Long-term clinical and radiographic results after lag screw ostheosynthesis of short incomplete proximal sagittal fractures of the proximal phalanx in horses not used for racing.
Authors: Bryner Marco F, Hoey Seamus E, Montavon Stéphane, Fürst Anton E, Kümmerle Jan M
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Lag Screw Fixation for Proximal Phalanx Fractures in Non-Racing Horses Short incomplete proximal sagittal fractures of the proximal phalanx (SIPSFP1) present a challenging injury in equine practice, and whilst lag screw fixation is a recognised surgical option, long-term outcome data in non-racing horses had been limited. This retrospective review examined 31 horses treated between 2008 and 2014, with 15 receiving formal clinical and radiographic follow-up at minimum 12 months post-operatively. Encouragingly, 27 of 31 horses (87%) returned to their previous level of athletic activity according to owner interviews, and nine of 15 horses (60%) assessed clinically were sound at the trot, with the remaining six showing only mild lameness; however, radiographic healing proved more inconsistent, with complete fracture consolidation evident in only six limbs versus persistent fracture lines in 13. The position of the proximal screw did not influence either radiographic healing patterns or return to soundness. For practitioners managing non-racing equines with SIPSFP1, this evidence supports lag screw fixation as a reliable treatment approach with a genuinely high functional success rate—though clients should understand that radiographic evidence of complete healing may not occur, and clinical soundness should not always be interpreted alongside radiographic findings.
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Practical Takeaways
- •Lag screw fixation is a reliable surgical option for non-racing horses with proximal phalanx fractures, with high rates of return to work despite incomplete radiographic healing
- •Expect incomplete radiographic healing at 12+ months post-surgery, but this does not necessarily indicate poor functional outcome or soundness
- •Most treated horses achieve their pre-injury activity levels, making this a worthwhile treatment option for valuable non-racing equines
Key Findings
- •27 of 31 horses (87%) returned to previous athletic activity level after lag screw fixation
- •9 of 15 horses (60%) were sound at trot on long-term follow-up (≥12 months)
- •Complete radiographic healing occurred in only 6 of 15 limbs (40%), with fracture lines remaining visible in 13 limbs
- •Proximal screw position was not associated with radiographic healing or return to soundness