Long-term clinical and radiographic results after lag screw ostheosynthesis of short incomplete proximal sagittal fractures of the proximal phalanx in horses not used for racing

Abstract

Objective: To determine long term outcomes of nonracing equines athletes treated for short incomplete proximal sagittal fractures of the proximal phalanx (SIPSFP1) by lag screw fixation. Study design: Retrospective study. Sample population: Thirty-one horses. Methods: Medical records from horses with an SIPSFP1 (2008-2014) were reviewed. Long-term (≥12 months) outcomes were assessed with telephone interviews and clinical and radiographic examinations. Results: Warmblood was the predominant breed in cases included in the study. Among horses with long-term interview information, 27 of 31 returned to previous athletic activity level. In total, 15 horses with 19 fractures had clinical and radiographic assessment after a minimum of 12 months. Among those, nine of 15 horses were sound at the trot, and six of 15 were mildly lame. Complete radiographic healing was confirmed in six limbs, and the facture line was evident in 13. The position of the proximal screw was not associated with radiographic fracture healing or return to soundness. Conclusion: Most horses treated for SIPSFP1 with lag screw fixation returned to previous activity levels, although radiographic fracture healing remained incomplete 12 months or more after surgery. Clinical significance: Lag screw fixation is a valid treatment for horses not used for racing that are experiencing an SIPSFP1 and results in a high rate of return to intended use, although complete radiographic fracture healing cannot be expected.