Outcome following repair of 63 sagittal fractures of the proximal phalanx in UK Thoroughbreds using either a triangular or linear screw configuration.
Authors: Findley Judith A, O'Neill Henry D, Bladon Bruce M
Journal: Equine veterinary journal
Summary
# Editorial Summary: Sagittal Fractures of the Proximal Phalanx — Screw Configuration Outcomes Sagittal fractures of the proximal phalanx in racehorses have traditionally been repaired using linear screw configurations, yet biomechanical theory suggests a triangular arrangement might provide superior stability and load distribution. Findley and colleagues reviewed 63 sagittal fractures (incomplete and complete, minimally displaced) in UK Thoroughbreds repaired under standing sedation, comparing outcomes between 54 horses treated with triangular screw placement and 10 with linear configuration. Horses receiving triangular repair demonstrated markedly superior return-to-racing rates at 81% (43/53) with a median return interval of 289 days, versus 70% (7/10) for linear repair at 351 days—a clinically meaningful difference suggesting faster functional recovery. The triangular configuration also showed lower complication rates, supporting its adoption as the preferred technique for minimally displaced sagittal fractures amenable to standing repair. For farriers and veterinarians collaborating on fracture management and rehabilitation planning, this evidence validates the triangular approach as offering tangibly better prognosis and earlier return to athletic function, though individual case factors remain paramount in technique selection.
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Practical Takeaways
- •Triangular screw configuration is an effective repair option for sagittal proximal phalanx fractures, achieving return-to-racing in over 80% of cases within ~9.5 months
- •Standing sedation repair is feasible and yields favorable outcomes without general anesthesia requirements
- •Triangular repair demonstrates faster return to racing and higher success rates than linear screw placement for this fracture type
Key Findings
- •81% (43/53) of horses repaired with triangular screw configuration returned to racing at median 289 days
- •70% (7/10) of horses repaired with linear screw configuration returned to racing at median 351 days
- •Triangular screw repair performed under standing sedation demonstrated excellent return-to-racing rates with low complication rates
- •Triangular configuration showed superior outcomes compared to linear configuration for proximal phalanx fracture repair in Thoroughbreds