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Fractures of the Small Metacarpal (Splint) Bones in Horses

By Matthew T. Brokken, DVM, The Ohio State University ; James K. Belknap, DVM, PhD, DACVS, Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Ohio State University ; Tracy A. Turner, DVM, MS, Anoka Equine Veterinary Services ; Jane C. Boswell, MA, VetMB, CertVA, CertES (Orth), DECVS, MRCVS, The Liphook Equine Hospital ; Peter Clegg, MA, Vet MB, DipECVS, PhD, MRCVS, Veterinary Teaching Hospital, School of Veterinary Sciences, University of Liverpool ; Marcus J. Head, BVetMed, Rossdales Equine Hospital and Diagnostic Centre ; James Schumacher, DVM, MS, Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee ; John Schumacher, DVM, MS, Department of Clinical Sciences, College of Veterinary Medicine, Auburn University ; Chris Whitton, BVSc, FANZCVS, PhD, Equine Centre, University of Melbourne

Fractures of the second and fourth metacarpal (splint) bones are not uncommon. The cause may be from direct trauma, such as interference by the contralateral leg or a kick, but often accompany or follow suspensory desmitis and the resulting fibrous tissue buildup and encapsulation of the distal, free end of the bone. The usual site of these fractures is through the distal end, ~2 in. (5 cm) from the tip. Immediately after the fracture occurs, acute inflammation is present, usually involving the suspensory ligament. Lameness is typically noted (may be severe initially), which may recede after several days rest and recur only after work.

Diagnosis is confirmed by radiography. Ultrasound examination of the suspensory ligament may also be beneficial to determine a more accurate prognosis as well as guide a rehabilitation program. Surgical removal of the fractured tip and callus is the treatment of choice. Fractures involving the proximal one-third of the bone may require surgical stabilization of the bone to prevent carpal instability, particularly if the fracture involves the second metacarpal bone. Prognosis is based on severity of the associated suspensory desmitis, which has a greater bearing on future performance than the splint fracture itself.