Fig. 5. A, A moderately comminuted fracture of the proximal phalanx involving both joints. B, Intra-operative arthroscopic image at the time of repair showing extensive cartilage loss consequent to the fracture. Even perfect repair will not result in a sound horse in many of these cases. C, E, Representative transverse, sagittal and dorsal plane CT slices and reconstructions of the fracture with sterile skin staple markers. D, Post-operative radiographs showing reduction of the visible fracture planes. F, Post cast-removal radiographs a few weeks post-op. G, Intra-operative CT verifies accurate screw position and checks for any complications. H, Six-month follow-up radiographs. Moderate arthritis but mare is very comfortable.
horse. In my opinion, the best current surgical technique is the combined use of interfragmentary and transarticular lag screws with two dorsally po- sitioned locking plates. This is an example of a surgery that can be done successfully without CT but is made much easier with the 3-dimensional imaging (Fig. 6). This is also an excellent example of a fracture that superficially appears to be almost irreparable but in fact, we should be able to tell an owner that they could expect more than 90% of
treated horses to heal and be comfortable. A much smaller proportion will be athletically sound.
Superior Implants
The use of bone plates for repair of major fractures and arthrodeses in horses have been accepted as the strongest and most versatile general technique available for many decades now. A major advance in bone plate design and application, the locking plate, made over 15 years ago has allowed equine
