Evaluation of transfixation casting for treatment of third metacarpal, third metatarsal, and phalangeal fractures in horses: 37 cases (1994-2004).
OBJECTIVE
To evaluate clinical findings, complications, and outcome of horses and foals with third metacarpal, third metatarsal, or phalangeal fractures that were treated with transfixation casting.


METHODS
Retrospective case series. Animals-29 adult horses and 8 foals with fractures of the third metacarpal or metatarsal bone or the proximal or middle phalanx.


METHODS
Medical records were reviewed, and follow-up information was obtained. Data were analyzed by use of logistic regression models for survival, fracture healing, return to intended use, pin loosening, pin hole lysis, and complications associated with pins.


RESULTS
In 27 of 35 (77%) horses, the fracture healed and the horse survived, including 10 of 15 third metacarpal or metatarsal bone fractures, 11 of 12 proximal phalanx fractures, and 6 of 8 middle phalanx fractures. Four adult horses sustained a fracture through a pin hole. One horse sustained a pathologic unicortical fracture secondary to a pin hole infec-tion. Increasing body weight, fracture involving 2 joints, nondiaphyseal fracture location, and increasing duration until radiographic union were associated with horses not returning to their intended use. After adjusting for body weight, pin loosening was associated with di-aphyseal pin location, pin hole lysis was associated with number of days with a transfixation cast, and pin complications were associated with hand insertion of pins.


CONCLUSIONS
Results indicated that transfixation casting can be successful in managing fractures distal to the carpus or tarsus in horses. This technique is most suitable for comminuted fractures of the proximal phalanx but can be used for third metacarpal, third metatarsal, or middle phalanx fractures, with or without internal fixation.
Lescun
Timothy B
TB
Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Purdue University, West Lafayette, IN 47907-1248, USA.
McClure
Scott R
SR
Ward
Michael P
MP
Downs
Christopher
C
Wilson
David A
DA
Adams
Stephen B
SB
Hawkins
Jan F
JF
Reinertson
Eric L
EL
D000818:Animals; D002370:Casts, Surgical / Q000662:veterinary*; D005260:Female; D005593:Fracture Fixation, Internal / Q000662:veterinary; D017102:Fracture Healing; D018460:Fractures, Comminuted / Q000601:surgery / Q000662:veterinary; D006736:Horses / Q000293:injuries* / Q000601:surgery; D016015:Logistic Models; D008297:Male; D050279:Metacarpal Bones / Q000293:injuries / Q000601:surgery*; D008682:Metatarsal Bones / Q000293:injuries / Q000601:surgery*; D012189:Retrospective Studies; D015996:Survival Rate; D050277:Toe Phalanges / Q000293:injuries / Q000601:surgery; D014034:Toes / Q000293:injuries* / Q000601:surgery; D016896:Treatment Outcome