Radiographic technique to improve diagnosis of sagittal axial sesamoid fracture in racing Thoroughbreds with lateral condylar fracture

Abstract

SummaryThe current study identified 124 lateral condylar fractures of the distal metacarpus or metatarsus over a 6‐year period. Thirty of 124 lateral condylar fractures were classified as displaced. Eight of 30 displaced lateral condylar fractures and 1/86 incomplete lateral condylar fractures had concurrent sagittal axial fracture of the lateral proximal sesamoid bone. A 20‐degree DMPLO view is the most sensitive radiographic projection to identify sagittal axial fracture of the lateral proximal sesamoid bone. A flexed 20‐degree DMPLO projection demonstrates displacement of complete sagittal axial sesamoid fractures. Radiographic identification of axial sesamoid fracture is critical to provide the most accurate prognosis for return to racing. Arthroscopic assessment of the axial sesamoid fracture and cartilage injury on the lateral proximal sesamoid bone, as well as post‐operative progression, are described in four surgical cases.