EQUINE VETERINARY EDUCATION / AE / SEPTEMBER 2017


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a)


c)


b)


d)


Fig 4: Post mortem dissections of complete fractures of the lateral condyle of the third metacarpal bone in two horses after removal of the extensor tendons and dorsal joint capsules demonstrating the joints in extension (a and c) and flexion (b and d) in a left (a and b) and a right (c and d) forelimb. Fractures are reduced in extension while flexion results in abaxial and rotational displacement.


extends from the bearing surface to the proximal metacarpus. Complete fractures should be considered potentially unstable (whether or not this is clinically evident) and mediolateral distracting forces resisted by application of medial and lateral splints to a Robert Jones bandage, use of


a compression boot, bandage cast or cast. All should be fitted with the metacarpophalangeal joint in an extended position with flat foot ground contact. Although afflicted animals usually will resist limb loading at this time, with judicious sedation and analgesia, the limb generally can be placed in a suitable position, if necessary in a slightly protracted location, i.e. in advance of the loaded contralateral limb. Firm but gentle hand pressure from an assistant onto the dorsal carpus and/or cranial antebrachium at this time will commonly steady the limb even if some degree of lifting and placing activity has continued (Fig 5). All fractures of the medial condyle of the third


metacarpal bone and any lateral fractures in which there are clinical and/or radiological concerns regarding the potential for proximal propagation of the fracture into the metacarpal diaphysis require circumferential temporary immobilisation and/or medial and lateral splints to the level of the distal row of carpal bones (Fig 6). Fractures of the metacarpal condyles also may be


involved in complex racing and training injuries. In a USA study of Thoroughbreds in 1991, multiple sites of injury were recorded in 27% (22/83) of fatal musculoskeletal injuries sustained in racing and 29% (23/79) while in training (Estberg


Fig 5: Position the majority of horses with distal forelimb fractures will tolerate for application of temporary immobilisation/support.


© 2016 EVJ Ltd


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