An article was published in the Equine Veterinary Journal in September 2019 that was titled, "Non-surgical and surgical management of metacarpo/metatarsophalangeal joint dorsal chip fracture in the Thoroughbred racehorse." The article was authored by Ramzan, P.H.L. and Wylie, C.E. of Rossdales veterinary practice in the United Kingdom.
Arthroscopy is considered the treatment of choice for dorsal osteochondral chip fractures of the metacarpo/metatarsophalangeal (MCP/MTP) joints in the racehorse. This retrospective study compared the surgical (SX) and non-surgical (non-SX) management of MCP/MTP joint dorsal chip fractures in racing Thoroughbreds.
Medical records from 2006 to 2014 were reviewed to identify Thoroughbred racehorses that were diagnosed with a MCP/MTP dorsal osteochondral chip fractures by radiography. In total, 98 horses met the inclusion criteria (70 non-SX, 28 SX), with chip fractures predominantly involving the forelimbs (n = 92, 93.9%) and considered to be clinically active in 86.7% of cases (n = 85).
Overall, 70 horses were managed non-surgically (71.4%) and 28 underwent surgery (28.6%). Significantly more SX horses had a reported ongoing problem associated with the affected joint than non-SX horses; however, there was no significant difference between non-SX and SX horses with respect to the number of intra-articular medications of affected joint per month of follow-up.
The proportion of horses racing post-diagnosis was not significantly different between the two groups (78.6% non-SX vs 85.7% SX). The median time to first start following diagnosis for non-SX (106 days) was significantly shorter than for SX (203 days).
Bottom line: Non-surgical management might be a valid treatment option for some cases of metacarpo/metatarsophalangeal joint dorsal chip fracture.
You can read or purchase access to this article at Wiley Online Library.