## Overview Capital physeal fracture is a break through the growth plate of the femoral head in foals. It produces acute, severe hind-limb lameness. Because the physis is still open, the fracture occurs almost exclusively in horses under one year of age. Displacement of the femoral head compromises blood supply and joint congruity. ## Causes Trauma from falls, struggles, or kicks is the usual cause. The open physis is a weak point in the immature skeleton. ## Diagnosis Acute non-weight-bearing or severe lameness in a foal, pain on hip manipulation, and sometimes crepitus are suggestive. Radiographs confirm the physeal fracture and degree of displacement. ## Treatment Surgical reduction and internal fixation with pins or a screw-and-plate construct have been attempted. Success rates are low; many foals are euthanized because of poor prognosis, implant failure, or contralateral limb complications. Conservative management is rarely successful. ## Recovery and Prognosis Prognosis is poor. The majority of reported cases have been euthanized. Occasional foals have become pasture sound after successful fixation. ## Prevention Minimizing traumatic incidents in foals is the only practical measure.
acute severe hindlimb lameness in a foal; pain on hip manipulation; possible crepitus; non-weight-bearing stance
## Overview Capital physeal fracture is a break through the growth plate of the femoral head in foals. It produces acute, severe hind-limb lameness. Because the physis is still open, the fracture occurs almost exclusively in horses under one year of age. Displacement of the femoral head compromises blood supply and joint congruity. ## Causes Trauma from falls, struggles, or kicks is the usual cause. The open physis is a weak point in the immature skeleton. ## Diagnosis Acute non-weight-bearing or severe lameness in a foal, pain on hip manipulation, and sometimes crepitus are suggestive. Radiographs confirm the physeal fracture and degree of displacement. ## Treatment Surgical reduction and internal fixation with pins or a screw-and-plate construct have been attempted. Success rates are low; many foals are euthanized because of poor prognosis, implant failure, or contralateral limb complications. Conservative management is rarely successful. ## Recovery and Prognosis Prognosis is poor. The majority of reported cases have been euthanized. Occasional foals have become pasture sound after successful fixation. ## Prevention Minimizing traumatic incidents in foals is the only practical measure.
acute severe hindlimb lameness in a foal; pain on hip manipulation; possible crepitus; non-weight-bearing stance