Equis ISSN 2398-2977

MC / MT 2 and 4: partial removal

Synonym(s): Splint removal

Contributor(s): Dallas Goble, Graham Munroe, Vetstream Ltd, Chris Whitton

Introduction

  • Fractures of MC/MT 2 and 4 most commonly result from direct external trauma such as a kick from another horse or by the horse itself kicking through an object with its leg.
  • In addition, they can occur in the mid or distal portions of the leg, both fore and hind, as part of chronic suspensory ligament desmitis involving the body   Suspensory ligament: desmitis - midbody   or branches   Suspensory ligament: desmitis - branch   of the ligament.
  • There is considerable controversy about how to treat these cases, with many clinicians advocating a conservative approach with box-rest and bandaging. Non-union and/or large callus formation may lead to interference with the adjacent suspensory ligament. Displaced and severely infected fractures can be removed by surgery with good results and more rapid return to function.

Uses

  • Fractures of the distal and middle third of the MC/MT II or IV bone   MC / MT 2 and 4: fracture  , particularly where there is displacement, comminution, infection or delayed/non-union.
  • It is essential the suspensory ligament of the affected limb is assessed clinically and by ultrasonography before the decision to undertake surgery.

Advantages

  • Simple procedure.
  • Rapid return to function if the splint bone is the only pathology.

Disadvantages

  • Invasive surgery.
  • Expense.
  • General anesthetic risk.

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

  • Good.

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Jackson M (2007) Splint bone fractures in the horse: a retrospective study 1992-2000. Equine Vet Educ 19, 329-335 VetMedResource.
  • Jenson P W, Gaughan E M, Lillich J D & Bryant J E (2004) Segmental ostectomy of the second and fourth metacarpal and metatarsal bones in horses: 17 cases (1993-2002). JAVMA 224 (2), 271-274 PubMed.
  • Harrison L J, May S A & Edwards G B (1991) Surgical treatment of open splint bone fractures in 26 horses. Vet Rec 128 (26), 606-610 PubMed.
  • Allen D & White N A (1987) Management of fractures and exostosis of the metacarpals and metatarsals II and IV in 25 horses. Equine Vet J 19 (4), 326-330 PubMed.

Other sources of information

  • 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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