Arthroscopic treatment of fractures of the lateral malleolus of the tibia: 26 cases.

Authors: Smith M R W, Wright I M

Journal: Equine veterinary journal

DOI: 10.1111/j.2042-3306.2010.00183.x PubMed: 21492204Log in to save

Summary

# Arthroscopic Treatment of Lateral Malleolus Fractures in Horses Lateral malleolus fractures of the tibia can be challenging to manage, but arthroscopic removal offers a minimally invasive alternative to traditional open arthrotomy. Smith and Wright retrospectively evaluated 26 horses treated arthroscopically at a referral centre, tracking surgical outcomes and long-term return to function through race records and owner questionnaires. All fractures were successfully removed, with the technique allowing comprehensive joint assessment, extraction of comminuted fragments, and management of associated ligamentous damage to the short lateral collateral ligament; only one horse experienced significant post-operative complications, and 18 of 22 horses with follow-up data (82%) returned to their previous level of use. The procedure demands considerable technical skill but delivers genuinely low morbidity, short hospitalisation periods, and a prognosis favourable enough that arthroscopy should be considered the preferred approach over open arthrotomy for these injuries. For practitioners involved in equine fracture management, this work provides robust evidence that lateral malleolus fractures—previously regarded as potentially career-limiting—can now be managed with confidence in horses intended for return to athletic work.

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Practical Takeaways

•Arthroscopic removal of lateral malleolus fractures is the preferred technique over open arthrotomy due to minimal complications, short hospitalization periods, and high success rates for return to work
•The procedure enables thorough joint inspection and removal of small comminuted fragments that might be missed with other approaches, improving overall outcomes
•Expect approximately 82% of horses to return to their previous level of use, making this a favorable treatment option for performance horses despite being technically demanding

Key Findings

•Arthroscopic removal of lateral malleolus fractures was technically feasible in all 26 cases with successful dissection from short lateral collateral ligaments
•Only 1 of 26 horses (3.8%) experienced significant postoperative complications
•Of 22 horses with long-term follow-up, 18 (81.8%) returned to their previous use
•Arthroscopic technique provided comprehensive tarsocrural joint evaluation and enabled removal of remote comminuted fragments with minimal patient morbidity

Conditions Studied

fracture of lateral malleolus of tibiatarsocrural joint injurycomminuted fracture fragmentsshort collateral ligament disruption

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