Treatment of subchondral lucencies in the medial proximal radius with a bone screw in 8 horses.
Authors: Roquet Imma, Lane Easter J, Coomer Richard P C, Ezquerra Luis J, Marsh Chad A, Trostle Steve S, Santschi Elizabeth M
Journal: Veterinary surgery : VS
Summary
Subchondral lucencies (SCL) in the medial proximal radius represent a challenging source of elbow lameness, and conservative management often requires prolonged rest periods that may not resolve the underlying pathology. Roquet and colleagues reviewed eight horses (aged 1–20 years) treated with a minimally invasive surgical approach: placement of a 4.5 mm cortical bone screw across the SCL under fluoroscopic or radiographic guidance, followed by 30–60 days of stall confinement with hand-walking and a further 30–60 days of pasture turnout. Within six months, seven of eight horses (87.5%) returned to their intended use (four to performance work, three to pasture turnout), with radiographic evidence of SCL healing visible at 3–4 months post-operatively; only one horse showed initial improvement in lameness before a recurrence. For practitioners managing elbow lameness refractory to conservative therapy, or where rapid functional recovery is a priority, this technique offers a viable alternative, though the modest sample size and single case of recurrence suggest careful patient selection and realistic prognostic discussion remain important.
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Practical Takeaways
- •Screw fixation of elbow subchondral lucencies is a viable surgical option when conservative treatment fails or rapid return to work is needed—expect 87-88% success rates
- •Recovery timeline is reasonable: 60-120 days total recovery with 3-4 months to radiographic healing; this can be faster than prolonged conservative management
- •Success appears consistent across different ages (1-20 years) and use types (performance and pasture horses), though sample size is small
Key Findings
- •Screw placement across subchondral lucencies of the proximal radius resolved or reduced lameness in 7/8 horses (87.5%)
- •Radiographic evidence of SCL healing (reduction in size) occurred in all 8 horses by 3-4 months post-surgery
- •7/8 horses (87.5%) returned to intended use (performance or pasture) within 6 months post-operatively
- •One horse (dressage) showed initial improvement but lameness returned, representing the single treatment failure