Conservative versus surgical treatment of 21 sports horses with osseous trauma in the proximal phalangeal sagittal groove diagnosed by low‐field MRI

OBJECTIVE: To compare the outcome following conservative vs surgical management of sports horses with a diagnosis of subchondral bone trauma of the proximal aspect of the proximal phalanx (PP) by low‐field MRI. STUDY DESIGN: Retrospective case series. ANIMALS: Twenty‐one mature sports horses with evidence of high water signal within the proximal sagittal groove of the PP according to low‐field MRI of the fetlock, with no definitive radiographic evidence of fracture. METHODS: Medical records (2010‐2017) of horses admitted to 2 referral hospitals were reviewed. Historical, clinical, radiographic, and MRI findings and treatment choice were recorded. Conservative management consisted of confinement to a stall followed by gradual reintroduction to exercise. Surgical management consisted of cortical screw fixation across the proximal aspect of the PP. Long‐term outcome was determined by telephone questionnaire or by clinical records review. Fisher's exact test was used to compare outcome between the 2 treatment groups. RESULTS: Follow‐up was available in 17 of 21 horses in the study, including 8 horses treated conservatively and 9 treated surgically. No difference in outcome was detected in this study; 4 of 8 horses were sound after conservative management, and 5 of 9 horses were sound after surgery (P > .99). CONCLUSION: Approximately half of the horses that had a diagnosis of osseous trauma within the proximal aspect of PP returned to athletic activity, regardless of conservative or surgical management. CLINICAL SIGNIFICANCE: The prognosis for return to athletic functions in horses with osseous trauma within the proximal aspect of the PP is guarded.