Surgical repair of mid-body proximal sesamoid bone fractures in 25 horses

Evita Busschers, Dean W Richardson, Patricia M Hogan, Midge Leitch

Research output: Contribution to journalArticle (Academic Journal)peer-review

7 Citations (Scopus)

Abstract

OBJECTIVE: To describe the characteristics of unilateral mid-body proximal sesamoid bone (PSB) fractures, to determine factors associated with the outcome of horses after surgical repair, and to describe a technique for arthroscopically assisted screw fixation in lag fashion.

STUDY DESIGN: Retrospective case series.

ANIMALS: Horses (n=25) with unilateral mid-body PSB fracture.

METHODS: Medical records (1996-2006), radiographs, and arthroscopic videos of horses with surgically repaired unilateral mid-body PSB fractures were reviewed. Retrieved data included signalment, affected limb and PSB, fracture characteristics, and surgical technique. Outcome was established by radiographic assessment of healing and race records; categorical data were analyzed using Fisher's Exact test.

RESULTS: Medial forelimb PSBs were most commonly affected (80%). Surgical technique and degree of reduction were significantly associated with outcome; 44% of horses with screw repair and none of the horses with wire fixation raced (P=.047). Factors that may have influenced this outcome were differences in fracture reduction (improved reduction in 22% wire repairs and 88% screw repairs, P=.002) and use of external coaptation (22% wire repair and 88% lag screw repair, P=.002). None of the horses with unimproved reduction raced after surgery.

CONCLUSIONS: Only 28% of horses with mid-body PSB fractures raced after surgery. Compared with wire fixation, screw fixation in lag fashion resulted in good reduction and is seemingly a superior repair technique.

CLINICAL RELEVANCE: For mid-body PSB fractures, arthroscopically assisted screw fixation in lag fashion and external coaptation for anesthesia recovery and initial support provides the best likelihood of return to athletic use.

Original languageEnglish
Pages (from-to)771-80
Number of pages10
JournalVeterinary Surgery
Volume37
Issue number8
DOIs
Publication statusPublished - Dec 2008

Keywords

  • Animals
  • Arthroscopy
  • Biomechanical Phenomena
  • Bone Screws
  • Bone Wires
  • Female
  • Forelimb
  • Fracture Fixation
  • Horses
  • Male
  • Radiography
  • Retrospective Studies
  • Sesamoid Bones
  • Sports
  • Treatment Outcome
  • Journal Article

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