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Management of fractures and exostosis of the metacarpals and metatarsals II and IV in 25 horses.

Twenty-five cases of fractures of the second and fourth metacarpal and metatarsal (splint) bones were reviewed. Fourteen fractures involved a thoracic limb and 11 involved a pelvic limb. Fractures of the proximal one-third of splint bones are reported in one of two forms: fractures that are closed, or fractures with a permanent or intermittent draining sinus. Thirteen of the fractures presented were closed fractures and the remaining 12 were open. All of the closed fractures were managed by surgical excision of the distal fragment and the exostosis at the fracture site, followed by primary surgical wound closure. Lag screw fixation of the proximal fragment was used in three cases. All of the open fractures were managed surgically by excision of the distal splint fragment and debridement of the contaminated fracture site. Primary wound closure was used in 11 of the 12 cases. All closed fractures healed by primary intention, and 10 of 13 were free from lameness at one year follow-up. The 11 open wounds which were operated and subsequently closed under suture healed by primary intention. The wound left open healed by granulation, scar contraction, and epithelialisation. Eight of these horses were sound one year later. The remainder of the open fractures were lost to follow-up.