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Diagnosis, management, and outcome in 19 horses with deltoid tuberosity fractures
Authors:Fiske-Jackson Andrew R  Crawford Andrew L  Archer R Michael  Bolt David M  Smith Roger K
Institution:Department of Veterinary Clinical Sciences, The Royal Veterinary College, North Mymms, UK. afiskejackson@rvc.ac.uk
Abstract:Objective: To describe the diagnosis and treatment of fractures of the deltoid tuberosity. Study Design: Case series. Methods: Medical records (1992–2009) of 19 horses with radiographic confirmation of deltoid tuberosity fractures were reviewed. Data retrieved included signalment, clinical and diagnostic imaging findings, and treatment. Outcome was determined by telephone questionnaire of owners and referring veterinarians. Results: Most horses were markedly lame on admission and 53% had reduced protraction of the affected limb. All fractures were identified on a cranio45° medial‐caudolateral oblique projection; however, only 32% (6 horses) were detected on a mediolateral projection whereas 86% were evident ultrasonographically. Treatment by local wound care and stall rest resulted in return to athletic function without lameness for 13 of 14 horses that had follow‐up. Conclusions: A cranio45° medial‐caudolateral oblique radiographic view was better than a mediolateral projection for identification of deltoid tuberosity fractures. Ultrasonographic detection of fractures was similar except when gas accumulation obscured the fracture site. Deltoid tuberosity fractures can cause severe lameness but can be treated successfully with conservative management.
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