For application of a medial and cranial plate, the horse is usually positioned in lateral recumbency with the affected limb down. The medial approach is the most useful for both Salter-Harris Type II and diaphyseal fractures. This provides the easiest access to the bone/fracture, but has the disadvantage that there is no muscle coverage, which would better facilitate fracture healing and to some extent limit the development of postoperative infection. Access to the proximal medial aspect of the tibia is essential for repair of Salter-Harris Type II fractures of the proximal tibia. Counteracting the tension forces on the proximal medial tibia is the primary principle in this repair.
For application of a cranial and lateral plate, usually the cranial approach is selected and the foal positioned with the fractured limb suspended vertically. Suspension of the fractured limb also facilitates fracture reduction through attenuation of tension and to some extent hemostasis.
2. Preparation for surgery
The site is prepared routinely for aseptic surgery.