Arthroscopic removal of fractures of the lateral malleolus of the tibia in the tarsocrural joint: a retrospective study of 13 cases.

Authors: O'Neill H D, Bladon B M

Journal: Equine veterinary journal

DOI: 10.1111/j.2042-3306.2010.00103.x PubMed: 20716198Log in to save

Summary

# Editorial Summary: Arthroscopic Management of Lateral Malleolus Fractures Lateral malleolus fractures of the tarsocrural joint have received minimal attention in the equine literature, with no published outcome data for arthroscopic treatment until this retrospective review of 13 cases treated between 1999 and 2009. O'Neill and Bladon examined hospital records and follow-up data from horses undergoing arthroscopic fragment removal, with performance tracking available for the 12 Thoroughbreds in the cohort (9 National Hunt, 3 Flat). All 11 horses with adequate post-operative follow-up (>6 months) returned to soundness, whilst 10 of the 12 racehorses resumed competition, accumulating 104 race starts at a median of 241 days post-surgery (range 180–366 days). These findings suggest that arthroscopic debridement offers an excellent prognosis for return to full athletic function, positioning it as the appropriate first-line surgical approach for managing these fractures in performance horses. For farriers and physiotherapists involved in post-operative rehabilitation, the timeline to return to work appears realistic for planning progressive conditioning protocols, though individual variation warrants close monitoring during the critical 6–12 month recovery window.

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Practical Takeaways

•Arthroscopic debridement of lateral malleolus fractures offers an excellent prognosis for return to full athletic performance in horses
•Racing Thoroughbreds can expect to return to competition within 6-12 months postoperatively with high success rates (83% return to racing)
•This technique should be considered the appropriate treatment method for lateral malleolus fractures in performance horses

Key Findings

•All 13 horses presented with acute unilateral lateral malleolus fractures and underwent successful arthroscopic removal
•11 of 13 horses with >6 months follow-up were nonlame postoperatively
•10 of 12 Thoroughbreds returned to racing, completing 104 races total with median 5 races per horse
•Median time from surgery to return to racing was 241 days (range 180-366 days)

Conditions Studied

lateral malleolus fracturetarsocrural joint fracture

Related References

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