The Surgical Repair of a Salter-Harris Type-2 Physeal Fracture of the Proximal Phalanx in a Foal.

A 6-month-old thoroughbred colt foal was referred to a private equine referral hospital for evaluation of an acute onset, left hind limb lameness. On arrival the foal was 4/5 lame on the left hind at walk and there was diffuse swelling of the left hind pastern and fetlock region. The physical exam was otherwise unremarkable. Digital radiographs of the left hind pastern identified a Salter-Harris type-2 physeal fracture of the proximal phalanx. The fracture was initially treated conservatively using a cast, but the immobilization was not sufficient at achieving adequate reduction. As a result, the fracture was stabilized surgically using a construct consisting of a cortical lag screw, four locking head screws and a locking T-plate. The foal recovered uneventfully and was sound and in race training at a 2 year follow up. This case report highlights that surgical repair via internal fixation is preferable to conservative management of proximal physeal fractures of the first phalanx.