Clinical Evaluation of a Titanium, Headless Variable‐Pitched Tapered Cannulated Compression Screw for Repair of Frontal Plane Slab Fractures of the Third Carpal Bone in Thoroughbred Racehorses

Abstract

To report clinical evaluation of third carpal bone (C3) frontal plane slab fracture repair with the Acutrak screw system. Prospective case series. Racing Thoroughbreds (n=17) with frontal C3 slab fractures. C3 slab fractures in Thoroughbred racehorses (1999-2004) were repaired by use of the Acutrak screw system. Data collected were (1) preoperative variables--gender, age at injury, limb involved, injury occurrence, fracture thickness, complexity, and displacement, race starts and earnings and (2) postoperative variables were: surgical complications, days to first start, race starts, and earnings. A Wilcoxon signed-rank test was used to compare pre- and postoperative starts and earnings; significance was set at P<.05. Seventeen Thoroughbred racehorses (12 females, 3 males, 2 geldings) were enrolled. Mean (+/-SD) age at injury was 3.3+/-1.0 years. Right carpi (10) were affected more than left (7). Ten injuries occurred during training, 7 during racing. Twelve of 15 horses that raced before injury returned to racing. Average days to first start was 349.3+/-153.9 days. Horses that returned to racing had more starts after repair (median, 6.5 versus 3.5; P=.04) and did not have decreased earnings per start (median, $2452 versus $3061; P=.30). The Acutrak screw system is a useful repair technique for frontal C3 slab fractures in Thoroughbred racehorses. Adequate reduction and stability of C3 slab fractures can be achieved with the Acutrak screw system, decreasing the likelihood of fragment splitting and screw head impingement on carpal soft tissues.