Proximal segmental ostectomy under standing sedation for treatment of open comminuted axially displaced fractures of the fourth metatarsal bone in two horses

Abstract

SummaryTwo cases with open, comminuted, axially displaced fractures of the proximal third of the fourth metatarsal bone were referred to the University Equine Hospital Vienna. Due to concerns regarding the risk of injury to the suspensory ligament and risk of implant infection with an open configuration, surgical treatment with proximal ostectomy of the fractured fourth metatarsal bone was performed in both cases. Based on telephone follow‐up, Case 1 was reported to be sound with no significant reaction at the surgical site 22 months following the procedure and Case 2 exhibited intermittent lameness, radiographically evident irregular new bone formation and some residual ultrasonographic changes of the proximal suspensory ligament 17 months after the procedure. Based on the results of this report, a proximal ostectomy facilitated by standing sedation and regional anaesthesia is a valid treatment option in cases of open, axially displaced fractures of the fourth metatarsal bone, minimising perioperative complications but not excluding long‐term postoperative complications.