Equis ISSN 2398-2977

MC / MT 2 and 4: fracture repair

Contributor(s): Rachael Conwell, Dallas Goble, Vetstream Ltd, Chris Whitton

Introduction

  • Plating of proximal splint bone fractures can provide rigid stabilization and increased chances of recovery in some selected cases.
  • Distal splint bone fractures are usually treated conservatively but can be removed where the fragment is substantially displaced or interfering with the function of the suspensory ligament.
  • If less than half of MC2 and the proximal third of MC4/MC2 and MT4 are left after removal, then stabilization of the remaining fragment by application of a conformed plate applied to the proximal portion and the MC/MT3 can be considered.
  • Application of a plate engaging only the cortices in the splint bone is preferred.

Uses

Advantages

  • Anatomical repair with retention of normal support provided by the metacarpal/metatarsal bones.
  • Potentially shorter convalescent times than conservative treatments.

Disadvantages

  • High risk of infection post-surgery if open wounds and contamination of the fracture are present prior to surgery. All efforts should be made to resolve the infection in the area of proposed surgery before fixation is performed.
  • Risks of GA and recovery.
  • Cost.
  • Technical ability of the surgeon and access to suitable plates, screws and equipment.

Requirements

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Preparation

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Procedure

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Aftercare

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Outcomes

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Prognosis

  • Guarded to good for return to athletic soundness, with the exception of fourth metatarsal proximal fractures.

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Sherlock C E & Archer R M (2008) A retrospective study comparing conservative and surgical treatments of open comminuted fractures of the fourth metatarsal bone in horses. Equine Vet Educ 20 (7), 373-379 VetMedResource.
  • Jackson M et al (2007) Splint bone fractures in the horse: a retrospective study 1992-2001. Equine Vet Educ 19 (6), 329-335 VetMedResource.

Other sources of information

  • Richardson D W (2011)Fractures of the small metacarpal or metatarsal bones.In:Equine Surgery. 4th edn. Eds: Auer J A & Stick J A. Saunders Elsevier, Missouri.
  • Doran R (1996)Fractures of the small metacarpal and metatarsal (splint) bones.In:Equine Fracture Repair.Ed: Nixon A J. W B Saunders, Philadelphia.


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