title: Surgical repair of rib fractures in 14 neonatal foals: case selection, surgical technique and results.
abstract: BACKGROUND
  Fractured ribs are encountered quite frequently in newborn Thoroughbred foals, often with fatal outcome. Surgical repair of fractures therefore requires consideration as a means of reducing mortality.
  
  
  OBJECTIVE
  To evaluate the repair of rib fractures using internal fixation techniques in foals at 2 different equine hospitals following similar diagnostics and case selection.
  
  
  METHODS
  The records of 14 foals that underwent internal fixation of fracture ribs were reviewed. Subject details, clinical presentation, diagnosis, surgical technique, post operative care and complications were recorded. Follow-up information was obtained in 7 foals.
  
  
  RESULTS
  The fractured ribs were reduced and stabilised using reconstruction plate(s), self-tapping cortical screws and cerclage wire in 12 cases, Steinmann pins and cerclage wires in 1 case and both techniques in 1 case. Not every rib was reduced on each case. Surgical reduction was performed on an average of 2 ribs, range 1-3 ribs in each foal. At the time of writing, 4 foals had been sold, one age 2 years was in training and 2 others died from unrelated causes.
  
  
  CONCLUSIONS
  Our data support the use of surgical stabilisation utilising reconstruction plates, self-tapping cortical screws and cerclage wire for selected cases of thoracic trauma in neonatal foals. The use of Steinmann pins may be suboptimal due to cyclic failure, implant migration and the potential for iatrogenic internal thoracic trauma.
  
  
  CONCLUSIONS
  Foals with existing extensive internal thoracic trauma resulting from rib fracture(s), or the potential for such trauma, previously considered to have a guarded to poor prognosis for survival, may be successfully managed with internal fixation of selected fracture sites.
authors.affiliation: Tufts University, School of Veterinary Medicine, North Grafton, Massachusetts 01536-1895, USA.
authors.forename: F
authors.initials: F
authors.lastname: Bellezzo
authors.forename: R J
authors.initials: RJ
authors.lastname: Hunt
authors.forename: R
authors.initials: R
authors.lastname: Provost
authors.forename: F T
authors.initials: FT
authors.lastname: Bain
authors.forename: C
authors.initials: C
authors.lastname: Kirker-Head
mesh_terms: D000818:Animals; D000831:Animals, Newborn / Q000293:injuries*; D001860:Bone Plates / Q000662:veterinary; D001863:Bone Screws / Q000662:veterinary; D001864:Bone Wires / Q000662:veterinary; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods / Q000662:veterinary*; D006736:Horses / Q000293:injuries*; D008297:Male; D011182:Postoperative Care / Q000662:veterinary; D011183:Postoperative Complications / Q000662:veterinary; D012189:Retrospective Studies; D012253:Rib Fractures / Q000401:mortality / Q000601:surgery / Q000662:veterinary*; D013898:Thoracic Injuries / Q000401:mortality / Q000517:prevention & control / Q000601:surgery / Q000662:veterinary; D016896:Treatment Outcome