Arthroscopic treatment of fractures of the lateral malleolus of the tibia: 26 cases

Authors: 
M. R. W. SMITH, I. M. WRIGHT
Volume: 
43
Number: 
3
Pages: 
280-287
Journal: 
Equine Veterinary Journal
Date: 
May 2011

Reasons for performing the study: A minimally invasive arthroscopic technique for removal of fractures of the lateral malleolus of the tibia is considered to be beneficial but data to this effect are required.

Hypothesis: Arthroscopic removal of fractures of the lateral malleolus of the tibia is technically feasible, provides a comprehensive evaluation of the tarsocrural joint and enables removal of remote comminuted fragments and disrupted short collateral ligaments. The technique is associated with low patient morbidity, requires only short periods of hospitalisation and affords a good prognosis to affected horses.

Methods: The case records of all horses that underwent arthroscopic removal of a fractured lateral malleolus of the tibia, admitted to a referral hospital, were evaluated retrospectively. Follow-up information was obtained from race records and by telephone questionnaire.

Results: Fractures were successfully removed arthroscopically in all cases following dissection from the short lateral collateral ligaments. Significant post operative complications occurred in only one horse. All other horses recovered well from surgery and of 22 horses with long-term follow-up, 18 returned to their previous use.

Conclusion: Arthroscopic removal of fractures of the lateral malleolus of the tibia is technically demanding, but can be performed with minimal complications and with low patient morbidity and short periods of hospitalisation. The majority of horses are able to successfully return to work following the procedure.

Potential relevance: The advantages of arthroscopic removal compared to removal via arthrotomy make this the technique of choice for treatment of fractures of the lateral malleolus of the tibia.