Distal humeral Salter Harris (Type II) fracture repair by an ulnar osteotomy approach in a horse.
Authors: Ahern Benjamin J, Richardson Dean W
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Distal Humeral Salter-Harris Fracture Repair via Ulnar Osteotomy A 3-month-old Standardbred filly presenting with a comminuted type II Salter-Harris fracture of the distal humerus was successfully managed through surgical repair using an ulnar osteotomy approach, which provided improved visualisation and access to the fracture site compared to traditional methods. Radiographic and computed tomography imaging guided surgical planning, whereupon the fracture was stabilised with a 7-hole broad locking compression plate (LCP) inserted in lag fashion, with the resulting ulnar osteotomy itself repaired using a 7-hole narrow LCP. At six-month follow-up, the filly demonstrated comfortable ambulation with normal cosmetic appearance, indicating successful fracture union. This case demonstrates that the ulnar osteotomy approach is a technically feasible method for accessing distal humeral fractures in young horses, and that modern plate fixation systems offer viable options for fracture types that historically carried a grave prognosis. For practitioners managing foals with distal humeral fractures, this approach expands the surgical toolkit beyond amputation or euthanasia, though success likely depends on early diagnosis, appropriate imaging, skilled surgical execution, and robust post-operative management in a dedicated equine facility.
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Practical Takeaways
- •The ulnar osteotomy approach provides reliable surgical access to distal humeral fractures in foals and may improve outcomes for what are typically high-mortality injuries
- •Locking compression plate fixation can be used for complicated distal humeral fractures in young horses, offering a potential alternative to euthanasia
- •Early surgical intervention with appropriate fixation and subsequent rehabilitation may result in functional recovery and return to normal movement
Key Findings
- •Ulnar osteotomy approach successfully provided access to distal humeral fracture in a 3-month-old filly
- •Locking compression plates allowed stabilization of a comminuted type II Salter-Harris fracture of the distal humerus
- •At 6-month follow-up, the filly was ambulating comfortably with normal cosmetic appearance