Equis ISSN 2398-2977

MC / MT 4: removal

Introduction

• Fractures of the splint bones are common. Fractures of the MT 4 are usually due to kicks from other horses/ponies. The proximal to middle thirds are often involved with open wounds, increased contamination and comminution. Bone infection and sequestration can ensue.
• Many treatments are available for treating fractured splint bones, including box rest, compression and support bandaging, standing local debridement and lavage if there are open wounds, systemic NSAIDs and antibiotics, segmental ostectomy, plate and/or screw fixation, and complete removal of the splint bone.
• The fourth metatarsal bone has a minor articulation with the tarsus unlike MT/MC 2 and MC 4.
• Complete removal has therefore little impact on the biomechanics of the hindlimb.

Uses

• Open and/or comminuted fractures of the proximal third of the fourth metatarsal bone   MC / MT 2 and 4: fracture                .

Advantages

• Complete removal of infected bone and soft tissue decreasing contamination by bacteria and foreign material, and improving response to systemic antibiotics.
• No internal fixation implants are used, decreasing costs, infection risks and complications post-operatively.
• Minimal periosteal reaction post-operatively with better cosmetic results than with fixation or conservative treatments.
• Quicker return to soundness and exercise than with fixation or conservative treatments.

Disadvantages

• Removes small amount of biomechanical support for hock, although this does not appear to be clinically significant.
• Invasive surgery with GA risks and initially higher costs than conservative treatments.

Requirements

Preparation

Procedure

Aftercare

Outcomes

Prognosis

• Good.