Successful treatment of an open metatarsus III fracture associated with osteomyelitis in a foal under field condition, using mostly external fixation

SUMMARY Background: The third metacarpal (McIII) and the third metatarsal (MtIII) bone fractures give one third of all long bone fractures in equine patients. There are different results between foals and adult horses, 91% and 30% were recently published, respectively. There are several complicatons that can determine the outcomeof the treatment. Objectives: This case report presents a successful treatment of a 14 days old filly with open fracture type II on MtIII bone associated with incisional infection, osteomyelitis following osteolysis, bone sequester formation under non-equine clinic conditions. To our knowledge no successful case was published with such complex complications under non-equine clinic conditions. Materials and methods: The 14days old filly was transported with external coaptation only 4 days after found on the pasture with bone fracture to a small animal clinic. Infected tissues (periosteum, subcutis and bonemark) were removed and open reduction with one screw and cerclage were made. Stability was given by fibreglass cast coaptation. In the early postoperative period the wound was flushed 4 times daily combined with new bandaging twice through a window of cast. First 2 types of antibiotic treatment was applied following each other, later Microdacin® were used locally as anti-infective agents. To improve stability 17 days after the first operation fixateur externa was applied with combination of cast. 4 weeks later it was removed and other 3 weeks later fit-tomeasure plastic orthesis was used to improve stability. The last operation was a sequestrectomy. Results and discussion: Filly recovered radiologically after 6 months and became clinically sound 8 months after the accident. During recovery the foal showed incisional infection, osteomyelitis, septicaemia and bone sequester formation. All of them were managed successfully. We think the most important factors were the elimination of infection and waiting with proper stabilisation