Surgical management of a Salter-Harris type I proximal physeal fracture of the tibia in a foal: a case report.
Authors: Mazaheri-Khameneh Ramin, Azizi Saeed, Davoodi Farshid, Gooran Mohammad Mahdi
Journal: BMC veterinary research
Summary
# Surgical Management of Proximal Tibial Physeal Fractures in Foals Salter-Harris physeal fractures of the tibia represent a significant traumatic injury in neonatal foals, with type II fractures typically documented as most common; however, this case report documents a relatively unusual type I fracture accompanied by concurrent tibial tuberosity involvement in a 2-week-old foal following kick trauma. The affected foal presented with characteristic signs of severe hindlimb compromise—non-weight-bearing lameness, valgus deviation, stifle immobility and crepitus—which radiographic examination confirmed as a displaced proximal physeal fracture with separated tuberosity. Rather than relying on conservative management alone, the surgical team stabilised the physeal fracture using a 4.5 mm T-plate with seven cortical bone screws, whilst a single cortical screw in lag fashion secured the tibial tuberosity fragment. Two months of post-operative monitoring revealed complete fracture healing without complications and full functional recovery, with the foal returning to normal weight-bearing and locomotion. This case represents the first documented use of T-plate fixation for Salter-Harris type I proximal tibial fractures with concurrent tuberosity fractures in foals, suggesting that rigid internal fixation with compression plating offers a viable and reliable alternative to conservative approaches, particularly where significant fragment displacement or concurrent injuries necessitate anatomical reduction to optimise long-term limb function and athletic soundness.
Read the full abstract on PubMed
Practical Takeaways
- •T-plate fixation is a viable surgical option for proximal tibial physeal fractures in foals and should be considered for cases unresponsive to conservative management
- •Careful radiographic evaluation is essential to detect all fracture components (physeal and tuberosity involvement) in traumatic hindlimb injuries in young foals
- •Foals with proximal tibial fractures and appropriate surgical management can achieve complete recovery and return to normal function within 2 months
Key Findings
- •A 2-week-old foal with Salter-Harris type I proximal tibial fracture and tibial tuberosity fracture was successfully treated with T-plate fixation and cortical bone screws
- •T-plate fixation combined with lag screw technique for tibial tuberosity achieved full recovery with no lameness at 2-month follow-up
- •This is the first reported case of Salter-Harris type I (rather than the more common type II) proximal tibial fracture in a foal treated with T-plate implant