Surgical repair of propagating condylar fractures of the third metacarpal/metatarsal bones with cortical screws placed in lag fashion in 26 racehorses (2007-2015).
Authors: Moulin N, François I, Coté N, Alford C, Cleary O, Desjardins M R
Journal: Equine veterinary journal
Summary
# Editorial Summary Propagating condylar fractures of the third metacarpal and metatarsal bones represent a significant injury in racing stock, yet surgical opinion has traditionally favoured plate fixation despite the added expense and complexity. Moulin and colleagues reviewed 26 racehorses (17 Thoroughbreds and 9 Standardbreds) treated between 2007–2015 using lag screw fixation combined with cast immobilisation, examining both immediate post-operative recovery and long-term racing outcomes. Fifty-eight per cent of horses returned to racing, with notably superior results in Standardbreds (100% return rate versus 35% in Thoroughbreds), and of those racing, 92% achieved competitive placings with 92% securing at least one win—crucially, with no significant difference in racing performance before and after surgery. The technique appears particularly valuable for managing the 76% of cases presenting with spiral fracture patterns, offering clinically equivalent outcomes to plate fixation at reduced surgical and financial burden. This evidence supports lag screw fixation as a legitimate surgical alternative where appropriate anatomical configuration exists, though standardised rehabilitation protocols and larger comparative studies would further strengthen recommendations for practice.
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Practical Takeaways
- •Lag screw fixation combined with tight casting offers a viable alternative to plate fixation for long condylar fractures, with over 50% return-to-racing rates comparable to plate outcomes
- •Standardbred pacers show substantially better prognosis (100% return to racing) than Thoroughbreds (35%), suggesting fracture type or breed-related factors may influence outcomes
- •While one severe recovery complication occurred, the technique appears sufficiently safe for clinical use when proper anaesthetic protocols and post-operative management are employed
Key Findings
- •58% of 26 horses (15/26) returned to racing following lag screw fixation of long condylar fractures of McIII/MtIII
- •100% of Standardbreds (9/9) raced post-surgery compared to 35% of Thoroughbreds (6/17)
- •12 of 15 post-surgical racing horses were placed in at least one race and 11 won at least once
- •No significant difference in racing performance was observed before and after surgery