Equine P1 Fractures

Question 1

signalment for P1 fractures

Answer 1

racehorses that present acutely lame

75% in forelimb!!

Question 2

cause of equine P1 fractures

Answer 2

torsion with axial weight bearing -> sagittal ridge of cannon bone to jam into sagittal groove of P1

Question 3

treatment for incomplete P1 fractures in racehorses

Answer 3

lag screws are best BUT can try conservative management (cast only) IF amenable to strict stall rest

Question 4

where do P1 fractures most commonly occur?

Answer 4

75% in forelimb

Question 5

indications for arthodesis of fetlock joint (3)

Answer 5

• septic arthritis
• complete rupture of SDF, DDF, and suspensory ligament
• fractures (sesamoids, cannon bone, or P1)

Question 6

treatment for complete P1 fractures in racehorses

Answer 6

lag screws + cast

place first screw PROXIMALLY as close to fetlock articular surface as possible (within 5 mm) to ensure good alignment and decrease chances of DJD

additional screws placed about 2 cm apart

cast 4-6 weeks

Question 7

what to remember when working up a racehorse with a potential P1 fracture

Answer 7

do NOT do nerve blocks since fracture lame

Question 8

treatment for comminuted P1 fractures

Answer 8

arthrodesis

Question 9

where to place first screw when lag screwing P1 fractures in racehorses

Answer 9

proximally as close to fetlock joint as possible (within 5mm); additional screws can be placed about 2 cm apart

Question 10

lag screw steps

Answer 10

1. drill GLIDE hold in NEAR cortex
2. drill THREAD hole in far cortex using a smaller bit
3. COUNTERSINK head of screw
4. MEASURE screw length with depth gauge
5. TAP threads in far cortex
6. insert screw with screw driver

Question 11

prognosis for P1 fractures in racehorses?

Answer 11

athletic return dependent on amount of DJD

comminuted = poor prognosis