, significantly (P<0.001) fewer post operative problems developed in 54 horses with apically infected CT in comparison with 71 previous cases that had repulsion of apically infected CT at our clinic. CONCLUSIONS AND POTENTIAL RELEVANCE: Oral extraction of cheek teeth is a successful technique in the majority of younger horses with firmly attached CT and greatly reduces the post operative sequelae, compared with CT repulsion. Additionally, the costs and risks of general anaesthesia are avoided. Further experience and refinement in the described protocol could potentially increase the success of this procedure and also reduce the incidence of post operative sequelae.     

Magnetic resonance imaging‐detected adaptation and pathology in the distal condyles of the third metacarpus,associated with lateral condylar fracture in Thoroughbred racehorses

Reasons for performing the study: Lateral condylar (LC) fractures of the third metacarpus (McIII) are a common reason for euthanasia in racehorses, and may be the result of repetitive overloading or cumulative pathological change. Magnetic resonance imaging (MRI) allows monitoring of bone and cartilage to detect pathological and adaptive changes that may be precursors of fracture. Objectives: To describe bone and cartilage MRI features in the distal condyles of McIII of Thoroughbred racehorses, with and without condylar fracture. Hypotheses: 1) A greater degree of bone and cartilage adaptation or pathology will be seen in fractured McIIIs compared with their respective contralateral McIIIs. 2) Contralateral McIIIs will have a greater degree of bone and cartilage adaptation or pathology than McIIIs from control horses that did not sustain a LC fracture. Methods: The McIIIs from 96 horses subjected to euthanasia at racecourses were divided into 3 groups: Group 1: nonfractured bones from horses without LC fracture; Group 2: nonfractured bones from horses with unilateral LC fracture; and Group 3: fractured bones from horses with unilateral LC fracture. The MR images were examined and graded for bone and cartilage changes. Results: Nine percent of Group 1 (n = 9) and 11% of Group 2 bones (n = 5) had incomplete LC fractures. Focal palmar necrosis was most frequently detected in bones from Group 1 (12%) compared with Groups 2 (9%) and 3 (4%). The prevalence of bone and/or cartilage abnormalities tended to increase from Group 1 to Group 2 to Group 3. Conclusions: Magnetic resonance imaging is able to detect cartilage and bone changes that may be associated with LC fracture. There was no significant difference in bone/cartilage changes between bones from Groups 1 and 2, despite increased pathology in Group 2 bones. Potential relevance: Periodic monitoring of bone and/or cartilage changes in distal McIII of Thoroughbred racehorses may help to prevent catastrophic LC fractures.     

Equine perioperative fatalities associated with general anaesthesia at a private practice--a retrospective case series

OBJECTIVE: To determine the fatality rate of horses undergoing general anaesthesia at a private equine referral practice using a limited number of anaesthetic protocols. METHODS: A retrospective analysis of records (n = 17 961) from all horses undergoing general anaesthesia for surgical procedures from 1997 to 2001 at Rood and Riddle Equine Hospital, Lexington, Kentucky, USA. Results were reported as percentage of the population, and as crude mortality rates for each procedure (deaths per 1000). RESULTS: The prevalence of equine fatalities directly related to anaesthesia was 0.12% (n = 21) and this rose to 0.24% (n = 42) with the inclusion of horses killed or dying within 7 days post general anaesthesia. Causes of death directly related to anaesthesia were cardiac arrest (n = 10), fracture in recovery stall (n = 8), neuropathy and myopathy necessitating euthanasia (n = 3). Crude mortality rates per procedure were < or =7 deaths per 1000 cases, except arthrodesis/osteotomy cases were 66.7 deaths per 1000 cases. CONCLUSIONS: The anaesthetic fatality rate at this practice is lower than has been reported previously. CLINICAL RELEVANCE: Familiarity with an anaesthetic protocol in combination with reduced anaesthetic time, emergencies of shorter duration between diagnosis and surgery, and adequate preoperative examination appear to minimize the risks associated with general anaesthesia in horses.     

Scanning electron microscopic examination of third metacarpal/third metatarsal bone failure surfaces in thoroughbred racehorses with condylar fracture

