Internal fixation of a fractured axis in an adult horse.
Authors: Gygax D, Fürst A, Picek S, Kummer M
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Internal Fixation of Fractured Axis in an Adult Horse Fractures of the equine axis (second cervical vertebra) present significant surgical challenges, yet internal fixation techniques remain underreported in the clinical literature. This case describes successful management of a complete transverse fracture in the cranial third of the axis in a 7-year-old Warmblood gelding using a 7-hole 4.5 mm dynamic compression plate (DCP), positioned while the horse was maintained in sternal recumbency under general anaesthesia, with intraoperative fluoroscopy guiding optimal plate placement and screw length determination. The patient demonstrated excellent recovery, regaining full function and returning to previous activity levels, with notably improved neck flexibility and head-bearing ability evident in the immediate post-operative period. This case demonstrates that rigid internal fixation with DCP can provide sufficient biomechanical stability to enable rapid functional recovery and restore normal cervical dynamics, offering a viable alternative to conservative management or other stabilisation methods. For practitioners managing horses with cervical trauma, this technique highlights the value of surgical consultation in fracture cases where anatomical reduction and rigid fixation may justify the anaesthetic risks and cost—particularly in valuable animals where preservation of athletic function is a priority.
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Practical Takeaways
- •Internal fixation with dynamic compression plates is a viable surgical option for axis fractures in horses, enabling rapid return to function rather than conservative management.
- •Fluoroscopic guidance during placement ensures optimal implant positioning and appropriate screw lengths for cervical spine surgery.
- •Recovery in an underwater pool may support post-operative rehabilitation and safe anesthesia recovery for cervical procedures.
Key Findings
- •Internal fixation of a complete transverse axis fracture using a 7-hole 4.5 mm dynamic compression plate achieved successful stabilization in a 7-year-old Warmblood gelding.
- •Fluoroscopy-assisted plate positioning and screw length determination optimized surgical technique.
- •Horse returned to previous activity level with excellent functional outcome and restored neck flexibility post-operatively.