Immediate pre-operative computed tomography for surgical planning of equine fracture repair: A retrospective review of 55 cases.
Authors: Taylor Camilla J, Peter Vanessa G, Coleridge Matthew O D, Bathe Andrew P
Journal: PloS one
Summary
# Editorial Summary: Pre-operative CT Imaging for Equine Fracture Surgery Pre-operative radiographs often fail to capture the full complexity of equine limb fractures, potentially compromising surgical outcomes through inadequate planning. This retrospective analysis of 55 cases (predominantly young Thoroughbred racehorses presenting with proximal phalanx, carpal, and metacarpal/metatarsal fractures) examined whether immediate pre-operative CT imaging under general anaesthesia altered surgical strategy compared to conventional radiographic assessment alone. Three blinded reviewers classified CT findings as having major relevance (23.6%), intermediate relevance (38.2%), or minor relevance (38.2%) to surgical decision-making, with no statistical difference across fracture types. In nearly two-thirds of cases, CT imaging either provided additional anatomical information or substantially modified the surgical approach, whilst in all instances it increased surgeon confidence in the planned procedure. For practitioners involved in fracture management, these findings suggest that pre-operative CT warrants serious consideration as a standard imaging modality prior to surgical repair, particularly where anatomical complexity is anticipated, given its capacity to refine surgical strategy and reduce intraoperative decision-making uncertainty.
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Practical Takeaways
- •Pre-operative CT should be considered standard for fracture cases as it changes or confirms surgical plans in nearly two-thirds of cases, improving outcomes through better preparation
- •CT is particularly valuable for complex fracture configurations that appear simpler on radiographs alone, ensuring you understand the true anatomy before surgery
- •While CT relevance varies by case, it universally increased surgical confidence—important for client communication and reducing intraoperative surprises
Key Findings
- •CT imaging was of major relevance in 23.6% of fracture cases, changing surgical planning decisions
- •In 61.8% of cases (major and intermediate relevance combined), CT provided additional information that influenced surgical approach
- •No statistical difference in CT relevance was found between different fracture types (p<0.05)
- •CT imaging increased surgeon confidence in surgical planning across all 55 cases