Management of a severely comminuted fracture of the third metacarpal bone in a horse.

A 4-year-old Standardbred stallion sustained a severely comminuted fracture involving the second, third, and fourth metacarpal bones. The fracture was repaired using two 14-hole broad dynamic compression plates positioned at 90 degrees to one another, allowing one plate to protect the other in the bending mode. An autologous cancellous bone graft obtained from the tuber coxae was added at the site of the defect in the mid- to upper third of the third metacarpal bone. Complications associated with the fixation included a Staphylococcus aureus infection 5 months after surgery, laminitis that developed in the opposite forelimb 6 months after the fracture, and septic tenosynovitis in the contralateral hind limb. The septic tenosynovitis prolonged hospitalization for a total of 20 months. Both postoperative problems resolved when the stallion returned to breeding use.