Outcome following repair of 63 sagittal fractures of the proximal phalanx in UK Thoroughbreds using either a triangular or linear screw configuration

Background: A triangular screw configuration has been suggested as preferable for repair of sagittal fractures of the proximal phalanx.

Objective: To assess the outcome of a triangular screw construct for repair of incomplete and complete minimally displaced proximal phalanx fractures under standing sedation in a population of Thoroughbred racehorses, compared with a cohort repaired using a linear screw configuration.

Study design: Retrospective cohort study.

Methods: Medical records and radiographs were accessed to garner clinical data. Date of return to racing was determined from www.racingpost.com. Survival data were compared using log-rank test.

Results: Sixty-two horses with one horse having two separate fractures. Fifty-four fractures were repaired using triangular screw configuration, 10 with a linear screw configuration. 81% (43/53) of horses with triangular repair returned to racing at a median of 289 days (161-482 days), 70% (7/10) horses with linear screws returned to racing at a median of 351 days (230-815 days).

Main limitations: A limited number of horses underwent conventional (linear) screw placement.

Conclusion: A triangular screw configuration placed in the standing sedated horse is an effective way to repair incomplete and complete minimally displaced proximal phalanx fractures. The rate of return to racing was excellent with a low rate of complications.