Repair of a proximal metatarsal Salter type-II fracture in a foal.

Bilateral radiographically persistent proximal third metatarsal physes and concurrent cuboidal bone immaturity were identified in a foal. Repair of a Salter type-II fracture of the left proximal third metatarsal physis was accomplished by use of lag screw fixation. A 6-day-old Arabian foal, intended for use as a show horse, was referred because of severe unilateral hind limb lameness and valgus deformity. A Salter type-II fracture of the proximal portion of the third metacarpal bone was identified radiographically and repaired by use of cancellous lag screws. The fractured limb was further supported with a modified Robert Jones bandage and fiberglass tube cast. Eight weeks after surgery, the colt was sound at a trot and had minimal valgus deformity. At this time, radiography revealed healing of the fracture and implants were removed. Six months after fracture repair, the outcome was considered successful on the basis of a desirable cosmetic result and no detectable lameness at a trot. The proximal third metatarsal physis is generally not radiographically visible in the neonate. This report describes the identification and successful repair of a fracture involving this persistent physis. Other sites of skeletal immaturity were also identified, and should be considered in the evaluation and management of unusual physeal fractures.