Page 170 - Equine Clinical Medicine, Surgery and Reproduction, 2nd Edition

Musculoskeletal system: 1.4 The forelimb 145

VetBooks.ir ligaments and other soft tissues associated with the fetlock arthrodesis will be required (Fig. 1.263).
In open contaminated cases, particularly with con-
fetlock joint (Fig. 1.261).
Management current injuries (e.g. avulsion fracture), euthanasia
may be necessary.
Closed luxations can be managed by casting for
6-8 weeks (Fig. 1.262). With open luxations, early Prognosis
aggressive lavage and debridement are required fol- The prognosis for closed fetlock subluxation is
lowed by external coaptation until any infection is favourable but with open contaminated luxation the
resolved and then casting. With ongoing instability, outcome is guarded.

METACARPALS/METATARSALS

FRACTURES OF THE THIRD through direct trauma and can be open/closed
METACARPAL/METATARSAL BONE and simple/transverse/comminuted (Fig. 1.266).
Transverse fractures of the distal third part of the
Definition/overview metacarpal bone are non-articular fractures occur-
Fractures of the third metacarpal/metatarsal bone ring through or close to the metaphysis and usually
include condylar fractures (lateral and medial), involving the palmar (or dorsal) cortices. The cause
diaphyseal, transverse, distal physeal and proximal of these fractures is unknown but is thought to be
articular fractures. due to a single overload/bending of the bone at exer-
cise. Distal diaphyseal fractures generally occur in
Aetiology/pathophysiology foals following trauma from the mare and are often
Fractures involving the third metacarpal/metatarsal
bone are a result of single acute overload injury or
external trauma (e.g. kick injury). Condylar fractures 1.264 1.265
show failure through repetitive strain cycles altering
the biomechanical properties of the bone, particularly
at or close to the parasagittal groove where the frac-
ture often originates. Lateral condylar fractures com-
monly exit through the lateral cortex 1–3 cm above
the physeal scar and can be complete/ incomplete,
displaced/non-displaced and may be associated with
additional injuries such as axial fractures of the PSB
or fragmentation at the articular surface of the dis-
tal palmar condyle (Fig. 1.264). Medial condylar
fractures also start at the articular surface but tend
to extend into the diaphysis of the bone in a spiral
or, less commonly, a Y-shaped pattern (Fig. 1.265).
Occasionally, biaxial condylar fractures may occur.
Diaphyseal fractures may be complete/incomplete

Fig. 1.264 A complete, minimally displaced lateral
condylar fracture pre internal fixation.

Fig. 1.265 A medial condylar fracture pre internal
fixation.