title: A lateral approach to the repair of propagating fractures of the medial condyle of the third metacarpal and metatarsal bone in 18 racehorses.
abstract: OBJECTIVE
  To report the technique, observations on fracture configurations and results of treatment by fixation lag screw following the fracture plane determined by an approach to the third metacarpal/metatarsal bone (MC3/MT3) that begins laterally over the metacarpo(metatarso)phalangeal joint and extends dorsally over the diaphysis of the bone.
  
  
  METHODS
  Case series.
  
  
  METHODS
  Thoroughbred horses (n=18) with propagating fractures of the medial condyle of MC3/MT3.
  
  
  METHODS
  Retrospective analysis of case records of horses with fractures of the medial condyle of MC3/MT3 that propagated sagittaly or in a spiral configuration into the diaphysis, repaired surgically under general anesthesia by screw fixation in lag fashion through a lateral approach with periosteal reflection.
  
  
  RESULTS
  Fractures were readily identified at surgery, enabling screw fixation in lag fashion following the fracture plane. Fracture configurations varied and could be classified as sagittal and spiral fractures with fractures within each group generally following a similar course. All horses recovered relatively uneventfully from general anesthesia and surgery, and all fractures healed well. Thirteen horses returned to training; 5 subsequently raced.
  
  
  CONCLUSIONS
  Repair of propagating sagittal and spiral fractures of the medial condyle of MC3/MT3 with diaphyseal involvement, through a lateral approach with periosteal reflection permits stable fixation with minimal complications. In this series there were no catastrophic failures.
  
  
  CONCLUSIONS
  Fractures of the medial condyle of MC3/MT3 that propagate either sagittaly or in a spiral configuration into the diaphysis can be successfully repaired with screw fixation in lag fashion using a lateral approach with periosteal reflection.
authors.affiliation: Newmarket Equine Hospital, Newmarket, Suffolk CB8 0FG, UK. referrals@neh.uk.com
authors.forename: Ian M
authors.initials: IM
authors.lastname: Wright
authors.forename: Matthew R W
authors.initials: MR
authors.lastname: Smith
mesh_terms: D000818:Animals; D001863:Bone Screws / Q000662:veterinary; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods / Q000662:veterinary*; D050723:Fractures, Bone / Q000601:surgery / Q000662:veterinary*; D006736:Horses / Q000293:injuries* / Q000601:surgery; D008297:Male; D050279:Metacarpal Bones / Q000293:injuries* / Q000601:surgery; D008682:Metatarsal Bones / Q000293:injuries* / Q000601:surgery; D011182:Postoperative Care / Q000662:veterinary; D012189:Retrospective Studies