Treatment of subchondral lucencies in the medial proximal radius with a bone screw in 8 horses

OBJECTIVE: To describe the results of screw placement through subchondral lucencies (SCL) of the proximal radius in 8 horses.

STUDY DESIGN: Retrospective clinical study.

ANIMALS: Horses with cubital SCL causing lameness (n=8).

METHODS: Medical record review and clinical follow-up.

RESULTS: Eight horses with SCL in the proximal radius causing lameness were treated with a screw placed across the lucency. The horses range in age from 1 to 20 years. In 4 of 8 horses, the lameness had been intermittently severe (apparent at the walk). Lameness was isolated to the cubital joint by intra-articular anesthesia in 5 horses and diagnosed radiographically in all 8. All horses had a 4.5 mm cortical bone screw placed from medial to lateral (6 lag, 2 neutral) across the SCL using fluoroscopic or radiographic control. Postoperative care included stall confinement with hand walking for 30-60 days, followed by an additional 30-60 days of pasture turnout. Radiographic SCL healing (reduction in SCL size) was demonstrated at 3-4 months after surgery in all horses, and 7/8 horses (87.5%) were used as intended (4 performance, 3 pasture turn-out) within 6 months. Lameness in the remaining horse improved initially (dressage) but returned.

CONCLUSIONS: A screw placed through the SCL of the proximal-medial radius was effective in reducing or resolving lameness associated with the elbow joint in 7/8 horses (88%). Screw placement in the proximal radius should be considered for horses with lameness caused by an SCL when a quick return to exercise is desired or conservative therapy is ineffective.