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Objective—To evaluate the outcome of horses with large fragments of the extensor process of the distal phalanx that were removed by use of arthrotomy. Design—Retrospective study. Animals—14 horses with large fragments of the extensor process of the distal phalanx. Procedure—Medical records for horses with large fragments of the extensor process that were removed by use of arthrotomy were reviewed. Data retrieved from medical records included signalment, use of horse, affected limb, lameness history, lameness examination findings, radiographic findings, surgical technique, and outcome. Follow-up evaluation was obtained by telephone interview. Results—Most affected horses were < 5 years old and had a history of chronic lameness. Lameness grade ranged from 1/5 to 4/5. Fragments involved 20 to 45% of the dorsopalmar articular surface of the distal phalanx. Eight of 14 horses had a successful outcome. Outcome was not associated with age, duration or severity of lameness, or fragment size. Conclusions and Clinical Relevance—Despite involvement of a large portion of the articular surface and use of arthrotomy, joint instability and permanent soft tissue injury was not a problem in most horses. Outcome may be improved by selection of horses with lameness of < 2 years' duration and careful management after surgery. A fair prognosis may be anticipated for removal of large fragments of the extensor process via arthrotomy. (J Am Vet Med Assoc 2000; 217:1351–1355)

Objective—To determine the clinical applications, short and long-term survival, and complications of using transfixation pin casts for treatment of comminuted phalangeal fractures in adult horses. Design—Retrospective case series. Animals—20 horses. Procedures—Medical records were reviewed to obtain information regarding signalment, fracture location, treatment methods, complications, and short-term survival (discharge from hospital). Long-term follow-up information was obtained via contact with owners or trainers. Results—12 fractures were in a hind limb, and 8 were in a forelimb. Fourteen fractures occurred in a middle phalanx, and 6 occurred in a proximal phalanx. Eleven fractures were treated with internal fixation combined with transfixation pin casts, and 9 fractures were treated with transfixation pin casts alone. Transfixation pin casts were maintained for a mean of 52 days (median, 49 days; range, 1 to 131 days). Fourteen (70%) horses were discharged from the hospital, whereas 6 (30%) were euthanized during the treatment period. Reasons for euthanasia included secondary fracture of the third metacarpal or metatarsal bone, avascularity of the distal aspect of the limb associated with an open fracture, and displacement of the fracture after transfixation pin cast removal. A significantly greater number of horses was discharged from the hospital when the transfixation pin cast was maintained for > 40 days, compared with those in which the transfixation pin cast was maintained for < 40 days. Conclusions and Clinical Relevance—Results suggested that horses should be maintained in a transfixation pin cast for a minimum of 40 days, as this was associated with an increase in short-term survival without an increased risk of catastrophic failure.