Dorsoplantar radiograph of a horse, demonstrating a chronic fracture (arrow) of the lateral malleolus of the tibia.
Courtesy of Dr. Hilary Rice.
Fracture of the distal tibia in horses most commonly involves the medial malleolus and is the result of trauma, such as a kick from another horse causing avulsion of the medial malleolus from the tibia. Larger fragments can be repaired with cortical screws in lag fashion or with plate fixation. Small fragments (1–2 cm) can be removed arthroscopically.
Fractures of the lateral malleolus also occur (see ) and often involve damage to the short collateral ligament of the tarsus. These fragments are usually removed arthroscopically, which can be technically challenging because of the large number of soft tissue attachments on the lateral malleolus; arthrotomy is often required for complete removal of the fragment.
The prognosis for athletic function in cases of distal tibial fractures is good with early removal of fragments or fracture fixation.
