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

Objective-To report clinical evaluation of third carpal bone (C3) frontal plane slab fracture repair with the Acutrak® screw system. Study Design-Prospective case series. Sample Population-Racing Thoroughbreds (n = 17) with frontal C3 slab fractures. Methods-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. Results-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). Conclusion-The Acutrak® screw system is a useful repair technique for frontal C3 slab fractures in Thoroughbred racehorses. Clinical Relevance-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.