Central tarsal bone fractures in horses not used for racing: Computed tomographic configuration and long-term outcome of lag screw fixation.
Authors: Gunst S, Del Chicca F, Fürst A E, Kuemmerle J M
Journal: Equine veterinary journal
Summary
# Editorial Summary: Central Tarsal Bone Fractures in Non-Racing Horses Central tarsal bone fractures remain poorly characterised in non-racing horses, prompting Gunst and colleagues to conduct a retrospective analysis of six cases (five Warmbloods in showjumping, one Quarter Horse in reining) diagnosed between 2009 and 2013, all treated with lag screw internal fixation. Computed tomography revealed a consistent fracture pattern across cases: sagittal slab fractures initiating dorsally and extending plantarly or plantaromedially through the plantar cortex at the plantar or plantaromedial indentation, with marked sclerosis of the central tarsal bone evident in all patients—suggesting chronic stress-related aetiology rather than acute traumatic injury. At minimum one-year follow-up, five of six horses (83%) returned to soundness and resumed their intended use, though mild osteophyte formation at the distal intertarsal joint was commonly observed. The distinctly consistent fracture configuration identified on CT imaging, alongside radiographically subtle additional fracture lines that could be missed on conventional radiography, underscores the diagnostic value of cross-sectional imaging and supports a strong prognosis when internal fixation is tailored to the individual fracture anatomy. For practitioners managing tarsal lameness in sport horses, this work advocates for CT imaging when central tarsal involvement is suspected, and demonstrates that anatomically guided lag screw fixation offers excellent long-term outcomes in non-racing populations.
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Practical Takeaways
- •Central tarsal bone fractures in sport horses (showjumpers and rein horses) can be successfully treated with lag screw fixation, with 83% achieving return to soundness and intended use
- •CT imaging is essential for identifying the specific fracture configuration and planning accurate surgical repair, as radiographically subtle additional fracture lines may be missed on conventional radiography
- •These fractures appear stress-related rather than acute traumatic injuries; consider the chronic loading pattern and conditioning of the athlete when counselling owners on prognosis and rehabilitation
Key Findings
- •All 6 horses presented with sagittal slab fractures of the central tarsal bone with a consistent dorsal-to-plantar direction and marked central tarsal bone sclerosis
- •5 of 6 horses (83%) were sound and returned to their intended use at long-term follow-up (≥1 year post-operatively)
- •Lag screw internal fixation resulted in successful fracture healing with mild osteophyte formation at the distal intertarsal joint as a common but non-debilitating sequel
- •Central tarsal bone fractures in non-racehorses appear to have a chronic stress-related aetiology with a distinct fracture configuration identifiable on computed tomography