Slab fractures of the third carpal bone involving both radial and intermediate facets and outcomes after surgical repair in racing Quarter Horses.
Authors: Nelson Brad B, Lawless Shauna P, McIlwraith C Wayne
Journal: Equine veterinary journal
Summary
# Editorial Summary: Third Carpal Bone Slab Fractures in Racing Quarter Horses Bilateral facet slab fractures of the third carpal bone (C3) represent a particularly challenging carpal injury in racing Quarter Horses, yet their surgical outcomes have remained poorly characterised until now. This retrospective analysis examined 22 Quarter Horses that underwent arthroscopic-guided internal fixation for C3 slab fractures involving both the radial and intermediate facets between 2008 and 2020, documenting pre-operative characteristics, surgical findings, and long-term functional outcomes. The fractures were notably severe, with 91% of cases presenting with bone collapse and concurrent avulsion of the medial palmar intercarpal ligament, whilst 91% also exhibited articular cartilage erosion and nearly half (41%) had associated osteochondral fractures of the radial carpal bone. At a mean follow-up of 5.5 years post-surgery, 86% of horses survived to either breeding or retirement use, though only 39% of those tracked beyond one year returned to any level of athletic work. These findings suggest that although bilateral facet C3 fractures carry a guarded prognosis for performance horses, surgical repair offers realistic long-term viability for breeding and retirement purposes, making informed owner counselling on realistic functional expectations essential when presenting treatment options.
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Practical Takeaways
- •Quarter Horses with bilateral radial and intermediate facet C3 slab fractures have a favorable long-term prognosis for retirement and breeding (86% survival at 5+ years) when surgically repaired, though athletic return is limited to low-level activity in only 39%
- •Expect significant associated lesions in these fracture cases: collapsing fracture morphology and ligament avulsion are nearly universal (91%), and assess for concurrent cartilage erosion and radial carpal bone involvement
- •Surgical repair via arthroscopic-guided internal fixation is a viable option for these severe fractures; however, owners should be counseled that athletic comeback is not the primary goal
Key Findings
- •91% of C3 slab fractures involving both radial and intermediate facets were collapsing fractures with 91% showing medial palmar intercarpal ligament avulsion
- •Articular cartilage erosion occurred in 91% of cases and osteochondral fractures of the radial carpal bone in 41% of cases
- •At 5.5±3.9 years post-surgery, 86% of horses were alive and used for breeding or retirement
- •39% of horses with follow-up >1 year resumed some athletic activity after surgical repair