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  Discussion on Rehabbing a Slab Fracture
Author Message
Member:
lloyd

Posted on Friday, Feb 15, 2008 - 2:52 pm:

Hello all equine lovers,

I have had a recent operation performed on my 3 year old filly, standardbred racehorse. The operation was performed on the 28th of December, 2007. This operation was performed when the injury was new(within 1 week)

A group of 4 veterinarian surgeons recommended that that we use a cortical bone screw rather than just rest as it is proven more reliable in studies and in their own experiences. I was told to follow up a month after surgery with Adequan I.M. once a week for eight weeks. Please comment on the surgery and the follow up treatment with your own thoughts or suggestions.

The operation was for a slab fracture of the hock(third tarsal bone)

My question for all who care to comment is, what was your rehab time frame and did your horses make a full recovery and continue performing at a high level?

Best Regards,

Lloyd
Moderator:
DrO

Posted on Saturday, Feb 16, 2008 - 8:19 am:

Hello Lloyd,
Not having a racing practice I do not see carpal or tarsal slab fractures except as healed sport horses. Individual case treatment and prognosis will differ depending on the extent of the fractures. Here are two different looks at these fractures one is where they were fixed surgically the other treated conservatively. Unfortunately details of the decision to treat conservatively or surgically is unknown. Concerning the IM Adequan it would certainly be considered typical therapy but of uncertain benefit. For more on this see the Antiinflammatory Topic in the Medication Section.
DrO

Acta Vet Scand. 1999;40(2):173-80.
Outcome and racing performance after internal fixation of third and central tarsal bone slab fractures in horses. A review of 20 cases.

Winberg FG, Pettersson H.
Large Animal Department, Regional Animal Hospital, Helsingborg, Sweden.

Twenty horses with central and third tarsal bone slab fractures, were treated internal fixation. Eighteen of the 20 cases were Standardbred trotters, one was a Thoroughbred racehorse and one a Swedish Warmblood. The central tarsal bone (CT) was involved in 12 cases and the third tarsal bone (T3) in 8 cases. The fractures were treated by lag screw fixation with one (18 cases) or two (2 cases) 3.5 or 4.5 mm cortical screws. Horses were confined to stall rest for one month and then put on a gradually increasing exercise programme. Convalescence time was 3-8 months until the fracture had healed and training could be resumed. Fifteen of the horses regained athletic soundness. Thirteen of the horses (72%) raced after surgery (12 Standardbreds and 1 Thoroughbred). Nine (69%) of these 13 horses won races after surgery.

J Am Vet Med Assoc. 2000 Jun 15;216(12):1949-54.
Long-term outcome of horses with a slab fracture of the central or third tarsal bone treated conservatively: 25 cases (1976-1993).

Murphey ED, Schneider RK, Adams SB, Santschi EM, Stick JA, Ruggles AJ.
Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Purdue University, West Lafayette, IN 47907, USA.

OBJECTIVE: To determine clinical features of horses with a slab fracture of the central or third tarsal bone and to report outcome of horses in which treatment did not include surgery. DESIGN: Retrospective study. ANIMALS: 25 horses (14 Standardbreds, 6 Thoroughbreds, 5 Quarter Horses). PROCEDURE: Medical records of horses with a slab fracture of the central (n = 9) or third (16) tarsal bone were reviewed. Only horses for which treatment consisted of confinement to a stall were included in this study. Clinical features and radiographic findings were recorded and summarized. Outcome was determined for racing breeds by obtaining official lifetime race results. Outcome for Quarter Horses was determined by phone survey of the owners. RESULTS: 16 (64%) horses had a successful outcome. Ten of 14 (71%) Standardbreds and 2 of 6 Thoroughbreds returned to racing and started at least 5 races after injury. Four of 5 Quarter Horses for which follow-up information was available successfully returned to their previous activity. Sex, age, limb affected, or gait was not associated with final outcome. Percentage of racehorses with central tarsal bone fractures that had a successful outcome (2/7) was significantly less than percentage with third tarsal bone fractures that did (10/13). CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that enforced rest without surgical fixation can be an effective therapeutic option for horses with a slab fracture of the central or third tarsal bone, even if athletic function is expected.
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