The Modern Equine Vet
November 2023
Vol 13 Issue 11 2023
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News Notes

Standing Fracture Repair Viable Option for P1, MC/MTIII Fractures

Standing fracture repair appears to be a worthwhile option for treating sagittal proximal phalanx (P1) and parasagittal metacarpal/metatarsal III (MC/MTIII) fractures because it can restore the horse’s presurgical athletic abilities and enable it to return to the track within a reasonable time, according to a recent study.

Repairing P1 and MC/MTIII fractures used to be done under general anesthesia, but now is done under standing sedation. However, the success of the standing fracture repair has not been studied in a large cohort, so the researchers set out to determine the short- and long-term outcomes of horses undergoing these procedures.

They did a retrospective clinical record review of cases undergoing standing repair of P1 or MC/MTIII fractures from Jan. 1, 2007 to June 30, 2021, collecting data about signalment, fracture configuration and complications. They also reviewed the full race records of the horses and compared their pre- and post-surgical outcomes on the track.

Of the 245 cases reviewed, 101 or 41.2% fractured the proximal phalanx and 144 (58.8%) had a condylar fracture. Of the repaired fractures, 64.9% (159/245) were bicortical and 35.1% (86/245) unicortical fissure fractures.

Almost all the horses—98%—survived to discharge, and just more than 75% raced a median of 241 days after surgery. The horses that were unable to race after surgery were more likely to experience complications (36.5% vs. 17.3%).

The researchers found no significant differences between the horse’s pre- and post-operative racing performance and earnings per start (median £628.00, interquartile range 115.90–1934.80 vs. £653.20, 51.00–1886.40, P=0.7) or placing first–third (77% [95% CI: 68%–85%] vs. 71% [95% CI: 62%–80%, P=0.5] in at least one race. MeV

For more information:
Colgate VA, Robinson N, Barnett TP, et al. Outcome and racing performance following standing fracture repair in 245 horses. Equine Vet J. 2023 Oct. 6. https://beva.onlinelibrary.wiley.com/doi/10.1111/evj.14016