References
Management of splint bone fractures
Abstract
Owing to their superficial position on the lower limb, close approximation to the suspensory ligament and rather insubstantial nature, it is unsurprising that splint bone fractures are commonly encountered in practice. These fractures can be caused by either external or internal trauma, and can take a number of configurations. Treatment and prognoses differ depending on the location, configuration and age of the fracture, as well as involvement of adjacent soft tissue structures, the third metacarpal or metatarsal bone, or the carpometacarpal or tarsometatarsal joints. However, despite the frequency of splint bone fractures, there is no consensus regarding appropriate treatment. Management consists of conservative or surgical strategies, both of which have distinct advantages and disadvantages. Most reports consist of small case series and clinical experience. This review article presents current information and guidance for managing splint bone fractures.
Fractures of the second and fourth metacarpal and metatarsal bones (splint bones) are frequently seen in equine practice (Jones and Fessler, 1977; Bowman et al, 1982; Allen and White, 1987). Splint bones are vestigial structures that articulate with the distal carpus and tarsus at their proximal extent, and are tightly adhered to the third metacarpal/ metatarsal bone along their axial margin for the proximal two thirds of the bone. They have a role in stabilising and supporting the carpometacarpal and tarsometatarsal joints via numerous soft tissue attachments, including distal parts of the collateral ligaments of the carpus and tarsus, and in transferring weight from the carpus and tarsus to the third metacarpal and metatarsal bones (cannon bones) respectively, via the interosseous ligament (Peterson et al, 1987; Richardson, 1990; Doran, 1994; Kidd, 2003; Sherlock and Archer, 2008; Lescun, 2021). The most substantial articulation is that of the second metacarpal bone at the carpus, while the fourth metatarsal has the smallest articulation with the tarsus with minimal weight-bearing function (Baxter et al, 1992; Lescun, 2021).
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