|Fractures with one intact strut of bone.|
Comminuted fractures, which have an intact strut of bone extending from the fetlock to the pastern joint, are amendable to reconstruction using cortex screws in lag fashion and supported with a half-limb cast during convalescence. Repair of such fractures is aimed at pasture soundness.
Those fractures without an intact strut of bone extending from the fetlock to the pastern joint are not amendable to complete reconstruction by means of cortex screws. Surgical options for these fractures include limited reconstruction with cortex screws and support with a transfixation cast, an external skeletal fixation device, or in selected cases double-plate fixation of the proximal and middle phalanx – the latter serves as “distal fragment” – in conjunction with a pastern arthrodesis.
Cast application alone is contraindicated because of fracture collapse, lameness and contralateral laminitis.
|Basic surgical experience, no specialized skills|
|Some specialized surgical experience|
|Highly experienced and skilled surgeon|
|Basic equipment only|
|Simple surgical and imaging resources|
|Full specialized surgical and imaging resources|