Monteggia type IV fractures in horses: Surgical management and long‐term outcomes of three cases

Summary Monteggia type IV fractures, defined as concurrent fractures of the ulna and radius associated with humeroradial luxation, are rare in horses and are traditionally considered to carry a poor to guarded prognosis, particularly in adult animals. This report describes the surgical management and outcomes of three equine cases, including one adult horse, one pony and one foal, presenting with Monteggia type IV fractures of the elbow. All horses underwent open reduction and internal fixation using locking compression plate constructs applied to both the ulna and the radius to restore humeroradial congruity and mediolateral joint stability. Transient postoperative radial nerve paresis was observed in all cases and resolved with conservative management. Short‐ and long‐term outcomes were satisfactory. The adult mare returned to ridden exercise with only mild radiographic signs of osteoarthritis before being bred. The foal achieved complete functional recovery and remained sound at 1‐year follow‐up. One adult pony developed late implant‐related complications 3 years postoperatively; however, satisfactory limb function had been achieved for an extended period following surgery. These cases demonstrate that, despite the complexity of these injuries, stable fixation and accurate surgical technique can result in satisfactory functional outcomes in both foals and adult horses.