Radiographic and Computed Tomographic Configuration of Incomplete Proximal Fractures of the Proximal Phalanx in Horses Not Used for Racing.
Authors: Brünisholz Hervé P, Hagen Regine, Fürst Anton E, Kuemmerle Jan M
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Incomplete Proximal Phalanx Fractures in Non-Racing Horses Incomplete proximal fractures of the proximal phalanx (P1) present a diagnostic and prognostic challenge in equine practice, yet limited literature describes their anatomical variation in non-racing populations. Researchers retrospectively analysed radiographs and CT scans from 24 horses (predominantly Warmbloods, mean age 9.5 years) diagnosed with incomplete P1 fractures between 2008 and 2013, using standardised measurement protocols to characterise fracture configuration and location. Whilst radiography identified fractures in these cases, CT proved substantially superior for determining fracture size and precise location; notably, 92% of fractures lay in the mid-sagittal plane with a mean length of 13 mm, and over half the cohort (54%) displayed a distinctive pattern of two parallel subchondral lines—a finding invisible on conventional imaging. Critically, fractures were frequently non-bicortical and showed significant variation in dorsopalmar/plantar positioning, with forelimb fractures located significantly more dorsally than hind limb equivalents. For practitioners managing lameness in performance and leisure horses, this work underscores the importance of CT imaging to fully characterise these fractures; radiographic assessment alone risks missing the anatomical detail needed to guide prognosis and rehabilitation protocols, particularly when subtle fracture patterns may substantially influence healing trajectories and return-to-work outcomes.
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Practical Takeaways
- •Standard radiographs may miss or underestimate incomplete P1 fractures; CT imaging should be used for definitive diagnosis and treatment planning
- •These fractures show significant variation in location (dorsopalmar/plantar), requiring individual imaging assessment to guide management decisions
- •Mean lameness duration of 8.7 weeks suggests these are chronic injuries; early advanced imaging and intervention may improve outcomes
Key Findings
- •CT was superior to radiography for identifying incomplete P1 fractures and determining their size and location
- •92% of fractures were located in the mid-sagittal plane with mean proximodistal length of 13 mm
- •A distinct fracture pattern with two parallel subchondral lines was identified in 54% of cases
- •Forelimb fractures were located significantly more dorsally than hind limb fractures