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Fractures of the central tarsal bone
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Introduction:
Central tarsal bone fractures are uncommon in horses and have received little attention in the literature. Most reports focus on racehorses. Lameness in these patients is moderate to severe initially and then diminishes to mild or moderate within two weeks. Clinically, mild focal swelling and effusion of the talocrural joint can often be noted. Central tarsal bone fractures are difficult to diagnose radiographically and can sometimes be undetected on initial radiographic examination. They are mostly described as slab fractures oriented in the frontal plane at the dorsal or dorsolateral aspect that can be best identified on lateromedial or slightly oblique radiographs. However, these fractures are often more complex and may have additional fracture lines that may be missed radiographically. Lag screw fixation is the therapy of choice for fractures of the central tarsal bone.
There are hardly any reports on configuration of these fractures based on cross-sectional imaging. A better understanding of the fracture configuration may improve surgical repair and outcome.
The objectives of our study were to describe the exact configuration of central tarsal bone fractures using computed tomography (CT) and to evaluate the outcome of internal fixation based on clinical and radiographic long term follow-up.
Materials and methods:
All horses diagnosed with a central tarsal bone fracture and absence of complex tarsal injuries at the Equine Hospital of the University of Zurich between 2009 and 2013 were included in the study. All patients underwent CT examination and internal fixation. For internal fixation, one or two 3.5 or 4.5 mm cortical screws were inserted in lag fashion via stab incisions into a bicortical drill hole created under fluoroscopic control.
A long term follow-up examination was performed at least one year after surgery in all horses and included an owner questionnaire as well as a clinical and radiographic examination. [...]
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