Arthroscopic removal of dorsoproximal chip fractures of the proximal phalanx in standing horses.

Authors: Elce Yvonne A, Richardson Dean W

Journal: Veterinary surgery : VS

DOI: 10.1053/jvet.2002.32393 PubMed: 11994846Log in to save

Summary

# Editorial Summary Dorsoproximal chip fractures of the proximal phalanx are a common cause of forelimb lameness in performance horses, yet surgical management traditionally required general anaesthesia with its inherent risks and costs. Elce and Richardson evaluated standing arthroscopic removal of these fragments in 104 horses aged 1–13 years, using intravenous sedation (xylazine and/or detomidine) combined with intra-articular and local infiltration analgesia to access the dorsal pouch of the fetlock joint via arthroscopic portals. The technique proved remarkably successful: no major operative or postoperative complications occurred, 91% of Thoroughbred racehorses resumed racing postoperatively, and 78% returned to competition at their previous level or higher. For practitioners and surgeons with appropriate training, standing arthroscopic removal offers a compelling alternative to general anaesthesia—reducing perioperative risk, hospital costs, and recovery time whilst maintaining excellent functional outcomes in athletic horses.

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Practical Takeaways

•Standing arthroscopic chip fracture removal is a viable alternative to general anesthesia for experienced surgeons, reducing cost and anesthetic risk while maintaining excellent racing outcomes
•Early surgical intervention via standing arthroscopy may optimize return-to-sport prospects, particularly for high-value racehorses
•Proper standing restraint, sedation protocols, and local analgesia blocks make this technique practical for routine lameness cases in experienced hands

Key Findings

•Standing arthroscopic removal of dorsoproximal chip fractures can be performed without major operative or postoperative complications in 104 horses aged 1-13 years
•91% of Thoroughbred racehorses returned to racing after standing arthroscopic surgery, with 78% racing at the same or higher level
•Standing surgery eliminates general anesthesia risks and associated expenses compared to recumbent arthroscopic approaches

Conditions Studied

dorsoproximal chip fractures of the proximal phalanxmetacarpophalangeal joint fracturemetatarsophalangeal joint fracture

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