Utrecht University, Yalelaan 114, 3584CM Utrecht, The Netherlands.
Vet J. 2012 May;192(2):176-82. doi: 10.1016/j.tvjl.2011.05.017. Epub 2011 Jun 16.
A multicentre study of 285 cases was performed to enhance the management of distal phalangeal fractures on the basis of clinical evidence. The outcome after treatment was available for 223 of the cases. Horses with a non-articular type I fracture had a better prognosis (91.7%) for return to original or expected level of use than horses with an articular type II or III fracture (69.6% and 74.1%, respectively). The prognosis for types IV and V fractures was fair (57.7% and 57.1%, respectively) and for type VI good (80%). Horses with a hindlimb fracture had a significantly greater chance of a successful outcome. No significant association between age or time to start treatment and success rate was noted. The best treatment option for types I-III fractures was a conservative approach (box rest). Type IV fractures were best treated by arthroscopic removal of the fragment. Immobilisation of the hoof did not seem to influence outcome. Radiological findings and clinical healing were not accurately correlated and the re-commencement of training should be based on clinical rather than radiological findings. Complete osseous union of the fracture was not essential for a successful return to athletic activity.
一项涉及 285 例病例的多中心研究旨在基于临床证据改善末节指骨骨折的治疗。223 例病例的治疗结果可用。非关节型 I 型骨折的预后（91.7%）好于关节型 II 或 III 型骨折（分别为 69.6%和 74.1%）。IV 型和 V 型骨折的预后一般（分别为 57.7%和 57.1%），VI 型骨折的预后良好（80%）。后肢骨折的马有更好的成功预后机会。未注意到年龄或开始治疗时间与成功率之间有显著关联。I-III 型骨折的最佳治疗选择是保守治疗（框式固定）。IV 型骨折最好通过关节镜清除碎片来治疗。蹄部固定似乎不会影响预后。放射学发现和临床愈合没有准确相关，训练的重新开始应该基于临床而不是放射学发现。骨折完全骨性愈合对于成功恢复运动活动并非必需。