OBJECTIVE : To examine the fracture failure surfaces from Thoroughbred horses that had sustained a catastrophic condylar fracture. SAMPLE POPULATION : Bone specimens from the failure surface were obtained from 12 Thoroughbred racehorses with catastrophic injury and 2 non-racing horses with accidental long bone fracture. METHODS : Bone specimens from the failure surface of each fracture were incubated with gold microspheres to label microcracks before examination at x50 to x60,000 using scanning electron microscopy. Microcracking at the failure surface was assessed using a visual analog scale. RESULTS : Branching arrays or clusters of microcracks were seen over a range of magnifications in adapted subchondral bone in the distal end of the MC3/MT3 bone from racing Thoroughbreds with a catastrophic displaced condylar fracture. In the palmar/plantar region, microcracking was associated with the formation of an array of macroscopic cracks in the condylar groove. A different pattern of microcracking was seen in specimens of bone from distal metaphyseal and diaphyseal MC3/MT3 failure surfaces from Thoroughbred racehorses with catastrophic fracture and non-racing horses with an accidental diaphyseal long bone fracture. Few microcracks were seen and typically did not form branching arrays. CONCLUSION : These data suggest that propagation of condylar fracture in Thoroughbred racehorses is initiated by the formation of nanoscale microcracks in adapted subchondral bone that form during exercise-induced bone adaptation. CLINICAL RELEVANCE : Accumulation and coalescence of branching microcracks into arrays or clusters appears to eventually lead to the development of macroscopic subchondral cracks in the condylar groove and initiation of a condylar fracture.     

Results of plate fixation of type 1b olecranon fractures in 24 horses

REASONS FOR PERFORMING STUDY: Previous olecranon fracture reports contain a small proportion of type 1b fractures, with only a few repaired by tension band plate fixation. OBJECTIVES: To evaluate subject details, history, clinical findings and outcome of type 1b olecranon fractures in a large group of horses treated by tension band plate fixation. METHODS: Medical records of 77 horses diagnosed with an olecranon fracture were reviewed. Twenty-four horses (31%) were classified as having type 1b olecranon fractures. Clinical details and follow-up results (4-128 months post operatively) were recorded. RESULTS: Treatment included open reduction and internal fixation using a narrow dynamic compression plate (n = 20), conservative therapy (n = 2) and euthanasia (n = 2). Long-term follow-up was available for 16 plated horses. Four were sound and in training and 9 were sound and performing athletically. Articular surface involvement, comminution, open status or removal of anconeal process fragments did not appear to affect prognosis or soundness. CONCLUSIONS: Internal plate fixation provides an excellent prognosis for an animal capable of athletic performance. POTENTIAL RELEVANCE: Describing tension band plate fixation and results offers a method of fracture repair that will improve the treatment and prognosis for type 1b olecranon fractures.     

Use of a condylar screw plate for repair of a Salter-Harris type-III fracture of the femur in a 2-year-old horse

A 2-year-old sexually intact male Paint horse weighing 427 kg (940 lb) was admitted for examination and treatment of intermittent non-weight-bearing lameness of the right hind limb of 1 week's duration. Radiography revealed a displaced Salter-Harris type-III fracture of the right femoral condyle with the sagittal component of the fracture line located in the intercondylar space and the transverse component exiting on the medial aspect of the femur. The fracture was repaired with a condylar screw plate designed for repair of femoral condylar fractures in humans. The owner reported by telephone 9 months after surgery that the horse was sound. To our knowledge, use of this particular implant system for fixation of a Salter-Harris type-III fracture on the medial side of the femur in a horse has not been described. Results in this horse suggest that this implant can be successfully used for repair of femoral condylar fractures in selected adult horses.     

Treatment of incisive bone fracture in a horse using an acrylic splint

A ventrally displaced incisive bone fracture was diagnosed in a 3-year-old Andalusian stallion. Symptoms included swelling of the lips, dysphagia and ptyalism. External manipulation revealed pain and crepitus in the gingival region of the rostral maxilla. An intraoral examination revealed upper gingival haematomas, misalignment and malocclusion of the incisors (prognathism). A radiograph of the rostral maxilla confirmed ventrally displaced bilateral fractures of the incisive portion of the maxilla rostral to the canine teeth (Triadan 104/204). The fracture was reduced under general anaesthesia. A methylmethacrylate intraoral splint was used to stabilise the fracture. Post operative radiographs confirmed the fracture reduction. Post operative clinical control confirmed the correct position of the splint. No complications were encountered in the post operative period and good stabilisation was obtained. The splint was removed 60 days post operatively. The use of an acrylic intraoral splint successfully stabilised a bilateral, ventrally displaced incisive bone fracture. Normal occlusion was obtained. The use of an acrylic splint may represent a relatively simple, inexpensive and noninvasive technique for the repair of incisive bone fractures rostral to canine teeth in horses.     

Sixteen fractures of the shoulder region in the horse

The clinical and radiological features of fractures of the shoulder region in 16 horses are described. High quality radiographic views were essential for an accurate diagnosis. This sometimes necessitated general anaesthesia. The limitations of radiography are discussed. Nine horses had articular fractures of the supraglenoid tuberosity and eight of these were destroyed because of persistent lameness. The possibility of surgical removal of the fracture fragment(s) is discussed and the importance of early diagnosis emphasised. Seven other fractures of the shoulder region are described. The clinical outcome depended upon the location and nature of the fracture.