Fracture of the medial intercondylar eminence of the tibia in horses treated by arthroscopic fragment removal (21 horses).
Authors: Rubio-Martínez L M, Redding W R, Bladon B, Wilderjans H, Payne R J, Tessier C, Geffroy O, Parker R, Bell C, Collingwood F A
Journal: Equine veterinary journal
Summary
# Editorial Summary: Medial Intercondylar Eminence of the Tibia Fractures in Horses Fractures of the medial intercondylar eminence of the tibia (MICET) remain poorly characterised in equine practice, despite their potential for significant morbidial consequences. This multicentre retrospective review examined 21 horses treated arthroscopically for MICET fractures across nine equine hospitals between 2004 and 2016, documenting associated soft tissue injuries, surgical outcomes and long-term prognosis. Beyond the primary fracture, concurrent injuries were the rule rather than exception: cranial cruciate ligament (CCL) damage occurred in 71% of cases (15 horses), with severity ranging from minor (≤25% cross-sectional area in 9 cases) to substantial (≥50% in 2 cases); medial meniscal cranial ligament injury affected 52% of horses and articular cartilage damage 67%, predominantly mild to moderate grades. Following arthroscopic fragment removal, 65% of horses with follow-up data (13 of 20) returned to soundness and previous work level, though prognosis darkened considerably when severe soft tissue involvement—particularly extensive CCL damage—was present: all four horses with the most severe combined injuries experienced poor outcomes, with two requiring euthanasia for intractable lameness. Early recognition of MICET fractures (typically following acute trauma) and prompt arthroscopic intervention appear critical to success, though the frequently concurrent CCL and meniscal pathology suggests that stifle stability and cartilage preservation status may ultimately determine whether affected horses achieve return to function.
Read the full abstract on PubMed
Practical Takeaways
- •Suspect MICET fracture in horses presenting with acute lameness following trauma; early arthroscopic diagnosis and fragment removal are recommended for optimal outcomes
- •Plan for concurrent soft tissue injury assessment during arthroscopy, as 71% of cases had cranial cruciate ligament damage that may affect prognosis and rehabilitation
- •Prognosis is generally good (65% return to work) but significantly worse when severe articular cartilage and ligament damage are present; manage owner expectations accordingly in these cases
Key Findings
- •21 horses with MICET fractures were treated arthroscopically across 9 hospitals between 2004-2016, with 12 horses having a history of acute trauma
- •Cranial cruciate ligament damage occurred in 15 of 21 cases (71%), ranging from ≤25% to ≥50% of cross-sectional area
- •13 of 20 horses with follow-up data (65%) returned to sound working status at median 14 months, while 2 of 4 horses with severe soft tissue damage were euthanized for persistent lameness
- •Associated injuries included medial meniscus damage in 5 horses (24%), cranial ligament of medial meniscus damage in 11 horses (52%), and articular cartilage damage in 14 horses (67%)