Maternal allogeneic cancellous bone graft for the treatment of osteitis along the physeal scar of the proximal metatarsus in a foal.
Authors: Sauer Fay J, Verhaar Nicole, Geburek Florian
Journal: Veterinary surgery : VS
Summary
# Editorial Summary Traumatic septic osteitis in foals presents a significant clinical challenge, particularly when infection resolution leaves substantial bone defects at weight-bearing sites vulnerable to pathologic fracture. This case report describes successful treatment of a neonatal Quarter Horse foal that sustained a laceration exposing the proximal metatarsus, resulting in septic osteitis along the physeal scar following initial surgical debridement; conventional autografting was not feasible due to the large defect size relative to the foal's available bone stock. The surgical team harvested fresh cancellous bone from the dam's tuber coxae and used it to fill the metaphyseal–epiphyseal defect, an innovative approach that circumvented the autograft limitation. Radiographic evidence of graft incorporation was evident within one month, with the foal remaining sound at walk and trot through 21 months of follow-up, achieving both structural integration and an even bone contour with homogeneous radio density. Whilst this case demonstrates the promising potential of fresh allogeneic cancellous bone grafting in foals—particularly the biological compatibility afforded by using maternal donor material—the authors appropriately highlight that pre-grafting compatibility testing warrants consideration in future applications to optimise success rates and minimise rejection risk.
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Practical Takeaways
- •Allogeneic cancellous bone grafting from dam to foal can be a viable salvage option when autograft bone stock is insufficient for large traumatic-septic defects
- •Fresh allograft incorporation appears reliable in this case, though compatibility testing should be considered before routine clinical use to minimize rejection risk
- •Early aggressive debridement and antimicrobial therapy of septic osteitis followed by strategic grafting can prevent pathologic fracture and restore functional soundness
Key Findings
- •Fresh allogeneic cancellous bone graft from mare's tuber coxae successfully incorporated into foal's proximal metatarsal defect with no adverse reactions
- •Foal achieved sound gait at walk and trot by 6 months post-graft with radiographic evidence of graft incorporation and homogeneous bone density at 21 months
- •Both foal surgical site and mare donor site healed without complications