Plate fixation of small metacarpal and metatarsal bone fractures in 27 horses.
Authors: Melly Virginia, Ortved Kyla F, Stewart Holly L, Stefanovski Darko, Richardson Dean W, Bubeck Kirstin A, Hogan Patricia M, García-López José M
Journal: Veterinary surgery : VS
Summary
# Plate Fixation for Small Metacarpal and Metatarsal Fractures When small metacarpal and metatarsal (SMCT) fractures occur in horses, surgeons increasingly consider plate fixation as a treatment option, particularly for complex proximal fractures involving the articular surface. This retrospective analysis of 27 horses treated across three centres between 2008 and 2023 examined whether plate fixation could achieve functional outcomes, with particular attention to complication rates and return-to-work success. The vast majority of fractures presented were proximal (all cases), articular (74%), comminuted (96%) and displaced (82%)—characteristics typically associated with poorer prognoses. Three-quarters of the 25 horses with documented follow-up (76%) returned to their previous work level, with postoperative complications occurring in a third of cases (33%), yet notably, no single surgical or patient variable predicted which horses would successfully return to use. Interestingly, racehorses that did return to competition showed statistically significantly lower earnings per start post-surgery compared to their pre-injury performance, suggesting residual functional deficits despite apparent return to work. These findings suggest that plate fixation offers practitioners a valuable surgical option for complex SMCT fractures with encouraging outcomes, though clinicians should counsel owners that complications are reasonably common and competitive performance may not fully recover to pre-injury levels even when horses resume work.
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Practical Takeaways
- •Plate fixation offers good return-to-work prospects for small metacarpal/metatarsal fractures, with 3 out of 4 horses returning to their previous level of activity
- •Be prepared for postoperative complications in about one-third of cases, and manage client expectations regarding potential performance decrements even in horses that return to work
- •This technique shows promise as an alternative to previously available treatments, though careful case selection and postoperative management remain critical
Key Findings
- •76% of 25 horses with follow-up (19/25) returned to prior work level after plate fixation of proximal SMCT fractures
- •33.3% of horses (9/27) experienced postoperative complications
- •74.1% of fractures were articular, 96.3% were comminuted, and 81.5% were displaced
- •Racehorse earnings per start were significantly lower postoperatively compared to preoperatively (p=0.02)