Plate fixation of small metacarpal and metatarsal bone fractures in 27 horses.

Objective: To present fracture cases selected for plate fixation (PF), describe surgical techniques and assess their association with postoperative complications and return-to-work outcomes in horses undergoing PF for small metacarpal/metatarsal (SMCT) fractures.

Study design: Multicenter retrospective study.

Animals: A total of 27 horses.

Methods: Horses treated with PF of a SMCT fracture between 2008 and 2023 across three hospitals were included. Medical records and imaging were reviewed. Long-term outcomes were established by readmission to the hospital, telephone interviews, and/or race records. Univariable and multivariable regression models evaluated variables associated with return to intended use.

Results: PF of fractures was performed in 27 horses. Fractures were all in the proximal SMCT, with 20/27 (74.1%) articular, 22/27 (96.3%) comminuted, and 24/27 (81.5%) displaced. Of horses with follow-up, 19/25 (76%) returned to prior work level. Postoperative complications occurred in 9/27 (33.33%) horses. No individual explanatory variable was significantly associated with return to use in the univariable analysis. Racehorse earnings per start were lower postoperatively compared to preoperatively (p = .02).

Conclusion: Most horses treated for SMCT fractures with PF returned to prior work level, although postoperative complications were common. None of the explanatory variables were significantly associated with return to use.

Clinical significance: PF for proximal SMCT fractures is effective, yielding high return-to-work rates and better outcomes than previously reported case series.