All the attachments to the splint bone are transected including the intermetacarpal/-tarsal ligament, the metacarpal/-tarsal fascia and the collateral ligaments of the carpus/tarsus.
2. Complete removal of the splint bone
The complete splint bone including all fragments are removed. With the removal of the head of the splint bone a part of the articular surface of the carpometacarpal/tarsometatarsal joint is removed. The removal of the attachment of the collateral ligament as well as the removal of a part of the carpometacarpal/tarsometatarsal joint raises the risk of joint instability.
Radiograph of a luxation of the tarsometatarsal joint that developed during recovery from anesthesia after complete splint bone removal.
3. Alternative: Segmental ostectomy
In some cases, a segmental ostectomy can be performed in horses with complicated fractures composed of multiple small fragments. If the distal fragment is not firmly attached to the third metacarpal/metatarsal bone, it should rather be removed, as it can irritate the suspensory ligament.
Clinical example before (left) and after (right) the segmental ostectomy.
The remaining proximal stump may dislocate, which can result in significant lameness and, eventually, degenerative joint disease.
To avoid dislocation of the proximal stump, the fixation of the proximal remaining splint bone to the third metacarpal/-tarsal bone with a plate is necessary.
A bandage is applied and changed every 3 days for wound evaluation and wound care for two weeks. Antibiotics are administered dependent upon the degree of infection. The sutures are removed after 10 days.
The horse is kept in a stall for 4 weeks followed by hand-walking exercises for another 4 weeks before the horse can go back to its intended work.
Follow-up x-rays are taken 8 weeks after surgery to evaluate fracture healing resp. the remodeling process.
Possible complications Splint bone fractures can be further complicated by the development of osteitis, osteomyelitis and/or bone sequestra.