Professor of Large Animal Surgery University of Copenhagen, Faculty of Health and Medical Sciences, Department of Veterinary Clinical Sciences Taastrup, Denmark
Splint bone fractures are common in horses, but factors affecting short- and long-term prognosis are sparsely investigated. To address the hypotheses that 1) simple midbody and distal fractures have better prognosis than comminuted and/or proximal fractures, and 2) complications occur less frequently after surgical than after conservative treatment, medical journals from 391 horses admitted over a 10-year period were investigated. Long-term outcome (8 months-10.8 years) was assessed through a questionnaire answered by 187/391 of owners. 15/391 horses (3.8%) were euthanized without attempting treatment. Short-term complications occurred in 106/376 horses (28.2%), with wound infection being the most common (27.9% of complications). Univariate analysis identified fracture placement (proximal) and characterization (open) as risk factors; in the subsequent multivariate analysis only characterization (open) was retained (1.8x higher risk of complications). 70.0% of horses returned to the same/higher level of athletic performance, with no significant differences in occurrence of poor performance or length of convalescence in conservatively and surgically treated horses. Univariate analysis identified joint involvement as a risk factor for long-term complications (the most common complication being lameness, 48.9% of complications), while no risk factors were identified in the multivariate analysis. Overall, short- and long-term prognosis of splint bone fractures is good after conservative as well as surgical management. The main risk factors for occurrence of complications were proximal location, open fracture, and joint involvement. Main study limitations were the retrospective assessment of short-term complications (missing values and misclassifications) and that long-term outcome was not assessed by a veterinarian.
