EQUINE VETERINARY EDUCATION / AE / july 2022


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TABLE 1: Case details from the 16 equid cases of elbow luxation found within the literature Author, year


1 Rubio-Martinez, et al., 2008


2 Hu, et al., 2007 3 Fridel, et al., 2022 4 Jalim, et al., 2009 5 Jones, 1995 Age Fracture 1 month None 2.5 months None 3 months None


Collateral ligament rupture


Biaxial Lateral Biaxial Treatment 1. Closed reduction: re-luxated


2. Surgical biaxial stabilisation (screws/ wires)


Closed reduction and lateral stabilisation (screws/Securos suture)


Closed reduction and biaxial stabilisation (bone anchors and FiberTape)


4 months Monteggia No comment Closed reduction and ulna repair 8 months None 6 Crawley & Grant, 1986 8 months None 7 Arnbjerg, 1969 8 Trostle, et al., 2001 Medial Biaxial Closed reduction


Open reduction and biaxial stabilisation (screws and wires)


1.7 years Monteggia No comment Closed reduction and ulna repair 2.25 years Monteggia None Open reduction and ulna repair 9 Levine & Meagher, 1980 3 years Monteggia No comment Reduction and ulna repair 10 Collar, et al., 2021 11 Fridel, et al., 2022 1 Daradka, et al., 2020 9 years None 11 years None


7 months Monteggia + humerus


2 Bottegaro, et al., 2017 10 months None 3 Nixon, 2019


4 Senior, et al., 2002 5 Janicek, 2005


Medial Medial Lateral Biaxial Medial Closed reduction


Closed reduction and medial stabilisation (bone anchors and FiberTape)


N/A N/A


>1.5 years Monteggia No comment N/A 4 years None


N/A 14 years Monteggia No comment N/A Cases are arranged in order of ascending age, with the cases that received treatment listed first.


et al., 2022; Hu et al., 2007; Jones, 1995; Rubio-Martinez et al., 2008; Senior et al., 2002). One of the Monteggia fracture cases also suffered a fracture of the humerus in addition to the ulna (Daradka et al., 2020). Of the luxation cases without fracture, 6 of the 9 (67%) were <12 months of age (Bottegaro et al., 2017; Crawley & Grant, 1986; Fridel et al., 2022; Hu et al., 2007; Jones, 1995; Rubio-Martinez et al., 2008). Collateral ligament rupture was reported in the medial collateral ligament only in 4 cases (one 8 month old and three cases aged 4–11 years) (Collar et al., 2021; Fridel et al., 2022; Jones, 1995; Senior et al., 2002), both medial and lateral collateral ligaments in 4 cases (all animals aged 1–10 months) (Bottegaro et al., 2017; Crawley & Grant, 1986; Fridel et al., 2022; Rubio-Martinez et al., 2008), and the lateral collateral ligament in 2 cases (Daradka et al., 2020; Hu et al., 2007). Collateral ligament rupture was either not found (Trostle et al., 2001) or not described (Arnbjerg, 1969; Jalim et al., 2009; Janicek, 2005; Levine & Meagher, 1980; Nixon, 2019) in 6 of the cases. Five of the 16 cases were euthanised with no attempt at treatment (Bottegaro et al., 2017; Daradka et al., 2020; Janicek, 2005; Nixon, 2019; Senior et al., 2002). One additional case had biaxial collateral ligament surgical repair and was euthanised after infection of the implants occurred (Rubio- Martinez et al., 2008). The remaining 10 cases (91% of cases where treatment was attempted) had successful outcomes (2 cases closed reduction only, 4 cases with ulna fracture repair and luxation reduction, 4 cases with reduction and surgical collateral ligament repair). Lameness evaluations were


limitedly described, but 8 of the 10 equids (80%) were found to be sound at the trot post-operatively (follow up range 10 weeks–19 months) (Arnbjerg, 1969; Collar et al., 2021; Crawley & Grant, 1986; Fridel et al., 2022; Jones, 1995; Levine & Meagher, 1980; Trostle et al., 2001). One horse was described as being sound at a walk and free of osteoarthritis based on radiographs (no comment on evaluation at a trot) (Hu et al., 2007). Another horse was found to be “pasture” sound with radiographic evidence of osteoarthritis (Jalim et al., 2009). Of the 4 horses with Monteggia fractures that received surgical repair, all horses survived and were sound (n = 3) (Arnbjerg, 1969; Levine & Meagher, 1980; Trostle et al., 2001) or pasture sound (n = 1) (Jalim et al., 2009) post-operatively. Only repair of the fractured ulna was performed in all 4 cases, with no stabilisation of the collateral ligaments. Of the 16 luxation cases (including cases with and without fracture), 7 had reduction of the luxation performed with no surgical collateral ligament stabilisation. Of these 7 equids, re-luxation occurred in only one (14%) case (Rubio-Martinez et al., 2008). Collateral ligament repair was performed in 5 cases (including the case that re- luxated) (Crawley & Grant, 1986; Fridel et al., 2022; Hu et al., 2007; Rubio-Martinez et al., 2008). One foal was euthanised due to implant-related infection (Rubio-Martinez et al., 2008). Of the 4 remaining cases, 2 cases had implants break (screws and wires) (Crawley & Grant, 1986; Hu et al., 2007), and 2 had implants that were not re-evaluated through imaging (Fridel et al., 2022). All 4 cases had successful outcomes despite implant breakage.


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Outcome (Post- Op Re-check)


Euthanised (Implant infection)


Sound at walk (7 months)


Sound (10 months)


Pasture sound (10 months)


Sound (19 months)


Sound (14 months)


Sound (>6 months)


Sound (6 months)


Sound (3 months)


Sound (8 months)


Sound (7 months)


Euthanised


Euthanised Euthanised Euthanised Euthanised


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