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Objectives:
The aim of this retrospective study was to collect information on comminuted fractures (≥ 3 major fragments) of the proximal phalanx (CFPP) from multiple centers and compare these data to the long-term outcome (>1 year). The secondary objective was to describe a modified radiographic classification that may help the clinician with treatment selection and prognosis.
Methods:
A questionnaire was sent to a selection of veterinarians who treat CFPP. Medical records and radiographs were reviewed. The level of comminution was graded as a moderately (M), severely (S), or highly (H) CFPP. A highly CFPP was defined as a fracture in the absence of a continuous cortical fragment between both joints along with concurrent extensive osseous fragmentation in the central part of the diaphysis of the proximal phalanx.
Results:
Between 2002 and 2024, 159 horses were examined. The survival rate (horses still alive) was 67% for MCFPP, 59% for SCFPP and 46% for HCFPP. When surgical treatment was undertaken, the highest survival rate was found for MCFPP treated with internal lag screw fixation (83%). Horses treated with a simple cast had a survival rate of 88% (n=7/8; 2 MCFPP, 5 SCFPP, 1HCFPP).
Sixty-eight% of the horses available for follow-up at more than one year were contacted and 9% were found to have been euthanized more than 1 year after injury. Only 4 horses (12%) had returned to riding activity.
Conclusions:
This is the most comprehensive review of CFPP to date, introducing a new fracture category with an adverse effect on survival.
34th Annual Scientific Meeting proceedings
Stream:
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Session:
Date/Time: 03-07-2025 (18:45 - 19:00) | Location:
Date/Time: 03-07-2025 (18:45 - 19:00) | Location:
Comminuted fractures of the proximal phalanx in horses: a multi-center retrospective review of 159 cases with long-term outcome (2002–2024)
De Chaisemartin C1, Farfan M2, Dal Cero B3, Rossignol F*2, Kalinovskiy A4, Lischer C*4, Tessier C*5, Grulke S*6, Manneveau G*7, Gouzer V8, Gomez G9, Samsel J10, Mespoulhes-Riviere C*11, Pichereau F12, Alfonso Gracia Calvo L*13, Trécu T14, Spadaro Rossello A1, Planes P15, Peyrecave X16, Mansuy C17, Henry-Perin C18, Guezennec A19, Schramme M*1
1Center for Equine Health, École nationale vétérinaire de Lyon, VetAgro Sup, University of Lyon, Marcy l’Etoile, France, 2Clinique équine de Grosbois, Boissy Saint Léger, France, 3Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium, 4Equine Clinic, Faculty of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany, 5Department of Surgery, Equine Clinic, ONIRIS, Nantes, France, 6Département clinique des équidés, Faculté de Médecine Vétérinaire, Liège Université, Liège, Belgium, 7Clinque équine du Moulin d’Ecalles, Buchy,, France, 823ème Groupe Vétérinaire, Régiment de cavalerie de la Garde républicaine, Paris, France, 9Servicio de Veterinaria y Remonta del Ejército, Canelones, Uruguay, 10Equine Hospital Sluzewiec, Warszawa, Poland, 11Ecole Nationale Vétérinaire d'Alfort, CHUV-Equides, Maisons‐Alfort, France, 12La Clinique du Cheval - Vet'équins Du Jat, Frejairolles, France, 13Veterinary Teaching Hospital, University of Helsinki, Helsinki, Finland, 14Clinique Vétérinaire du Panorama, Dragey-Ronthon, France, 15Cabinet Vétérinaire de Mercurey, Mercurey, France, 16Cabinet Vétérinaire du Vallon, St Paul en Jarez, France, 17Cheval d’Azur Vétérinaires, St Paul en Forêt, France, 18Clinique Vétérinaire Voltaire, Dijon, France, 19Clinique Rance Frémur, Ploüer-sur-Rance, France.
Objectives:
The aim of this retrospective study was to collect information on comminuted fractures (≥ 3 major fragments) of the proximal phalanx (CFPP) from multiple centers and compare these data to the long-term outcome (>1 year). The secondary objective was to describe a modified radiographic classification that may help the clinician with treatment selection and prognosis.
Methods:
A questionnaire was sent to a selection of veterinarians who treat CFPP. Medical records and radiographs were reviewed. The level of comminution was graded as a moderately (M), severely (S), or highly (H) CFPP. A highly CFPP was defined as a fracture in the absence of a continuous cortical fragment between both joints along with concurrent extensive osseous fragmentation in the central part of the diaphysis of the proximal phalanx.
Results:
Between 2002 and 2024, 159 horses were examined. The survival rate (horses still alive) was 67% for MCFPP, 59% for SCFPP and 46% for HCFPP. When surgical treatment was undertaken, the highest survival rate was found for MCFPP treated with internal lag screw fixation (83%). Horses treated with a simple cast had a survival rate of 88% (n=7/8; 2 MCFPP, 5 SCFPP, 1HCFPP).
Sixty-eight% of the horses available for follow-up at more than one year were contacted and 9% were found to have been euthanized more than 1 year after injury. Only 4 horses (12%) had returned to riding activity.
Conclusions:
This is the most comprehensive review of CFPP to date, introducing a new fracture category with an adverse effect on survival.
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