Diagnosis and surgical treatment of four radiographically incomplete, articular, proximal third metatarsal bone fractures

Summary The objective was to describe the diagnosis, surgical repair and outcome of four radiographically incomplete, articular, proximal third metatarsal bone fractures with an uncommon, dorsomedial–plantarolateral oblique configuration and this is a retrospective analysis of four racehorses presenting for surgical treatment of this uncommon fracture configuration to four different hospitals in Ireland, England, Scotland and France. Four horses were included, each presenting with acute hindlimb lameness following fast exercise. The cases involved a 4‐year‐old Standardbred mare used for racing, a 5‐year‐old Thoroughbred mare used for jump racing, a 7‐year‐old Thoroughbred gelding also used for jump racing and a 6‐year‐old French Trotter mare. Clinical features included marked lameness, mild swelling and pain on palpation of the proximal metatarsal region. The fracture location and configuration were consistently identified by D40‐50°M‐PlLO radiographical projections. All cases were repaired using screws placed in lag fashion but one case subsequently required double plate fixation due to fracture propagation. Three horses returned to their previous level of exercise between 7 and 8 months and successfully raced between 9‐ and 14‐month postoperatively with two horses subsequently winning. One horse was retired to stud as a broodmare. It was concluded that accurate diagnosis and surgical repair of this fracture type can result in a good outcome and return to athletic function in affected racehorses.