Equis ISSN 2398-2977

MC / MT 3: condylar fracture repair

Contributor(s): Steve Adair, Andy Bathe, Bud G E Fackelman, Graham Munroe, Vetstream Ltd, Chris Whitton

Introduction

  • Internal stabilization using lag screws +/- bone plates improves articular surface healing, prevents fracture propagation, encourages a more rapid return to weight bearing and probably shortens convalescence.
  • There are 3 commonly used techniques:
    • Internal fixation using lag screw(s) +/- bone plate via stab incision.
    • Internal fixation using lag screw(s) +/- bone plate via arthrotomy.
    • Internal fixation using lag screw(s) +/- bone plate via arthroscopy   Tarsus: arthroscopy    Joint: arthroscopy - overview  .
  • Fracture fixation can be performed in the uncomplicated case under standing sedation using lag screws +/- bone plates via stab incisions   Anesthesia: standing chemical restraint   using regional anesthesia   Forelimb: perineural analgesia    Hindlimb: perineural analgesia  , rather than under general anesthesia.

Uses

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 - for lateral condylar fractures, and uncomplicated medial condylar fractures.
  • Guarded - for extended or displaced condylar fractures; or if extensive soft tissue injury or other fractures complicate the issue.

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Goodrich L R et al (2014) Dynamic compression plate (DCP) fixation of propagating medial condylar fractures of the third metacarpal/metatarsal bone in 30 racehorses: Retrospective analysis (1990-2005). Equine Vet J 46 (6), 695-700 PubMed.
  • Smith L C, Greet T R & Bathe A P (2009) A lateral approach for screw repair in lag fashion of spiral third metacarpal and metatarsal medial condylar fractures in horses. Vet Surg 38 (6), 681-688 PubMed.
  • Wright I M & Smith M R W (2009) A lateral approach to the repair of propagating fractures of the medial condyle of the third metacarpal and metatarsal bone in 18 racehorses. Vet Surg 38 (6), 689-695 PubMed.
  • Lloyd D, Johanson C & Phillips T J (2008) Treatment of medial condylar fractures of the third metatarsus in three horses with fibreglass casts under standing neuroleptanalgesia. Vet Rec 162 (18), 586-589 PubMed.
  • James F M & Richardson D W (2006) Minimally invasive plate fixation of lower limb injury in horses: 32 cases (1999-2003). Equine Vet J 38 (5), 246-251 PubMed.
  • Perez-Olmos J F, Schofield W L, McGovern F, Dillon H & Sadlier M (2006) Standing surgical treatment of spiral longitudinal metacarpal and metatarsal condylar fractures in 4 horses. Equine Vet Educ 18 (6), 309-313 VetMedResource.
  • Russell T M  & Maclean A A (2006) Standing surgical repair of propagating metacarpal and metatarsal condylar fractures in racehorses. Equine Vet J 38 (5), 423-427 PubMed.
  • Smith L C, Greet T R & Bathe A P (2006) A lateral approach for screw repair in lag fashion of spiral third metacarpal and metatarsal medial condylar fractures in horses. Equine Vet J 38 (3), 246-251 PubMed.
  • Zekas L J, Bramlage L R, Embertson R M & Hance S R (1999) Results of treatment of 145 fractures of the third metacarpal/metatarsal condyles in 135 horses (1986-1994). Equine Vet J 31 (4), 309-313 PubMed.
  • Bassage L H et al (1998) Longitudinal fractures of the condyles of the third metacarpal and metatarsal bones in racehorses - 224 cases (1986-1995). JAVMA 212 (11), 1757-1764 PubMed.
  • Richardson D W et al (1984) Medial condylar fractures of the third metatarsal bone in horses. JAVMA 185 (7), 761-765 PubMed.
  • Rick M C et al (1983) Condylar fractures of the third metacarpal bone and third metatarsal bone in 75 horses - radiographic features, treatments, and outcome. JAVMA 183 (3), 287-296 PubMed.

Other sources of information

  • Richardson D W (1999)The Metacarpal and Metatarsal Bones.In:Equine Surgery.Eds: Auer J A & Stick J A. W B Saunders, Philadelphia. pp 810-815.


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